SPECIALISTS SEE IMPACT OF COVID- 19 ON CANCER

City’s experts say patients coming in far later

CANCER specialists in Glasgow are experiencing a surge in new cases and have said it is “inevitable” that doctors are seeing more patients with advanced and harder- to- treat disease because of delays in diagnosis caused by the pandemic.

While the Scottish Government stressed repeatedly in public messages that anyone with cancer symptoms should seek help, Dr Rob Jones, professor of clinical cancer research at Glasgow’s Beatson centre, said delays had happened “all the way through the pathway” from initial contact with GPs to further investigation by clinical specialists.

The cancer specialist, who splits his time between research and patient consultations, said the majority of appointments were also still being carried out by telephone or video and described the challenges of assessing patients remotely.

He said the majority of Scottish cancer trials halted during the pandemic had resumed but suggested some patients might miss out on opportunities because trials “may be given less prominence” in a remote consultation because of the need to simplify the process.

He said some also require patients to have additional procedures in a clinical setting before they can be enrolled.

The Scottish Government said the NHS had remained open for emergencies and urgent cancer care and a cancer recovery plan is due to be published shortly.

Cancer Research has warned it may be forced to cut research funding by £ 150 million a year without support from the UK Government.

Mr Evans said: “We saw far fewer newer referrals during the heat of the pandemic.

“We are now seeing a surge in patients and by default some of those patients will have more advanced disease – it’s inevitable if you delay presentation.

“I’ve not seen any statistics but it must be happening.

“You can’t really point the finger at anyone. The delays are not just about people being seen in hospitals, it’s delays in the ways people presented to their GPs, people were reluctant to trouble them. The delays are all the way through the pathway.

“Where the challenge lies is actually in healthcare. We are doing most of our consultations remotely, by telephone and video whereas previously it would have been face to face.

“There is a desire to simplify consultations so the trial option may be given less prominence. Trials often involve additional procedures which require the patient to attend hospital.

“It actually becomes quite hard to enrol patients into trials if they are not in the building, for a whole variety of reasons.

“The bureaucratic barrier is no longer there so legally the patient can enter the trial but we are not seeing the same numbers, partly because they are reluctant to bring patients up to hospital, yet partly because patients are to come into hospitals.”

Cancer Research has said major funding losses caused by the pandemic are likely to “severely impact” the ambition of improving cancer survival to three in four by 2034 – but it may also have had an impact on outcomes.

The suspension of most trials meant that in some cases patients were left with no more treatment options, said the cancer specialist.

He said: “For some patients where the trial was the only treatment option, those were the trials we tried to keep open but for some patients their treatment options were more limited, and in some cases, it meant they no longer had any options.

“Most of the trials we were doing before coronavirus have now re- opened apart from those where there is a very specific risk with the virus.”

A Scottish Government spokesman said: “We recognise the impact the pandemic has had on those diagnosed with cancer during this time and throughout this pandemic NHS Scotland has remained open, continuing to provide emergency and urgent cancer treatment as well as maintaining Covid- 19 capacity and resilience.

“We are establishing a Cancer Clinical Trials Subgroup as part of our recovery of cancer services.

“We are also in the process of developing a new cancer recovery plan, to be published shortly, which will ensure patients have access to the best possible treatment and care, including through new Early Diagnostic Centres.” reluctant