• Two-fifths of kidney cancer patients were told about their diagnosis in a way that was not ‘appropriate’.
• Over half of UK kidney cancer patients reported no follow-up contact from their GP or practice nurse after initial diagnosis.
• Nearly two-thirds did not receive a GP Cancer Care Review 12 months post-diagnosis – going against standards set out by NHS England.
• This concerning lack of communication at crucial stages throughout the pathway means kidney cancer patients are unable to make informed decisions about their ongoing care – heightening feelings of fear and anxiety during an already distressing time.

• Rebuild the UK’s global position in biomedical research.
• We want the UK Government to pledge to back research: Set out a plan to close the more than £1bn funding gap for research into cancer over the next decade.

Mission 2

• Prevent more cancers than ever before.
• We want the UK Government to pledge to end cancers caused by smoking: Raise the age of sale of tobacco and fund a world-leading programme of measures to help people who smoke to quit.

Mission 3

• Diagnose more cancers early.
• We want the UK Government to pledge to drive earlier diagnoses: Implement proven measures, including a lung screening programme, to diagnose cancers early and reduce inequalities in access.

Mission 4

• Bring innovation to patients more quickly and reduce inequalities.
• We want the UK Government to end the waits: Ensure cancer wait time targets are met across England.

Mission 5

• Build a national movement to beat cancer, sooner.
• We want the UK Government to lead on cancer: Publish a long-term cancer strategy for England and establish a National Cancer Council, accountable to the prime minister, to drive cross-government action on cancer.

• Qualitative research participants described their experience leading up to diagnosis as being marked by stress and anxiety, with 48% of the young people, parents and carers surveyed wanting more support to understand their or their child's diagnosis.
• During treatment, financial and practical pressures further compound the emotional toll on families. 43% of survey respondents said they received support related to financial help or benefits, but 38% said they needed more support and 12% said they didn't receive any.
• Unsurprisingly, young people undergoing cancer treatment, and their parents, carers and siblings, report poorer wellbeing and quality of life, and higher cancer-related needs than those after treatment.
• After treatment the sharp decline in signposting to relevant support leaves individuals feeling isolated and struggling to access the necessary support.
• Young people who were treated for cancer have 36% higher anxiety than the population at large, and this remains true more than six years after treatment.

At best, BCRL can only be managed with life-long, constant adherence to physiotherapy and use of compression garments. Attempts at treatment, mostly involving additional surgery, has shown mixed success and are largely inaccessible due to additional cost and complexity.

BCRL prevention has been identified as a top priority by lymphatic physiotherapists who are in the best position to understand how difficult it is to manage the disease. A widely accessible BCRL prevention strategy, a well-documented unmet need, would not only see BCRL patients gain an estimated 12 QALYs (quality adjusted life years), but would also save the NHS substantial costs – the 5-year treatment costs per patient for BCRL is £36 K.[1] 

After establishing myself as a leader in cardiovascular biomechanics research and device development, I began research on the lymphatic system in 2004, motivated in part by cancer-related deaths of close ones. Recognising the opportunity to improve lives for cancer survivors, I invented FaciliFlow.

FaciliFlow is a small implantable device manufactured from medical grade silicone. The device would be permanently implanted during lymph node removal surgery to promote regrowth of surgically damaged lymphatic vessels, thus restoring lymphatic function and preventing fluid accumulation. Its dual modes of action include parallel channels to guide fluid flow and vessel regrowth by minimising resistance to interstitial flow, and localised release of VEGF-C (minimising risk of off-target delivery). FaciliFlow can be deployed in minutes by any surgeon.

Following encouraging early animal results, I received a £1.4 million grant in 2020 to develop the device at Imperial College London. I had been covering IP costs himself up to that point. The grant allowed me to hire a highly enthusiastic and committed team that now has the device ready for large animal trials.

We have involved patients, surgeons and industry experts throughout FaciliFlow’s development. In order to design this medical device, we worked with Imperial’s Cancer Research UK Lead Nurse to form a committee of patients who would be able to help us. They told us how BCRL had affected their lives and this enabled us to understand the importance of making the device low-cost and easy-to-use, thus accessible to everyone receiving breast cancer surgery to prevent all cases of BCRL. 

The patient group came about through our interactions with breast cancer surgeons, many of whom are aware of the severity of BCRL and want to help prevent its occurrence. Given the severity of the disease, these patients are strongly motivated to share their input on any type of solution. Their stories include every day struggles, disruptions to their careers and the effects on their families. One patient said that her son gets upset at the sound of the pump she uses to minimise the swelling in her arm because it reminds him that his mum had cancer.

There is a lot of work still to do to make FaciliFlow available for clinical use. First we need to do more preclinical studies, then first-in-human clinical trials in hopes of achieving regulatory approval. In parallel we need to continue our analysis of end-user needs: conduct stakeholder engagement studies, hold patient and public involvement (PPI) meetings and refine our business planning accordingly.

View the short video featuring BCRL patients sharing their stories and hear how we involved them in the development of Facilifow

Reference

1. Humphreys I, Thomas MJ. Evaluation of the economic impact of a national lymphoedema service in Wales. British Journal Nursing 2017: 1093-1100.

1. Rebuild the UK’s global position in biomedical research.  

The UK Government should set an ambition in its first 100 days to lead the G7 in research intensity, increase government investment and make the UK an attractive destination for scientists and clinicians worldwide.  

2. Prevent thousands more cancer cases.  

The UK Government has a once in a generation opportunity to tackle one of the biggest health issues facing the country – smoking. Around 500,000 hospital admissions every year in England are attributable to smoking – equivalent to one person being admitted every minute.   

The UK Government should urgently progress laws to increase the age of sale of tobacco products.  

If these measures help achieve a smoke free England by 2030, it could prevent around 18,200 cancer cases in the country by 2040.  

3. Diagnose cancers earlier and reduce inequalities.  

Almost half of cancers in England are diagnosed at a late stage, and around 1 in 5 cancer patients are diagnosed via emergency routes. Earlier cancer diagnosis saves lives, and we are calling on the UK Government to implement measures to reduce late-stage diagnosis in England.  

The UK Government should transform and optimise cancer screening programmes and accelerate the roll-out of the lung cancer screening programme in England.  

Cancer Research UK is also calling on the UK Government to address variation in treatment across different geographical areas and reduce inequalities in early diagnosis in England through targeted action plans.   

4. Bring tests, treatments and innovations to patients more quickly.  

Despite the tireless work of staff within the NHS, patients continue to wait far too long for vital tests and treatment.    

While there is huge potential for innovation in the NHS, change must be backed by long-term funding for staff, essential kit and facilities.  

The UK Government should set out a 10-year cancer-specific workforce plan to address the chronic staff shortages in cancer services. The UK Government should eliminate the £10.2 billion NHS maintenance deficit by 2030 and commit to rolling ringfenced capital investment for cancer.  

5. Build a national movement to beat cancer, together.  

The current system is fragmented. In England, responsibility for cancer research and care is spread across NHS England, at least 5 government departments and multiple agencies.   

Cancer Research UK thinks that the best opportunities for improving cancer outcomes need those responsible for research, innovation, NHS services and public health from across government to coordinate their actions, ensuring we accelerate research, the adoption of innovation and reduce inequalities for everyone affected by cancer.  

A new National Cancer Council for England, accountable to the Prime Minister, should be set up to drive cross-government action on cancer and deliver a 10-year cancer strategy for England.