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Last Updated: Friday, 29 October, 2004, 10:54 GMT 11:54 UK
Can cancer care services be improved?
Patient receiving radiotherapy
Cancer services in England are disjointed and should be reformed according to a report by a group of MPs.

The All-Party Parliamentary Group on Cancer says that GPs are not referring patients needing urgent treatment quickly enough and should go on cancer education programmes.

It also calls for the control of cancer budgets to be transferred from primary care trusts to the country's 34 cancer networks.

ASK THE EXPERT
Joanne Rule, Chief Exec, Cancer BACUP answered your questions in an interactive forum

How can the UK's cancer services be improved? What is your experience of cancer treatment? Send us your comments and experiences on the post form.


This debate is now closed. Read your comments below.

The following comments reflect the balance of opinion we have received so far:

It would seem that the current leaf on the line is a lack of radiologists
Mark, Cardiff, Wales
My mother has just been diagnosed with breast cancer after 24 weeks waiting for a scan and biopsy, and two years before that of being fobbed off with ointment by a GP. Having discussed these issues with a few people who work in the NHS, it would seem that the current leaf on the line is a lack of radiologists. They are probably retraining as plumbers or estate agents to escape the dirty stressful environs of the NHS under the Thatcherist internal market, micro management, "best value" policies that are perpetuated and proliferated by New Labour.
Mark, Cardiff, Wales

The government should put more money into researching cancer treatments, instead of funding illegal wars and myriad other worthless pursuits.
Neil, Glasgow, UK

I lost my mother to cancer in August of this year. The care she received from the NHS varied in quality. Especially distressing was the fact that in her last few days she was force to wait for over 6 hours for an ambulance to move her between two London hospitals. She was forced to wait on a trolley, in quite severe pain and without drugs for most of this time. It is quite upsetting to our family that one of her last days was spent in what can only be described as agony. Of course, the ambulance service is privately owned and profits clearly come before patient care! I must say, however, that the nurses and doctors who attended to her on the ward were excellent.
Wesley Hall, Marden, Kent

My father would still be alive today if he'd received the care he was due
Anon, UK

My first wife died of cancer aged 35 in 1986. She received the best treatment possible given the severity of her type of cancer - by a wonderful team of carers in Scotland. My father died from metastasised prostate cancer in 1990 after being told for months by his English GP that his abdominal pain was indigestion! My wife could not have survived longer than she did, but my father would still be alive today if he'd received the care he was due instead of the incompetence he actually got.
Anon, UK

My Father went to his GP a number of times. The doctors put his symptoms down to stress (severe headaches, vision problems). He died suddenly and without warning after a brain tumour that caused (as it was pressing on) a main blood vessel in his brain to haemorrhage. Without doubt he should have been referred to specialist at the outset. However, so many ailments have symptoms similar to cancer. If all were referred, I'm not sure our health service could/would cope in it's current state. Huge waiting lists would become a death row for those with a genuine condition and no access to immediate care.
Dave, Glos, UK

Please, for once, when it comes to a medical story, could the media try and present a more balance picture? I'm a GP, dealing daily with an increasingly worried (but no more seriously ill) population who seem to have lost the ability to rationalise their symptoms. Every headache is a brain tumour, every bruise is leukaemia. Of course GPs consider cancer, of course we refer patients that we suspect have malignancy, but we also have to sift through a vast amount of mild self limiting illness.

We will misdiagnose from time to time, we will get it wrong. We are human. But we are doing our best to help people because it is still a vocation. It would be wonderful if the headline on tomorrow's newspapers read 'thousands treated correctly by family doctors', but seeing as it happens every day it's hardly news, is it?
Andrew Bill, Winchester, Hants

She was lucky enough to be referred to one of the leading cancer hospitals in the country
Carly Hagan, Bromley, Kent
My mum has ovarian cancer and the treatment she has received since diagnosis seven years ago has been excellent. She was lucky enough to be referred to one of the leading cancer hospitals in the country and has received the best forms of treatment that would unfortunately not be available to people in certain parts of the country. The standard needs to be kept constant regardless of your postcode.
Carly Hagan, Bromley, Kent

I was diagnosed late but got good treatment and care. Although I had to take medical retirement at 37, at least I was cured. Mount Vernon Hospital in Middlesex was excellent but the building was falling down. Great care, bad facilities.
Mark S, France

In recent weeks, both my father and father-in-law have been diagnosed with cancer. They live 250 miles apart, one in Scotland the other, England. I am pleased to say that both have been seen by hospital consultants within 2 weeks. I have no idea what funding is required, and clearly, advances are being made all the time. But, it is astonishing that we rely so heavily on charities for research.
Richard Toulson, Dumfries, Scotland

