This is the biggest failure in my 50 years in oncology

One of the most heart-breaking parts of being an oncologist today is when a patient has come to me, often with a young family, and the prognosis is very poor. If they had presented a month or two earlier, far more could have been done.

It’s not an exaggeration to say that these relatively short delays can be the difference between life and death – the difference between a mother seeing her child graduate or a father walking his daughter down the aisle. Each one of these stories is a tragedy but what about almost 50,000?

That’s the number of “missing” cancer patients, according to Macmillan, with 24,000 additional patients already in the system but with significant delays in getting to their first treatment.

I struggle to get my head around these numbers. To be frank, it is an utter disaster. Everybody reading this will have lost a close relative from cancer. It is a relentless disease which begins as a rogue cell in one organ and spreads round the body. Delay is a killer. We know the reason that Britain was already performing poorly in cancer league tables – simply the serial delays in referral, investigation and in starting treatment. What takes a week in Europe can take months here, even before Covid.

How many deaths will result from this? Tens of thousands. Cancer does not discriminate, many of these will be young men and women in the prime of their lives.

Difficult decisions in medicine are often taken on a “life years lost” basis. If you apply that metric to the cancer crisis, the results are nothing short of catastrophic. It is easily the biggest failure in my 50 years in oncology. Yet with Covid, the average age of death in people that have been vaccinated is over 85 years.

One missed cancer diagnosis is a tragedy, 50,000 are a statistic. But each one is a grandfather, a mother, a friend, a colleague. In my view, as a society, we have let them down.

I’ve seen many tragic cases. Earlier this year, a 42-year-old woman with two young children had been experiencing headaches for roughly six months. A telephone appointment with her GP led to a migraine diagnosis, with no investigations requested.

Not long after, she collapsed from a major bleed into an undiagnosed brain tumour. Despite radiotherapy, she died in hospital after eight days on a ventilator. Devastating.

There are three key issues: those who are unable to access the healthcare system; those who are in the system but are significantly delayed; and perhaps the most abundant are those who are simply too frightened even to call their doctor.

One such person was an elderly man who eventually came to us. He had lost two stone in weight, been coughing up blood for several months and was extremely unwell. It was lung cancer. He is now on palliative radiotherapy after the cancer had progressed to stage three. People of his generation felt that suffering in silence was patriotic, but it will cost him his life.

We told hundreds of thousands of seriously ill people to stay at home, and that’s exactly what they did. The consequent human suffering and death will be difficult to measure. We owe it to future patients not to make the same mistake again.