• People treated for cancer in England report generally positive experiences of care in hospital, but the results also show that care can lack personalisation, and that there are gaps in the wider support for people with cancer outside of hospital. 
• Most respondents described positive experiences of care from specialist cancer teams and in hospital. Nine in ten had a main point of contact in their care team (92%), and almost all said that this person was “quite” or “very” helpful (96%). Similarly, respondents were positive about the support they received in hospital. A large majority said that they were “always” treated with respect and dignity (89%) and had confidence and trust in all of the team looking after them in hospital (81%).  
• Despite these positive findings about direct patient care from cancer teams and in hospital, other areas showed significant room for improvement. Personalisation and person centredness, which are policy priorities and important to patients and users, were too often lacking. For example, only 70% of respondents said that they were “always” involved in decisions about their care and treatment while in hospital. A similar proportion (72%) said that they “definitely” had a discussion with a member of the team looking after them about their needs or concerns.  
• Outside of hospital, the survey showed evidence of gaps in the support available for people with cancer. Of those who said that their GP practice was involved in their cancer treatment, less than half (44%) said that they “definitely” received the right amount of support. Similarly, around one in six respondents (16%) indicated that they would have liked more emotional support at home from community or voluntary services after their cancer treatment had finished. 

Because of a lack of awareness of the risks of skin cancer among Black people and clinicians’ lack of experience diagnosing skin conditions in people with darker skin, melanoma for Black patients can go untreated far longer than when it’s identified for White patients, Moossavi explains in this article.

The study found that most women (10/12) became aware of overdiagnosis after their own diagnosis. All were concerned about the possibility of overdiagnosis or overtreatment or both. Finding out about overdiagnosis/overtreatment had negative psychosocial impacts on women’s sense of self, quality of interactions with medical professionals, and for some, had triggered deep remorse about past decisions and actions. Many were uncomfortable with being treated as a cancer patient when they did not feel ‘diseased’. For most, the recommended treatments seemed excessive compared with the diagnosis given. Most found that their initial clinical teams were not forthcoming about the possibility of overdiagnosis and overtreatment, and many found it difficult to deal with their set management protocols.

The experiences of this small and unusual group of women provide rare insight into the profound negative impact of finding out about overdiagnosis after breast cancer diagnosis. Previous studies have found that women valued information about overdiagnosis before screening and this knowledge did not reduce subsequent screening uptake. Policymakers and clinicians should recognise the diversity of women’s perspectives and ensure that women are adequately informed of the possibility of overdiagnosis before screening.

The Department of Health and Social Care and NHS England should:

• develop specific plan to address gaps in diagnostic workforce, short-term and long-term shortages in key professions and level of investment required to deliver sustainable long-term increases.
• publish a detailed analysis of the extent of the cancer backlog to support the delivery of the elective care recovery plan.
• set out an estimate of what level of additional capacity in NHS cancer services will be needed to address the backlog in cancer services and treatment by March 2023.
• set out an action plan to ensure that NHS cancer services are able to provide this additional capacity above normal levels.

The new Office for Health Improvement and Disparities should conduct a rapid review of existing evidence of the impact of demographic factors on cancer outcomes and commits to developing a joint strategy with NHS England to address disparities in outcomes.

• Pancreatic cancer
• Lung cancer
• Brain tumours
• Oesophageal cancer
• Stomach cancer
• Liver cancer

Despite accounting for 51% of common cancer deaths, the less survivable cancers still suffer from low awareness amongst the public and health practitioners. Delays in diagnosis have a detrimental effect on survival of these rapidly-advancing diseases, which are currently difficult or impossible to treat at later stages.

If you have a less survivable cancer, you are twice as likely not to be diagnosed until your symptoms are severe enough to go to hospital, compared to someone with a more survivable cancer. Late diagnosis and a slow pathway to treatment can severely limit treatment options for patients, who then face poorer survival prospects.

The Less Survivable Cancers Taskforce have put together key facts for each of the six cancers.

Click on image to view the GEMS video or use the link below.

The risks of targeting the wrong cancer 

Cancer patients often have to undergo rigorous, exhausting treatments and drug regimes, without achieving the improvements or remission that they seek. This is because certain therapies only work on a particular subset of cancers, based on the specific genetic mutations that the cells contain – if the cancer does not contain such mutations, the drug may be pointless. Moreover, patients who lack the mutation targeted by a drug will not only fail to benefit, but can actually be harmed by inappropriate targeted therapies.[1] Therefore, it is essential that cancer treatments are tailored to each patient’s cancer, to save not only NHS money, but personal suffering too.

Biobanks and genetic profiling

In the UK (and worldwide), there are many tissue biobanks that contain tumour samples for research purposes, such as the Manchester Cancer Research Centre Biobank which brings together organised tissue sample collection across four NHS Trusts under one centralised framework.[2] Biobanks provide an essential service to scientists seeking to perform research on tumour samples to discover new genetic variants or ‘biomarkers’ that could serve as targets for new cancer therapies. In 2013, Genomics England was established to deliver the 100,000 Genomes Project, which aimed to sequence 100,000 whole genomes from NHS patients with rare diseases and common cancers.[3] Tumour data from this project has been used for pan-cancer genome analysis, which looks at the complex patterns of genetic changes specific to different tumour types.