Professor Mike Richards answers your questions

Professor Mike Richards answers your questions on cancer

BBC News Online asked readers to send in any questions they had about cancer.

Professor Mike Richards, National Cancer Director has answered a selection of them.

Due to the volume of emails received, Professor Richards was not able to answer them all but we have tried to ensure all issues have been addressed.

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CANCER MEDICATION

I'm a cancer patient who needs drugs not available on the NHS to help prolong my life. I find it frustrating that there are drugs being used in the USA and Europe which aren't available here. I'm frightened, I don't want to die.
Dawn Hughes, Reading

I have been diagnosed with secondary inoperable renal cancer and sent home with only palliative, pain killing drugs. I can pay privately for a drug to arrest the cancer development, this will cost £5000 a month. How long will my life savings support me?
Mr Hardwick, Northampton.

My husband has renal cancer and his consultant wants to prescribe 'sutent' but Sunderland PCT will not fund it. Does Professor Richards have a solution to this?
Wendy Dillarstone, Sunderland

Professor Richards:

I am sorry to hear about the situations you all describe. I certainly understand that this is a difficult time and that you want to be sure you are having the best treatment possible.

The Government set up the National Institute for Health and Clinical Excellence (NICE) as an independent body to advise the NHS on which treatments are both clinically and cost effective and should therefore be available for all patients who might benefit.

As the NHS has a finite budget it is important that it spends its money on treatments that are sufficiently effective to justify their cost.

If your PCT has refused funding, you can appeal

If NICE has not yet looked at the drugs your doctor has mentioned, it will be for your local Primary Care Trust to consider if they will fund this treatment - they should consider the evidence available on the drug when making this decision and not the cost of the drug alone.

Lack of NICE guidance should not be a reason to turn a drug down either.

If your PCT has refused funding, you can appeal against this decision. You might also want to contact your local Patient Advice Liaison Service (PALS) for support.

CANCER RESEARCH

Over the last 30 years, cancer research has increasingly shifted its focus away from animal models, and towards clinical (human) research. The interpretation of animal data for humans is frequently hampered by species differences. To what extent are present successes in understanding and treating cancers attributable to this move away from animal models?
Dr Gill Langley, Hitchin, England

Professor Richards:

All cancer scientists would wish to avoid using animals for research purposes if at all possible.

As you say, there has been a very welcome development of new scientific approaches over the past 30 years.

Our understanding of the molecular and genetic basis of cancer has increased enormously and this is now leading to effective new treatments.

However, it is important to say that some vital research still requires the use of animals.

Quite rightly such experimentation is very closely regulated in the UK. Researchers have to demonstrate that no alternative is viable.

CANCER PREVENTION

I would like to know how much research has gone into the origin of cancer? Where does it come from?
George Saah, Monrovia, Liberia

Professor Richards:

I am pleased to say a great deal of research has been done and continues to be done to understand the origins of cancer, though of course we need to do more.

Perhaps the best known research of this type was the pioneering work of Sir Richard Doll who showed the link between smoking and cancer.

We could prevent 30% of all cancer deaths is we could eliminate smoking

This is now universally accepted, but it was not clear 50 years ago. In the UK we could prevent 30% of all cancer deaths if we could eliminate smoking.

There is also a great deal of research showing that poor diet, obesity, physical inactivity, excessive alcohol intake and excessive exposure to sunlight all cause cancers.

SURVIVORSHIP

I'd like to know if more effort will be put into long-term survivorship programs. I was treated with ABVD for Lymphoma. A lot of people I met were unaware of many of the long-term issues and problems associated with their treatments.
Tim, Leeds, UK

Professor Richards:

More than one in three people are likely to develop cancer at some time in their lives and as survival rates continue to increase, more people will be continuing their lives as survivors of cancer.

I am currently working with people from across the field of cancer to develop a new Cancer Reform Strategy, which will set out the plans for cancer services over the next five to 10 years.

Several groups have been set up to consider specific issues and support the development of the strategy.

Survivorship is a major issue being considered by the Patient Experience Working Group. This group is also looking at the provision of information before, during and after treatment.

I would really appreciate your response to our situation. My Mother had a kidney removed in February of this year. A scan was arranged for today but the first available appointment to discuss the results is at the end of June. She is increasingly unwell. We feel treatment needs to be sorted now. The end of June is too far away. Please can you advise?
Sue V, Milton Keynes

Professor Richards:

Over the past few years the NHS has made very good progress in reducing the time patients wait between being referred to hospital with suspected cancer by their GP and their first treatment.

