The Institute of Cancer Research is calling on the NHS to make sure that delays in cancer surgery don’t cost more lives than the number of Covid-19 patients saved.
The Institute’s Prof Clare Turnbull says that in some cases, a three-month delay to cancer treatment could make the difference between a tumour being curable or not. The Institute’s projections suggest that delaying surgery could lead to thousands of additional deaths.
Many cancer patients have had their treatment delayed due to resources being switched to coronavirus care, and by the end of April, cancer referrals had dropped by an estimated 70 percent.
Prof Turnbull says it’s particularly important that as normal service resumes, priority is given to cases of lung and colorectal cancer which can be particularly fast-moving, while others such as prostate and some breast cancers can safely be delayed.
According to the Institute’s estimates, for every 10 Covid-19 patient whose lives are saved in hospital, four cancer patients could die if tumour-removal surgeries are delayed by six months. Normally there are 95,000 operations to remove common cancers in adults in England each year, and of these, more than 80,000 patients survive for at least another five years. The ICR study suggests that a three-month delay could lead to almost 5,000 excess deaths, and a six-month delay to almost 11,000.
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An NHS document advises healthcare providers to decide which patients will receive cancer treatments if services are overwhelmed. It also urges them to “make contingency plans for supply chain issues”.
It said: “It is suggested that clinicians begin to categorise patients into priority groups 1-6”, with top priority given to chemotherapy that is seen as “curative therapy with a high (>50 per cent) chance of success”. If a patient is receiving palliative cancer treatment with little chance of surviving more than a year, they will be given lowest priority.
Similarly, providers have been told to deprioritise patients receiving radiotherapy treatments to reduce the chance of cancer returning within 10 years.
While some patients may be given chemotherapy or hormone therapy as an interim measure, or moved to another hospital for treatment while surgery is delayed, NHS Trusts have been told that all essential cancer treatments must continue.
The NHS said: “Vital tests and treatments are going ahead in a safe way for thousands of patients, including by introducing Covid-protected cancer hubs.
Tests and treatment
“The NHS has now set out guidance so that hospitals can further increase the number of cancer tests and treatments they carry out, as well as having the extra capacity to treat future coronavirus patients.
“So our message to anyone worried about symptoms is, ‘Help us help you, and seek help as you always would.”