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Cancer Screening Take Up Rates Are Falling.
I am feeling well. YES – I AM FEELING WELL – VERY WELL AND I have cancer!
It has been strange for me this year as I learned in February that I have a tumour with some smaller deposits in my abdomen and in my lungs.
Well because here we are in November and I still have not got any symptoms and YES I am still feeling well – even though my treatment has now started.
No symptoms – but a secret, silent, hidden cancer.
I will tell you my story below – but first of all let me explain why I am writing this blog.
[The figures I quote in this blog are from UK studies]
50% of Briton’s will be diagnosed with cancer in their lifetimes. So this is an issue which will affect every family.
But even with this alarming statistic I read this in the paper this week: levels for breast cancer screening are at their lowest for a decade according to NHS digital data. NHS figures showed uptake of screening checks for cervical cancer fell for the fourth year to hit 71.4% in 2017-18.
What a crying shame as early cancer diagnosis makes all the difference to treatment outcome.
In fact – UK cancer survival rates have fallen to the bottom half of world league tables for seven cancers and only come in the top 10 for two.
This is really disturbing when you look at what is possible with early detection and screening.
A pilot program in Manchester recently scanned more than 2500 people in three deprived areas of the city where lung cancer is more prevalent and discovered 46 cases of cancer. Of these 80% were early stage one, the scheme funded by the Manchester Clinical Commissioning Groups and Macmillan Cancer Support has quadrupled the early diagnosis rates for lung cancer in Manchester
The difficulty is that the majority of cancers present with vague symptoms and are much more likely to be something else.
- headaches are rarely brain tumors,
- abdominal pains, rarely bowel cancer,
- lower back pain and tightness, rarely, kidney cancer
GPs (doctors) are gatekeepers and have to decide which merit urgent investigation. Money and politics get in the way! Why the GP practices are not working well to achieve good fast referrals will be for another blog.
This week, the former National Director of cancer Professor Sir Mike Richardson published a report on how NHS treatment could be transformed and speeded up. It is driven by the new understanding that delays of a few months really matter. It requires a radical rethink, including investment in many more machines and staff so that diagnostic tests can be done far more rapidly alerting people to the importance of having their symptoms seen at the earliest point, more screening and specialist cancer centers and pushing GPs to refer anyone whose chance of cancer is higher than 3%.
Let Me Tell You My Story Which Has a Quirky Twist and a Touch of Romance.
I had cancer of the kidney five years ago, which I discovered through finding blood in my urine. So I had a clear symptom and followed up right away. I had that kidney removed and have been for yearly follow up since.
This year was the fifth anniversary, and in February I went along to see my consultant surgeon, Mr Wedderburn at Bournemouth hospital.
All was looking good – bloods were fine, my renal function from the remaining kidney was good. I felt well. So Mr Wedderburn said that he would get a scan done and if that was ok I could be discharged from his care.
Three days after I had the scan a letter arrived with an appointment (I nearly wrote invitation :-)) to see the consultant. It had been two years since my previous scan and a tumour had not been apparent at all then. However now two years later there was a growth near to where the kidney was originally – but also there were some new small deposits including in my lungs.
The thing to stress is that from that day in February right through to this day in November – I have had no indication or symptoms that anything is wrong. Everything normal, pilates classes, badminton and daily walks all carried on as usual. A strange situation really – knowing you have cancer but totally well. A fortunate scan giving earlier warning and earlier treatment.
Isn’t Life Strange – Location – Randomisation – ROMANCE thrown in.
Bournemouth – 5 miles from home
My starting point was locally. I was referred to Dr Delgart an Oncologist at Bournemouth.
In a nutshell – the cancer cells that I have are papillary. Now that apparently is not good as clear cancer cells respond more easily to the standard treatment currently available. Trust me to have the wrong sort!
However the doctors world being very research based meant that Dr Geldart had colleagues working elsewhere that were doing clinical research into the papillary cells that I have.