We can't expect GPs to know everything, so it's obvious that they need to refer these kinds of cases to a part of the NHS which specialises in cancer detection and treatment. Give the GPs a break, but give patients an alternative route to medical care if they aren't happy with what the GP is doing.
Mo C, Durham, UK

They have treated me with care, respect and everything in a speedy service
Iain Richardson, Manchester, UK
I was diagnosed in 18 December 2002 with Non Hodgekinsons Lymphoma. I went to the GP with what I thought was a pulled muscle / trapped nerve. The doctor advised that he could send me away with strong pain killers but he thought I should go to my local hospital for further tests/ X-ray. I had my tests/ CT scan which showed up the lymph glands, I was discharged and told I would be put over to Christies Hospital. I was seen by a consultant between Christmas and New Year to get me into the system, then further appointments and for the last 12 months I have been in remission. Unfortunately I have been called back from my last check up so it must be coming back. I have been lucky with the NHS, they have treated me with care, respect and everything in a speedy service.
Iain Richardson, Manchester, UK

Successful cancer treatment in the UK is a lottery. My late father, when I was 16, experienced countless delays and poor diagnoses. For 3 years, he was shunted around London hospitals in a vain attempt to heal his now-spreading cancer. And when they finally realised it "was" cancer, it was too late and he died in 1999. Throughout our trauma, we never got the impression that everything was being done to help him - it just seemed lottery-like.
William Luke, Maidenhead, UK

My father has just been diagnosed with prostate cancer at the age of 58. We are currently waiting to see if it has spread to his bones. He has no symptoms at all, is actually is better shape than he has ever been but the only reason we know he has cancer is because a friend of his was diagnosed and dad decided to go for a check up. Luckily, for us, it has been caught relatively early, but I know of other people who weren't that lucky. I believe that there needs to be better cancer screening services in this country for men and women. Perhaps then needless deaths could be avoided. I would like to add that the cancer nurses in this country do a fantastic job and we need far more of them as well.
Anon, UK

Doctors and nurses treat those with cancer as quickly and efficiently as they can
Michelle, Cardiff, Wales
I find it rather odd that the government is more than willing to blow its own trumpet with regards to the improvement in cancer services, but as soon as there is a problem they are fast to blame the NHS. Doctors and nurses treat those with cancer as quickly and efficiently as they can. They are held up, not by laziness or an unwillingness to help, but by low budgets and petty regulations - which the government are responsible for. People should not blame the staff, but a government that seems hell bent on destroying the NHS.
Michelle, Cardiff, Wales

My mum had cancer a few years back and I was astonished to learn how little money is put into cancer research. The Government pours millions into penalising people who step over the speed limit on the roads, and next to nothing on advancement of cancer treatments. Confused priorities?
Paul Sealey, Cannock, England

I am able to write this e-mail because my GP realised that an apparently minor problem was potentially dangerous. I had immediate treatment for a pre-cancer and did not complain when later on he sent me for an elaborate test which proved (thank goodness) to be negative. No GP in any health system in the world is perfect. A friend's French-born mother died in great pain and distress because her GP in France refused to see that she was in a moribund condition.
Deirdre, London

I was pleasantly surprised with the efficiency with which I was treated
Clare, High Peak, Derbyshire
About 4 years ago, I discovered lumps in my breast, and went to the doctors immediately. Although the doctor assured me it was nothing to worry about I received a hospital appointment through the next day for an appointment within 2 weeks, and then had several regular follow-ups. Being very cynical about the NHS, I was pleasantly surprised with the efficiency with which I was treated (turned out not to be cancer), but I think it is a postcode lottery, so why can some areas get it right and not others?
Clare, High Peak, Derbyshire

A family member was diagnosed with breast cancer last year. She was in surgery within ten days, and subsequently underwent chemotherapy and radiation therapy. She was self-diagnosed; tests did not reveal the tumour, which turned out to be around 1.3 cm at its largest dimension. She is now taking tamoxifin to help prevent a recurrence. In early treatment we were able to get second opinions from Johns Hopkins, one of the premier cancer centres in the US, covered by our HMO insurance plan. Doctors in the US are very frank about discussing diagnoses and prognoses in a relatively technical way with their patients, who are often very well informed about treatment options to start with.
Nicholas, Philadelphia, USA

There's always room for improvement
Anon, Sutton
It's without doubt that the UK's cancer services can be improved, there's always room for improvement. But as my partner was diagnosed with Non-Hodgkins Lymphoma in 2003, I will say that the standard of care that he has received personally and the support that we have received as a couple in coping with this was and is second to none. As long as the medical profession continue to make progress towards diagnosing this disease and catching it in time so treatment and drug delivery stand a fighting chance, then we all stand a chance of beating that illness should we be so unfortunate as to suffer with it.
Anon, Sutton

