Cancer will touch most of our lives at some point. One in three people in England will develop the disease and it will kill one in four.
Tackling cancer is one of the government’s top priorities and, in September 2000, it launched the NHS Cancer Plan. It sets out a strategy to prevent, diagnose and treat cancer – all part of the goal of cutting the number of people dying from the disease.
Millions of pounds are now being pumped into the NHS to support the Plan and people across the country are seeing the results. A report by the chief executive of the NHS in May 2004 showed that patients are benefiting from shorter waiting times to see specialists, access to new drugs and the most modern equipment for diagnosing and treating cancer.
Progress in putting the Plan into practice has had a real impact on patients. In Newcastle upon Tyne, for example, a new booking system means that women with suspected breast cancer can get the time of their appointment with a specialist within seven minutes of their GP making a referral. The speed of the service helps to reduce some of the anxiety that patients can feel.
Prevention
There are many causes of cancer, but people who smoke, don’t eat healthily, are obese or don’t do enough exercise can be more at risk.
Smoking causes one in three deaths from cancer, and poor diet may cause another third of deaths.
The Cancer Plan sets out steps to stop people developing the disease by reducing smoking rates and promoting healthy eating. Hard-hitting adverts are warning people of the effect that smoking can have on their health and the health of those around them and support services are helping people to quit for good.
On the food front, the government is backing up its ‘5 a day’ fruit and vegetable message with free fruit in schools. Most children don’t eat the recommended five daily portions of fruit and vegetable and one in five eat no fruit at all. The national school fruit scheme aims to address this problem by providing all four to six year olds with a piece of fruit or vegetable. It’s the biggest health initiative for child nutrition since the introduction of free milk in 1946 and will benefit 2m children by the end of 2004. Children form their food habits early on, so helping children to get into the habit of choosing an apple or banana instead of crisps or chocolate will set them up for a healthier future.
The healthy eating message is also aimed at adults. Fruit and vegetables are important for overall good health and reduce the risk of heart disease and some cancers.
Screening
Screening programmes can help to detect cancer-type activity before symptoms appear. This can pick up the disease at an early stage and make a big difference to the success of treatment. Cervical screening, for example, save the lives of around 1,300 women in England and Wales every year.
A new centre at Nottingham has helped to double the number of women screened for breast cancer in the area over the last 15 years. The Nottingham Breast Institute opened to patients in September 2003 and now brings together all outpatient services for breast cancer patients under one roof. The design of the new building reflects the needs of patients and families. A counselling wing provides privacy for patients and their families when they receive test results and the use of natural light, art and garden areas creates a welcoming environment.
One in nine women are expected to develop breast cancer, but over 95% of women who have had invasive breast cancer detected by screening are alive five years later.
The government is committed to expanding cancer screening programmes, where it is clear this will reduce mortality. The Department of Health has just announced that a new national screening programme for bowel cancer will be introduced from April 2006.
Diagnosis
People with suspected cancer need to see experts who can diagnose the disease. A speedy diagnosis can reduce the worry and uncertainty felt by patients and increase the chances of successful treatment, so the government is working to cut waiting times.
Nearly all people with suspected cancer – over 99 per cent – now see a specialist within two weeks of being referred urgently by their GP. The Cancer Plan includes the targets that by December 2005 no-one should wait longer than two months from urgent referral to the beginning of treatment, or longer than one month from diagnosis to treatment.
Treatment
Once diagnosed with cancer, patients rightly expect to be treated quickly. Investment in new equipment and staff is helping to make sure that people get the best treatment as soon as possible.
One of the new measures is the introduction of specialist multi-disciplinary teams. It might sound like jargon, but in reality it means teams made up of all the people involved in treating particular types of cancer. By working together and understanding each other’s work, the team members can provide better care for patients.
Another development is the replacement of scanners to make sure that none of them are more than eleven years old. The investment will mean that hundreds of thousands of patients will benefit from faster diagnosis and the most targeted and appropriate treatment for their specific cancer.
Care
Patients and their families should get the information, support and specialist care they need to cope with cancer. Good communication between patients and health professionals is an important part of this and the NHS is making sure that staff get the training they need.
The government is also putting more money into services that will enable terminal cancer patients to choose where they die and give them the option of spending their last days at home. A £50m fund for palliative care is providing extra consultants to help people manage their pain and more Marie Curie nurses. The NHS continues to work with hospices to make sure that people have access to services that will allow them to die with dignity.
Tackling cancer across the UK
Wales is continuing to develop cancer services – from prevention through to specialised care. The Welsh Assembly Government is committed to providing first class prevention, screening, diagnostic and treatment services for tackling cancer.
A new ‘cancer bank’, for example, will allow researchers to collect blood samples from patients to help them work out what causes cancer and how best to treat it. You can find out more about what’s being done to target cancer in Wales at www.wales.gov.uk (external link).
Cancer is Scotland’s biggest killer, so tackling the disease is a priority for the Scottish Executive. Its national cancer strategy aims to create a faster, more patient-centred service and it is investing in new facilities like a £187m centre in the west of Scotland.
Bringing a range of specialist cancer services under one roof will cut the time that patients spend travelling to appointments and it will also encourage staff from different areas to work together. You can find out more about Scotland’s drive to cut cancer rates at www.scotland.gov.uk (external link).
People with cancer are helping to shape services in Northern Ireland, where it has overtaken heart disease as the biggest killer. Two people who have been diagnosed with cancer have joined the Regional Cancer Services Framework group, which is planning how to meet the needs of patients over the next 20 years. Details of Northern Ireland’s approach to tackling cancer are available online at www.nics.gov.uk (external link).
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