Tuesday, 12 March 2019

Britain is no country for old men with bladder cancer

Bladder cancer is the seventh most common cancer in Britain, with just over 10,000 cases diagnosed each year. These are unevenly split between men, for whom it is the fourth most common cancer and women, for whom it is 11th most common cancer. More than twice as many men as women are affected and of those, the age group most affected, are old men between the ages of 75 and 79. About 5,000 men and women in Britain die from bladder cancer each year.

Given the fact that any delay between diagnosis and treatment can be a potentially life threatening for cancer patients, it has now been revealed that patients with bladder cancer are having to wait almost five months, or approximately 150 days for treatment, far beyond the 62 days that National Health Service rules say is the longest delay anyone should face. 

Why is this ?

Well, apparently, people with the disease have been forced to endure this long wait because of a “loophole” in NHS cancer waiting time guidance. This flaw in the guidance means a patient who has had a biopsy, which is a surgical, diagnostic procedure requiring the patient being anaesthetised, is counted as having been 'treated' and thus the 62-day countdown stops and their clock begins again at day one, even though their cancer may have spread and they require further treatment. When that happens they may not undergo treatment for many weeks and sometimes for months.

'NHS Improvement', the health service regulator, acknowledged the problem in a report last year. It found that bladder cancer patients were waiting up to 144 days after being referred to undergo surgery or radiotherapy to tackle their invasive disease.

Jonathan Ashworth, the Shadow Health Secretary, has written to his counterpart in Government, Matt Hancock, urging him to act so that people with bladder cancer start to get their care within 62 days. He said : "I am concerned that this loophole is hiding the true picture of patient waits, concealing the fact that patients with bladder cancer are having to wait nearly five months for their first treatment.” He went on : “However, if the cancer is more advanced, there can be further cancer tissue in the body and patients will, invariably, then need definitive treatment of the cancer, such as surgery or radiotherapy.” 

Old men who have had their biopsy should take note : Surgery usually involves removing your bladder in a procedure called a cystectomy and for your long term prospects, the quicker this is done, the better. Unfortunately, for you the Secretary of State for Health's Department of Health and Social Care did not respond to a request for comment. In fact, the Department of Health and Social Care refused a request to comment, beyond saying said that it had not received a letter from Jonathan Ashworth about the issue.

Andrew Winterbottom, the founder and Director of 'Fight Bladder Cancer', said : “A technical problem with the government’s cancer waiting times guidance makes the NHS’s key 62-day waiting time target for cancer treatment redundant for thousands of bladder cancer patients. We see the impact every day, with vulnerable patients left to wait far too long for potentially life-saving treatment, with devastating results.”

Matt Case from 'Cancer Research UK' said: “Despite the best efforts of NHS staff cancer patients – including patients diagnosed with bladder cancer – are waiting for more than two months to be treated for cancer after an urgent GP referral. Staff shortages are harming the NHS’s ability to diagnose cancer quickly and at an earlier stage.” In fact, waiting times for cancer treatment in England are among the longest they have been since records began.

Having undergone a cystectomy for bladder cancer, preceded by a course of chemotherapy, as a cancer patient, I know from experience that feeling that in my treatment, time was of the essence because, like rust, the bad guys never sleep. I am only thankful that my own treatment in 2016 preceded the emergence of the more recent loophole, which has given rise to the delay in treatment for too many today.

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