More cancer patients cured – but Britain lags behind
MORE cancer patients are now being cured across Europe thanks to improved care and awareness of the disease, research revealed yesterday.
The Eurocare report – the widest study on the survival of people with cancer in Europe – found the proportion of patients becoming free of the disease had risen significantly in the space of a decade.
But the report, published in the European Journal of Cancer, also found wide variations between countries, with Scotland and England lagging behind some of the best survival rates.
Experts said that with increased funding now going into the health service in the UK, survival rates should be catching up with the best in Europe and would improve further in the future.
The researchers, based in the UK and across Europe, used information from cancer registries to assess cancer survival between 1988 and 1999.
But rather than basing survival rates on the proportion of patients alive five years after diagnosis – a measure traditionally used by researchers – the team tried to estimate the number of people actually cured of the disease.
They worked this out by looking at the survival of cancer patients compared to the rest of the population. Those with a life expectancy equal to others without cancer were deemed to be cured of the disease.
Focusing on three types of cancer, the researchers found significant increases in survival.
Between 1988-90 and 1997-9, the proportion of patients estimated to be cured of lung cancer across the 23 European countries increased from 6 per cent to 8 per cent.
For stomach cancers, the cure rate increased from 15 to 18 per cent in the same period, while colorectal cancers went up from 42 per cent to 49 per cent.
The findings back up earlier figures showing rapid improvements in survival since the 1970s and earlier.
For example, in 1971 there were 30 deaths from colorectal cancers per 100,000 people in the UK, but by 2006 this had dropped to fewer than 20.
Professor Michel Coleman, from the London School of Hygiene and Tropical Medicine, said that while the research did not include figures to show improvements across each country, survival rates in the UK were also improving.
"There's no question that the UK is getting better," he said.
"The improvements are down to the better organisation in the management of cancer patients, as well as better surgery and more widespread use of radiotherapy."
But Prof Coleman said researchers still needed to answer the question of whether the situation in the UK was improving as much as in other countries.
The researchers estimated the proportion of cases cured in the different countries during the period 1988 to 1999, showing wide variations across Europe.
For lung cancer, the proportion of patients cured in Scotland was 5 per cent. This compared to a high of 10 per cent in France and Spain, but was higher than the 4 per cent reported in countries such as Poland and the Czech Republic.
For breast cancer, 66 per cent of Scottish women were estimated to be cured. This compared to 73 per cent in countries including Finland, France and Spain. The lowest rate was 55 per cent in countries including Slovenia and Poland.
Dr Riccardo Capocaccia, from the National Centre for Epidemiology, Surveillance and Health Promotion in Rome, said difference in breast cancer survival could be explained by different approaches to the disease.
"Part of this difference has been attributed to the introduction of breast cancer screening from the mid-1990s in several western European countries," he said.
Prof Coleman said working out why countries like Scotland had lower proportions of cured cases was complex.
"The differences in survival and cure between Britain and other countries may relate to the way in which people get diagnosed early or late," he said.
He also said that until recently, the UK had put less money in the health service compared to other nations, particularly Nordic countries. But funding for the NHS had gone up significantly in the last five to ten years and future survival figures should reflect this investment.
Kate Seymour, of Macmillan Cancer Support in Scotland, said that the rising number of patients being cured of cancer was "fantastic".
"It is obviously great that more people are surviving cancer, but with the incidence of cancer expected to increase we need to make sure there is support for the survivors who may have other problems linked to their cancer," she said.
Harpal Kumar, Cancer Research UK's chief executive, also welcomed the improvements.
But he added: "We also need to improve access to the world-class cancer services that are available in this country – by reducing radiotherapy waiting times, investing in the training and specialisation of surgeons, driving recruitment to clinical trials and increasing the UK's cancer drug spend up to the average of western European countries."
Ian Beaumont, from Bowel Cancer UK, said: "England and Scotland fare reasonably well overall in terms of the proportion of cured cases of colorectal cancer, but the UK still has considerable catching up to do in comparison to the rest of western Europe."
