CANCER CARE IN CRISIS...
Almost a third of NHS patients still wait too long for treatment to start
CANCER patients still wait too long for care with one revealing he was told it would take nine months for him to get treatment.
There are fears it could needlessly cost more lives unless the problem is urgently tackled by No10.
New data for NHS England shows almost a third of cancer patients are waiting longer than the 62 days standard to start treatment.
Retired NHS consultant Allan Dodds, 81, told how he faced a nine-month wait for a biopsy of a suspected skin cancer on his nose so he went private.
He said: “I think, ‘What about the people who can’t afford it?’ If you’d been left, as I would have been, for nine months with cancer on your face, you wouldn’t be able to sleep at night, you would be in a state of panic for weeks.”
Oncologist and founder of the Catch Up With Cancer campaign Professor Pat Price added: “The depressing drumbeat of missed targets continues as just under a third of people face treatment delays. I fear there is a lack of ambition for cancer patients.
“Without a strategy to improve things, we will continue to see lives lost needlessly.” Macmillan Cancer Support manager Mairaid McMahon said: “Cancer can impact people’s lives in many ways, from finance to emotional wellbeing, so having to also face an excruciating wait just to start treatment is an added burden that no one should have to bear.”
Data shows 68.7% of patients in England began treatment within 62 days of an urgent suspected cancer referral in March. This was up from 63.9% in February.
The NHS standard is that at least 85% of patients should start treatment within this time.
Average performance against the 62-day target was worse in 2023/24 than in the previous year.
Separate NHS data shows the number of people with a diagnosis and decision to treat who were still waiting to start it more than two months later remained around 2,900 through March.
But the health service has met its target to diagnose or rule out cancer within 28 days of referral in at least 75% of patients for two months in a row.
Cancer Research UK’s chief executive Michelle Mitchell said: “While it’s promising that more people are finding out if they have cancer or not faster, too many patients are still waiting too long to begin cancer treatment.
“The last time all cancer wait targets were met in England was in 2015.”
NHS England Medical Director Professor Sir Stephen Powis, said: “Today’s figures show just how hard NHS staff are working to deliver the best possible care for patients, despite ongoing significant demand and a difficult recovery journey.”
Health Secretary Victoria Atkins added: “We’ve delivered on our target of ensuring over 75% of patients tested for cancer receive a diagnosis or all clear within 28 days of referral.”
Data for March shows the overall NHS waiting list backlog stayed at 7.5 million appointments.
Shadow Health Secretary Wes Streeting said: “Rishi Sunak has broken every pledge he’s ever made on the NHS, causing patients to wait for months in pain as a result.”
BEAUX Harris describes her body as a “ticking time bomb”. The 29-year-old dancer and choreographer was diagnosed with the BRCA1 genetic mutation two years ago, which gives her a 90% chance of developing breast cancer and a 60% chance of ovarian cancer over her lifetime.
“I was told I need preventative surgery – a mastectomy and hysterectomy – within five years, but the NHS waiting list of two to five years per procedure means it isn’t realistic to think I will be treated in time,” she tells me.
“I’m timed out. They are essentially just waiting for me to get cancer, and I’m terrified. The surgery isn’t a ‘choice’. It’s a 90% risk – if I don’t choose it, it feels like suicide.”
She looks out the window. “Would you get on a plane with a 90% chance of it crashing? I wouldn’t.”
For Beaux, like many BRCA patients, trauma runs deep.
“I’ve seen it kill every woman in my family who has the BRCA1 mutation,” she says, quietly. “My mum, my auntie and my grandmother.
STRAIN
“In my mum’s generation only one of the three sisters has survived. I am one of three sisters – I am speaking out because I can’t let history repeat itself.”
As King Charles returns to work after his own cancer diagnosis, and that of his daughter-in-law, Kate Middleton, he met cancer patients saying the challenge was to “get enough people early”.
Aides said his first public engagement was to highlight cancer innovation, treatment and support.
But Beaux’s story highlights the strain on NHS waiting lists, where breast and ovarian cancer patients get priority over BRCA patients for surgery, often at short notice.
“And rightly so,” Beaux says. “No one would want to take an appointment from a cancer patient.
“But, in the meantime, that means there are many of us who will get cancer before we can get the procedures we desperately need.”
BRCA1/2 is sometimes known as the “Angelina Jolie” gene – after the actor went public with her decision to have her breasts and ovaries removed after discovering she carried BRCA1. She wrote: “Knowledge is power.”
For Beaux, the opposite feels true. She feels powerless knowing the waiting list is too long to help her. Although Beaux, who also has a brother, knew she had Jewish heritage, she only discovered her Ashkenazi family history when she began the genetic testing.
Having Jewish ancestry increases the risk of a BRCA mutation – one in 40 Ashkenazi and one in 140 Sephardi Jewish people have a changed BRCA gene, compared to around one in 250 people in the UK general population.