Unfortunately, as your mother's case shows, we have made less progress on the delays between first treatment (your mother's operation) and patients receiving their next treatment if this is needed.

Cancer research in the UK is excellent

We are considering how best to tackle this as part of the Cancer Reform Strategy.

In the meantime, if your mother is increasingly unwell I would suggest that you talk to your mother's GP and her consultant to see if her appointment could be brought forward.

COST OF MEDICINES

The amount of cancer research taking place in the UK is excellent. However, what is the point of cancer research if the pharmaceutical companies out price all the patients?
Frank Dias, Gravesend, Kent

Professor Richards:

You are right in saying that the amount of cancer research taking place in the UK is excellent.

The government is committed to providing cancer medicines which have been shown to be both clinically effective and cost effective through the NHS.

In order to decide which treatments should be made available, the government receives independent advice from the National Institute for Health and Clinical Excellence (NICE).

If NICE approves the use of a drug, Primary Care Trusts have been directed to make funding available within a period of three months.

Developing a new medicine takes on average ten to twelve years and can cost more than £550 million. Before it is authorised for use by patients, it has to undergo a long and complex process of selection, testing and development.

The prices of branded prescription medicines supplied to the NHS by the pharmaceutical industry are controlled through the Pharmaceutical Price Regulation Scheme (PPRS).

This scheme, administered by the Department of Health, regulates the profits that pharmaceutical companies are allowed to make through their trade with the NHS, helping to ensure value for money for the taxpayer whilst recognising that the industry needs to earn enough money to enable it to develop and market new and improved medicines.

HOMEOPATHIC TREATMENTS

I am a 52 year old breast cancer patient. There is currently a move to withdraw contracts for homeopathy treatments in my area. There are so many people who's immune systems just cannot take the side effects of manmade drugs, and need the choice of access to homeopathy whether cancer patients or not. What is going on?
Pam Kish, London

Professor Richards:

I am glad that you have benefited from the treatment you have received at the Royal London Homeopathic Hospital.

Primary Care Trusts are responsible for commissioning their services to meet the needs of their local populations, but if, as you say, you think your local PCT is using an incorrect assessment model in reaching its decision about whether or not to continue buying services from the Royal London Homeopathic Hospital, I suggest you raise this as a concern with them.

PROSTATE CANCER

There should be more publicity, support and a screening program for prostate cancer. It is a disgrace that the major cancer in men gets so little publicity and that no screening program is in place. Just when will men be able to get tested easily?
James Nicolson, London

Professor Richards:

Currently there is no evidence that screening for prostate cancer would save lives.

However, we are committed to introducing a screening programme if and when screening and treatment techniques are sufficiently well developed.

The UK National Screening Committee is advising us on this issue and we are keeping it under close review.

Alongside this, the Department of Health is supporting the development of screening technology for prostate cancer by having a comprehensive research strategy into all aspects of prostate cancer.

There is no evidence that screening for prostate cancer would save lives

A £20m trial of treatments for Prostate Specific Antigen (PSA) screen-detected early prostate cancer (the ProtecT trial) is under way, funded by the Department of Health.

We have also set up the Prostate Cancer Risk Management Programme for men who don't have any symptoms of prostate cancer but still want a PSA test.

The programme allows men to discuss having a PSA test with their GP and, after weighing up the pros and cons of having the test, they can have one free on the NHS if they wish.

We want men to know what their prostate is, what it does, and what can go wrong with it.

However, we have to raise awareness in a responsible way so as not to cause undue anxiety and worry for men, or to overwhelm NHS services.

A pilot public awareness programme on prostate cancer is expected to start later this year. It is jointly funded by the Department of Health and signatories to the Prostate Cancer Charter for Action.

CHILDHOOD CANCER

My five-year-old niece died from Wilms Tumour on December 30, 2006. This is an uncommon childhood cancer, but not one with a high mortality rate. But my understanding is that there is no dedicated research into Wilms Tumour in the UK. Why not?
Keith Jackson, Brighton

Professor Richards:

I am extremely sorry to hear about your niece.

Thankfully childhood cancers are rare and survival rates are generally high: 75% of children are now successfully treated.

I have checked with the National Cancer Research Network and they are currently supporting four studies for children with Wilms Tumour. Details can be found at http://pfsearch.ukcrn.org.uk/ by following the links for 'National Cancer Research Network' and then 'CCLG'.