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Covid vs. Cancer
 

Cancer Care

 

The idea of trading Covid vs. Cancer should be anathema to the British people.  It goes against one of the Core Values of the NHS, which is that:-

"We maximise our resources for the benefit of the whole community, and
make sure nobody is excluded, discriminated against or left behind."

Yet 'excluded' and 'left behind' is what has been happening since the start of the pandemic.  The initial and necessary rush to create Nightingale hospitals and ensure that there were enough intensive care beds for the populace, has ossified into an unthinking view that Covid-related deaths are more important than those from any other cause.

This has caused a decreasing level of care for Cancer patients, combined with political messaging from the Government that resulted in some potential patients not coming forward for diagnosis.

It is time to revisit this and reset the situation.  This is particularly important with Cancer, where early and correct diagnosis is such an important part of the outcome.  One feature of Covid is that seriously ill patients don't need telling that they should present themselves to hospital and seek help.

This page is provided by Industry-19 to demonstrate the case for an alternative and better way forward, as called for by the wider Cancer community.

 
 
 

Covid vs. Cancer
 

Background

 

The world of Cancer care and support is surprisingly fragmented.  In the UK the two largest charities attract the most attention, while numerous smaller charities carry on their work in parallel.  Each of these focuses on their particular aims, such as nursing or children for example, creating a distributed, "market economy" type of support infrastructure.

Academic researchers are pursuing the subject, and drug companies are in competition with each other to develop treatments, but this is the same for all illnesses.  Pharma companies did collaborate much more openly in the quest for a Covid-19 vaccine [i], and it is an interesting question whether they might create better treatments for Cancer by collaborating in a similar way, but that is a wider issue.
[i]:  The Association of the British Pharmaceutical Industry.

The NHS is the primary medical care provider, and also the arbiter of how much care is provided. And as the NHS follows Government instructions, it is at the Government level where change must be applied.

So far there has been no single voice representing patients as a whole, and as yet there is no clearly-defined course of action to remedy the situation.

 
 
 

Covid vs. Cancer
 

The Case for Change

 

Examples of people dying preventable deaths, simply due to late diagnosis, are everywhere.  In his article, Fraser Nelson (see Journalism) quotes one from his own experience, and goes on to say: I was thinking of her yesterday, when a study came out showing that 18 per cent fewer people were diagnosed with cancer last year – and you can bet that’s not because of a sudden plunge in illness. For breast cancer, it was 29 per cent. Prostate cancer: 51 per cent. We can only guess how many will now die who might have been saved. An estimate in The Lancet Oncology has put the total at about 3,500 avoidable cancer deaths from the first wave alone.

[...] Not so long ago, we saw official adverts urging us to seek NHS care if we felt a suspicious lump. Now, adverts in bus stops show the face of a Covid patient with an oxygen mask asking us to “look him in the eyes” and say if our journey is necessary. This changes the mood – and will obviously have consequences. Positive and negative.

There are two photos of similar young people in Angus Dalgliesh's article in the Daily Mail [ii].  He is a professor of oncology at the University of London, and he expressed it in more detail.

As the second wave of Covid-19 retreats, the devastating impact on cancer patients is becoming ever more apparent. We are now facing a savage new health crisis, one which may prove even more destructive than the pandemic itself. Life-saving operations have been postponed, vital treatments delayed and new cases missed as screening programmes have been cut back and GPs refer fewer cases.

He refers to a letter signed by 75 MPs, and backed by cancer charities, in which they warn that the current ‘Covid-induced’ backlog could lead to at least 35,000 excess deaths, but says: I fear that the signatories to the letter are greatly underestimating the scale of the problem. From the evidence I have seen, cancer referrals are down by no less than 50 per cent over the last quarter in many parts of the country, while cancer waiting times are now at their worst level on record. There isn’t a single NHS cancer specialist who hasn’t witnessed the suffering caused by this crisis.

Such agonising ordeals are being repeated thousands of times nationwide. [...] The tragedy is that if cancer is caught early, patient outcomes can be very positive because of the huge advances made in surgery, screening, scans, and chemotherapy. The dark days of 40 years ago, when a cancer diagnosis was likely to be a swift death sentence, have passed. Yet due to Covid hysteria we are squandering those gains.

There is another aspect to the crisis which illustrates the negative consequences of the Government’s anti-Covid propaganda. It is the incidence of cancer patients themselves cancelling their scheduled hospital operations because they fear catching Covid. That might seem a bizarre overreaction given that Covid – even for vulnerable people – is rarely fatal, while untreated cancer is a certain killer.
[ii]:  Professor Angus Dalgleish, Daily Mail, 18 February 2021.

For a more in-depth picture of the impact of Covid policies on Cancer care there is also a survey that was carried out by Cancer Research UK in May 2020 [iii].  This runs to 31 pages, but conveys a similar message.
[iii]:  The impact of COVID-19 on cancer patients in the UK, July 2020.

