UK strategy to improve cancer services
15 January 2007
The UK government has published a five-year cancer
strategy focussing on prevention and improving services. The major actions
- encouraging changes to lifestyle — such as avoiding smoking, obesity
and excessive alcohol consumption;
- earlier diagnosis through screening, especially for cervical, breast
and bowel cancer; and
- better treatment through surgery, radiotherapy and drug treatment.
Over £500m has been invested in additional and replacement equipment
for cancer in recent years, including 167 new linacs for radiotherapy.
Despite this, the number per unit of population is still low compared to
other European countries, therefore additional radiotherapy equipment
will be needed in many parts of the country. Also, despite investment in
training, there is still a shortage of radiographers and a long-term
workforce strategy is needed.
The report acknowledges that proton
therapy is a promising new technology, giving precise treatment and avoiding
damage to non-cancerous tissue, but there is only one facility in the whole
of the UK, and that is limited to eye treatment. From April 2008 other
facilities for proton therapy will be commissioned by the National
Commissioning Group and the Department of Health "will consider" options for
providing proton therapy services.
The number of drugs licensed for cancer
treatment is growing rapidly, as is the expenditure on the new types of
drugs. However, problems were identified in delays in approval of new drugs,
including variability in the use of approved drugs across the country and
poor planning for chemotherapy services in some areas.
The government will
be investing £250m in capital equipment for cancer services over the next
three years. The revenue costs of the strategy are expected to be around
£450m by 2010/11. However, the NHS is expected to be able to make savings of
£320m by per annum by that time, mainly through eliminating unnecessary
hospital admissions for cancer patients.
Clinical Director of Cancer
Services Mike Richards said: "We have made good progress on cancer over the
past 10 years thanks to the efforts of many people throughout the NHS and
"However, we know there is much more to be done. The commitments in the
Cancer Reform Strategy will enable us to develop world-class cancer services
in this country, saving more lives and ensuring patients get the care they
Ciaran Devane, chief executive of the charity Macmillan Cancer
Support , said: "Cancer patients are being diagnosed and treated much
quicker today. As a result, more people are surviving the disease. The
challenge now is to help these growing numbers live with the long-term
medical, emotional and financial effects of cancer. Macmillan welcomes
the new Cancer Reform Strategy and the strong emphasis it places on
improving patients' quality of life."
The University of Surrey welcomed the new strategy but said that "it
is extremely sad that the UK currently has no plans for the newest type
of radiotherapy which uses charged particles rather than x-rays. This
exciting new generation of radiotherapy, which delivers more damage to
the tumour and much less to the surrounding healthy tissue, will
especially benefit children and tumours that are more difficult to treat
with conventional (photon) radiotherapy. A report on particle therapy
was submitted to HMG by the National Radiotherapy Advisory Group (NRAG)
"The UK is in an excellent position to take advantage of particle
therapy as there are excellent networks both on the clinical side
(ACORRN) and between clinicians scientists and engineers (EPSRC Research
Network on Biomedical Applications of High Energy Ion Beams). Moreover,
the research infrastructure to take this research from bench to bedside
is already in place, via the Wolfson Nanobeam Project at the University
of Surrey and recent funding through the Research Councils Basic
Technology programme (CONFORM and LIBRA) for the next generation of
particle therapy machines, which aim to develop the next generation of
ion sources for particle therapy."
The UK Cancer Reform Strategy is