NHS England is now offering free BRCA gene testing for anyone living in England, aged 18 or over, with one or more Jewish grandparent. But increased screening means longer waiting lists, and it needs to be matched with funding for treatment.
As well as the trauma of her own diagnosis, Beaux carries intergenerational trauma. Added to which, she doesn’t have her mum to support her at a frightening time in her life.
“I get awful PTSD from hospitals having watched so many people die,” she says. “I was 11 when my mum was diagnosed and 15 when she passed away aged 52.” In a moving video aimed at
I’ve seen it kill every woman in my family who has the mutation
raising funds via gofundme for private surgery, which Beaux estimates will cost a minimum of £50,000, she says: “I never knew my grandmother Esther – my mother’s beautiful flamenco dancer mother. Sadly, I never met her because she passed away of breast cancer when my mother was a teenager.
“Then my beautiful Auntie Mara moved in with us when she was dying of cancer. She was a warrior and she fought hard and long but sadly lost her battle when I was eight years old.
“I watched my mother – it’s one of my most profound memories – say goodbye to her sister as she went off to die. My mother was then diagnosed with ovarian cancer. She had aggressive treatment three times, but unfortunately when I was 15, she lost her battle with ovarian cancer. I watched my mother take her last breath, and I don’t think I’ll ever go through anything more traumatic.”
When her mother was younger, “she wasn’t even advised to get these procedures,” Beaux tells me. “She didn’t even know she had BRCA until she developed ovarian cancer – they call it the Silent Killer. By the time she was tested she had a tumour the size of an American football on her right ovary. And 13 years later, there’s still no screening for ovarian cancer. Not much has changed.”
In 2022, a report from Breast Cancer Now found riskreducing surgery, had been de-prioritised during Covid.
The charity had heard of “instances where people who were identified as being at increased risk of breast cancer went on to develop the disease during their wait”.
Breast Cancer Now’s Melanie Sturtevant says they are “concerned far too many women at an increased risk of breast cancer are struggling to access treatments that reduce their risk.” She adds: “Getting the news you’re at very high risk of breast cancer due to inheriting an altered gene such as BRCA, can bring a range of emotions, including anxiety and worry. Lengthy waits for risk-reducing surgery can
cause further distress – and in the worst cases some women may develop breast cancer while they wait.”
Beaux, who lives in North London, is attempting to fundraise to have at least four procedures privately – egg-freezing, which she says is not available for BRCA patients on the NHS, double mastectomy, hysterectomy, and reconstructive surgery.
“Having these procedures will reduce my chance of getting cancer by 95% – it’s a no-brainer,” she says. “What would my mother be saying to me?”
As Beaux is self-employed, uncertainty around medical appointments is an added worry. “I’ve had five appointments cancelled since April 2022. I’m a freelance creative, I teach at two drama schools and a variety of dance studios. I’ve lost thousands of pounds in cancelled appointments.
“Then I was rushed in and out in under 15 minutes. The surgeon I saw was brilliant, but she said I will be waiting two to five more years for each procedure. I had already waited two years for an initial consultation.”
NHS England says cancer treatment activity is also at its highest ever level with more than 1,400 patients starting cancer treatment every day.
A University College London Hospitals spokesman says: “We are deeply sympathetic to those living with the knowledge of a hereditary cancer and our specialist team work with patients and discuss the treatment options available.
“We ensure appropriate surveillance is in place for patients while awaiting risk reducing surgery. Our waiting times for risk-reducing surgery are in line with national standards and within guidance. Wherever possible we take account of individual circumstances and requests in planning surgeries and this may impact waiting times.”
STRENGTH
Shadow Health Secretary Wes Streeting says: “Fourteen years of Tory neglect has left patients who are most at risk of cancer in the lurch.
“NHS waiting lists are higher than when Rishi Sunak pledged to cut them, with BRCA1 carriers among the many victims of his broken promises.
“Having gone through treatment for kidney cancer, I know every minute matters when it comes to cancer. Labour’s plan to catch cancer earlier and treat it faster will deliver two million more appointments a year on evenings and weekends, and double the number of NHS scanners, paid for by clamping down on tax dodgers.”
Beaux also wants to bring wider attention to the issue of BRCA patients being forced to wait for preventative surgery.
“I have to use the strength I have left to make things better for other women,” she says. “I will make it my purpose now. I have no choice.
“My older sister doesn’t have the BRCA gene. My younger sister doesn’t yet know. I’m doing all this for her. I’m doing it to start a conversation, so she doesn’t have to. To stop history repeating. I’m terrified – but I owe it to my mum, her sister and her mum, and to the many women who come after me, to do this.”
And then, when she’s won her fight, she says: “I’ve got some bloody Olivier Awards to win!”
‘‘
Tory neglect has left patients most at risk in the lurch