A Scottish Government spokeswoman said: "Cancer remains a top clinical priority for Scottish Government and NHS Scotland.
"Better Cancer Care: An Action Plan, published in October 2008, set out the Scottish Government's plans for cancer services over the next 3-5 years.
"Better Cancer Care acknowledged there are some cancers where we are doing well and also others where Scotland could improve, in terms of incidence, survival and mortality. The commitments given around prevention, screening and early detection in particular will go towards achieving improvements in cancer statistics in the future.
"It is very encouraging that in general survival is improving."
Five reasons why cancer cures are up
Scientists are investigating hundreds of molecules with the potential to become new cancer drugs. In recent years, more targeted drugs such as the breast cancer treatment Herceptin have helped improve chances of survival. One concern is that the rising cost of more innovative treatments will not be possible within the NHS's budget. The Scottish Government is considering using deals with the pharmaceutical industry which would share the costs.
Many international studies have been conducted to determine the best methods of treating and managing cancers. These include pursuing the most effective use of radiotherapy and surgery.
A more targeted form of radiotherapy known as intensity modulated radiation therapy (IMRT) is now helping doctors to give higher doses of radiation directly where they are needed. This reduces the side-effects suffered by the patients and also cuts damage to health tissue. It will be rolled out across Scotland once enough staff are trained.
There are currently three screening programmes for cancer running in the UK, for breast, cervical and bowel cancers. While screening for bowel cancer is still at an early stage, evidence from the breast and cervical programmes show more women are being diagnosed earlier and improving their chances of survival in the future. Recently research has suggested that screening programmes could also potentially be introduced for ovarian and prostate cancer, though this is still at an early stage of development.
Increased education about the signs and symptoms of cancer has encouraged patients to come forward earlier than in the past. While there is evidence that some people are still not fully aware of all cancer symptoms, high-profile campaigns have led to more patients being diagnosed quicker and starting treatment sooner. Efforts to encourage women to be aware of changes and lumps in their breasts, as well as raising awareness of the dangers of sun exposure and changes to moles on the skin, have helped increase knowledge of different cancer signs.
The last decade has seen the NHS across the UK putting more funding into tackling cancer. Money has helped improve facilities for treating cancer patients as well as allowing research to look for new treatments and cures. The UK governments have also published various cancer strategies over the years to improve survival rates. Most recently in Scotland, the Scottish Government published Better Cancer Care: An Action Plan last October, setting out plans for the next three to five years. This included attention being given to prevention, screening and early detection.
'You just have to take it on and get through it'
WHEN Hazel Caswell was given the all-clear from cancer she said she felt like she was "walking on air".
After being diagnosed with colon cancer almost five years ago, the 57-year-old underwent surgery and chemotherapy.
She said the experience of fighting cancer – and beating it – meant that she was no longer afraid of taking the disease on.
Ms Caswell, who lives in Leith, was diagnosed with cancer after she had suffered a number of nasty symptoms.
"I was losing weight, I was feeling sick and I had the most chronic pains," she said. "It was just very, very bad.
"I knew I was desperately ill and just wanted someone to say what was wrong."
An exploratory operation revealed that she had cancer of the colon and a tumour was removed.
She then had chemotherapy, but said she did not find the treatment as gruelling as some patients and did not lose her hair.
After several years of regular check-ups at the Western General in Edinburgh, Ms Caswell was given the all-clear in January last year.
"I thought I was going to leave in trepidation, but I was just walking on air," she said.
"I am not worried about having cancer again. Having been through it, I see it as being just a disease. I was very lucky that my cancer was treatable."
Ms Caswell, who works at the Cancer Research UK shop in Stockbridge, said being diagnosed with cancer was a roller-coaster.
"You just have to go through it. You can't go around it or under it," she said. "You just have to take it on and get through it."
Each year, more than 36,500 people are diagnosed with bowel cancer in the UK. About 16,000 people die from the disease annually.
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