Southampton – 30 miles from home
So from Bournemouth – I was referred to Dr Wheater in Southampton where they were hoping to start the new clinical trial in September.
The study has a great name SUNNIFORECAST which is a European randomised phase 2 study of Sunitinub/Ipilumumab immunitherapy. Basically attacking the tumours with two antibodies at the same time.
I had another scan arranged for September and with a bit of luck I would meet all the right criteria (checking other things medically such as my heart background – heart attack and stroke in the past!) That scan showed that the tumour was growing slowly.
However a disappointment. In September it became clear that the clinical trial was not going to start till next year.
BUT here was the big surprise for me!
Dr Wheater also had a colleague who was going to start the Clinical Study in London at the Royal Free Hospital and that had the go ahead to start in November.
Royal Free Hospital – Hampstead, London – 120 miles from home
The Royal Free is a 120 mile journey from my home in Poole – but the thing that made it attractive was because I had worked there for four years as a Charge Nurse on a Surgical Ward in the 1970s.
I had also met my wife Barbara there as she was a student nurse when I first got to know her. She came to work on my ward as a staff nurse when she finished her training and – well – I was her boss then. (Guess she is the boss now). Love her.
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Anyway it is an area of London we both love. I was due to start my treatment at the Royal Free on Monday and so we made a weekend of it. We spent last weekend around Hampstead and the picture is me and Babs with our daughter Zoe and a friend of hers.
My Clinical Trial For a New Combination Of Immunotherapy Infusions.
Doctor Boleti is my new Oncologist and she has a terrific team at the Royal Free. My real champion has been the renal cancer research nurse Anna Pejovik who has arranged tight schedules for investigations and frankly everything!!
I had one concern because there is a slight lottery about all of this.
It is a randomised trial and there is a chance that you will be selected for the old treatment rather than the new therapy. I prayed that the computer would pull my name out and it did. A week ago Anna rang me to say that I would be getting the new combination immunotherapy and it would start on Monday.
After the treatment on Monday all has been well. No side effects to date! AND Yes I am Feeling Well!
I Am Telling My Story Here For a Couple of Reasons.
1. Cancer Treatment is changing fast and Immunotherapy is the name of the game.
My journey over just a few months show how much is changing and new treatments are emerging all of the time. Dr Boleti told me that dealing with cancer is like control of any chronic condition, and that most people will die from some other cause.
In last weekends Times Supplement there was an article about James Allison who was one of the first research scientists looking into Immunotherapy.
The long article was entitled (which I can’t give you the URL link because it is a paid subscription)
‘Immunotherapy could revolutionise care for cancer patients. So is this the end of chemotherapy as we know it?’
Quote from Times Article:
Cut, burn, poison, aka surgery, radiation and chemotherapy, were the options for cancer sufferers. But one man had other ideas. James Allison pursued his belief in immunotherapy for years when the medical world was doubtful. No longer. Last month he won the Nobel prize for medicine (with help from his brilliant colleagues and brainy wife – Dr Sharma). Now his research is changing everything we know about treating cancer.
What do I owe this man and his team?
And yes, it is quite amazing that treatments like the chemotherapy treatments (which I was involved with at times in my nursing days) that we hear about from the past, which were pretty onerous and very toxic drugs – have now been replaced by much better treatments.
2. Cancer Screening
I was lucky because my original cancer was obvious because of the bleeding. The cancer this time was not obvious but post surgery after care highlighted the problem.
So I got my scan 9 months ago and the secret, silent, hidden cancer was revealed. If my cancer had got to the stage where I was showing symptoms … need I say more.
The answer is to really improve our screening rates. Get those take up figures rising.
Depending on your age, sex, occupation – there are various screening checks available. PLEASE seek them out and give yourself a better chance of picking up any issues early.
Cancer Screening picks up the problems before symptoms occur and at an early stage where the treatment and control will have a better chance to work. The solutions and treatments are improving daily.
Big Letters to Shout Again – KEEP YOUR SCREENING UP TO DATE!
Please share this blog message – it is so important to emphasise the need for early access.