Perhaps another illustration is Public Health England's own Campaign Resource Centre, which positions Covid-19 above all other health campaigns put together.

 
 
 

Covid vs. Cancer
 

Medical Fairness

 

In order to rectify the situation, we need to step back and look at the whole picture.  Detailed instances are evocative, but they cannot be used to set national policy.

Furthermore, Cancer is not the only serious illness to have been neglected during the pandemic. However, if we deal with Cancer it should correct the approach for everyone else.

Returning to the starting premise (above) that:-

  1. the NHS makes sure that nobody is discriminated against; and,
  2. the fact that the NHS is merely following Government instructions;

then it is clear that the Government must cease to be biased, if it is to meet its own obligations of impartiality across the country.

 
 
 

Covid vs. Cancer
 

Corrective Action

 

It is not enough just to lobby for change - the Government will only enact change if it is shown how to do so.  At present there are too many voices, in the Cancer field and beyond; and MPs are overwhelmed. Proponents of Cancer care need to produce a concentrated and specific set of instructions for the politicians to follow.

We therefore need to pull together as many as possible of the Cancer care proponents, and define what actual changes the Government needs to make.

Industry-19 can provide a platform for this.  This begins with a Survey to poll the views of stakeholders and experts.  It could lead to a Task Force that will take a more clinical and in-depth look at the statistics and options.

 
 
 

Covid vs. Cancer
 

Covid vs Cancer Survey

 

The Covid vs Cancer Survey ran for 6 weeks during March and April, across the UK.  Its purpose is to establish whether there is a problem; if there is a problem, how does it manifest itself; and, if problems exist, what should be done to correct them.

The Survey collected respondents' views on some very straightforward questions:-

  • Has Cancer care deteriorated because of the response to Covid-19?
                     and if so:-
  • What are the main reasons?
  • What specific problems have occurred, and how could they be fixed?
  • What policies does the Government need to change?
  • What policies does the NHS need to change?
  • What wider improvements would also make an impact?

The Survey was constructed as an unbiased and dispassionate method of gathering informed views about the current situation.  No assumptions were made about the answers or the outcome.  A copy of the document that people filled in is still available via this link, though the Survey itself is now closed.

 
 
 

Covid vs. Cancer
 

Survey Results

 

The Survey was made available in the form of a Word document that respondents could download, complete, and return via email. This method, rather than an on-line response, was chosen deliberately in order to maximise the thought and expression that respondents could apply to their answers.

All of the respondents to the Survey have a direct and significant involvement with Cancer care as it has been enacted during the pandemic restrictions. The spreadsheet was processed to capture as many of their views and suggestions as possible, and the findings are presented in the Survey Results document.

Covid vs Cancer Survey Results  

The Survey Results show the scale and extent of the problems facing Cancer treatment.  Of its 36 pages, 24 are, in essence, a listing of what is wrong and what needs to be redressed, under 15 different subheadings.

 

As such, this is probably the most comprehensive sector-wide report on the UK Cancer situation that has ever been produced.

 

The most obvious cause of problems is the severe impact that the reaction to Covid has had on the whole Cancer environment; reinforced by the messaging and the response of the media.  This has resulted in a backlog of treatment that is specific to Cancer, over and above the general increase in NHS waiting lists as a whole.

However, this Survey goes on to show a much wider range of issues that are endemic to the Cancer situation.  These include the lack of leadership within the sector; the lack of focus on, and failures with, the patient experience; and a host of problems with the main players, including Government, the NHS, charities and pharma.  These are compounded in turn by lack of attention to what should be regarded as generic fundamentals of management.

It is not as if these problems are unknown or hidden - they are in plain sight.  The Results Document is simply a collection and presentation of what people already know.  This Survey, therefore, shows what "something needs to be done" actually is.  In so doing it lays bare the extent of the problems and the current ineffectiveness of the response.

Download a copy of the Survey Results to see the full details.  (It is also downloadble in PDF format.) If you agree with the results and conclusions, help with the follow-through by keeping up with What's Next.

 
 
 

Covid vs. Cancer
 

What's Next?

 

The Covid vs Cancer Survey was devised, produced and run in partnership with Chris Lewis of Chris' Cancer Community, a major driver for change and improvement in the Cancer sector.

In Chris' words: We want to know exactly what the real issues are according to the people that count. This will then be used to talk to Government and media with evidence. Not only do we want to say how unacceptable the current situation is, but what we need to do to improve it.

The Survey Results are a fixed point of reference that everyone can use as a basis for action.  Follow the progress from here on, and add your input and help, via the web page.

Meanwhile you can send questions, feedback, or comment about the issues that have been raised on this site via i19cancer@industry-19.com.

 

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