At the moment many types of cancer have very poor survival rates as the treatments just haven't been invented yet. The Government should increase both funding and pay for researchers. This would mean more people could be cured instead of having nicer places to die in. It should also crack down hard on the so-called animal rights campaigners who are making biomedical research so much harder in this country.
Nick Holway, Guildford, UK

I need to get an exploratory examination done. My doc said I would get a letter confirming the appointment. This arrived today, three weeks after the initial consultation. The examination isn't for another four weeks! If I could afford it, I would pay to go private, but I can't, so I'm stuck with a lengthy delay. Of course this should be improved.
Nick, UK

Eliminating the waiting time at the hospital would be the biggest improvement to the quality of her care
Cary, London
My mum is very poorly with ovarian cancer, and dreads each hospital visit. She is on a harsh chemotherapy regime which makes her feel continually sick and so weak she is barely able to stand. During a typical visit to the hospital she is kept waiting in a hard plastic chair for hours, even if she is just there for a blood test which takes 5 minutes. This leaves her exhausted, feeling much more ill than when she arrived, and since oncology departments never have a particularly cheerful air, she comes home very depressed. Eliminating the waiting time at the hospital would be the biggest improvement to the quality of her care.
Cary, London

GPs and local surgeries are becoming nothing more than rough filters to treat minor ailments. For serious illnesses they're often a hindrance, causing long delays to obtaining appropriate treatment. Most people nowadays who have even the remotest inkling of the seriousness of their illness go direct to hospitals to which they know they will be referred anyway. Restricted opening hours and reluctance to undertake home visits simply enforce the argument that money and resources should be invested in 24-hour hospitals with all the relevant skills and resources to diagnose and treat illnesses, not inaccessible local surgeries.
John M, Lyne Meads, UK

The biggest concern is the length of time it took to get an appointment with a consultant
Monica, London
Judging by my own recent experience of the NHS cancer services, I would say that overall, I received adequate care - and I am in remission as a result. But everything was disjointed and that added to the stress of having a potentially deadly disease. Having several consultants handling my treatment, having appointments for scans scheduled and rescheduled and just not getting a clear explanation, at the beginning, of what was going to happen to me made this already scary time in my life even worse. But I think the biggest concern is the length of time it took to get an appointment with a consultant after being referred by my GP. No-one going to the doctor with a lump in their neck should have to wait 5 months for tests as I did. If I had had a more aggressive form of cancer it would have cost me my life.
Monica, London

My research is funded by CRUK and each year we struggle to meet salaries and overheads. The government doesn't pay one penny towards cancer research, apparently protecting foxes is a more important use of funds.
Peter, Nottingham

The problem is that some GPs do not want to believe that it is cancer and referral means to them - a failure on their part to diagnose. Also some GPs have the attitude that they know best and the patient is wrong to ask for a referral. Until the GPs change their attitude and approach to cancer - we will always get cases where referrals were done too late and extensive treatment is required.
Roshan, UK

I do think that the cancer networks would benefit from control of their own budgets
Terry, Epsom, Surrey, England
My grandmother died of cancer in Norwich and my brother died of it in Bad Salzufalen in Germany. I can honestly say that both countries did all they could to treat them and, when it became clear that there was no hope, they dealt with the situation with care and compassion. Yes, you can always improve things like detection, treatment and convalescence. I don't see that it's always the doctors who are late referring patients, sometimes it's the patients who are late consulting their doctors - certainly true in my grandmother's case. I do think that the cancer networks would benefit from control of their own budgets and it would help them greatly with long term planning.
Terry, Epsom, Surrey, England

It really isn't fair or reasonable to blame our GPs. Many types of cancer are difficult to identify at an early stage, often producing symptoms similar to many other relatively minor ailments. Unfortunately, GPs can't refer to a consultant every patient who presents with vague aches and pains, on the off-chance that the root cause might be cancer. The fundamental problem seems to be understaffing, lack of finance, and the pernicious and secretive nature of the disease itself.
Chris B, Bedford, UK

Cancer is a terrible thing, but when my first (late) wife had it, it was only the excellent charities doing pioneering work and providing superb care that were primarily her refuge. If the NHS care of cancer patients is seen as disjointed - well whose fault is that? They need to take on more palliative care and pioneer treatments. It is only by doing so that inroads will be made that may eventually lead to the eradication of all forms of this disease.
John Fairlie, Bristol, UK

Of course cancer services can be approved. However, the cancer services that we do have at present are fantastic. Let's not forget how deadly the disease is - sometimes by the time it rears its ugly head it is too late. If people have a suspicion that they have cancer they should be dealt with immediately and GPs should ensure they do everything they can to catch it early.
Jo, Dorset




SEE ALSO:
Cancer services 'need shake-up'
27 Oct 04  |  Health


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