22 June 2015
Findings highlight the urgent need for comprehensive plan for care and support for people long after diagnosis
Fewer than one in three people diagnosed with a common cancer at an early stage[i] will go on to survive both long term and in relatively good health, new analysis from Macmillan Cancer Support has found. This is despite their early diagnosis and the cancer not spreading[i].
The analysis, based on the charity’s Routes from Diagnosis research programme, found that while those who were diagnosed early and had cancers that didn’t spread are between four and 13 times more likely to survive long term than those diagnosed late, an ‘unacceptable’ proportion who do survive, do not live in good health. They either live with another serious long-term condition, experience a cancer recurrence, or develop a new cancer[ii].
Macmillan is using the findings to underline the need for people with cancer to receive a coherent, comprehensive plan for ongoing support even after their treatment has finished.
The analysis found that 2 in 3 men (66%) with prostate cancer who are diagnosed before their cancer has spread and whose cancer doesn’t spread will survive seven years or more, compared to just 1 in 20 men (5%) who were diagnosed late. Of those who survive more than seven years, more than half (53%) are in poor health[iii].
Furthermore, the analysis found substantial costs in terms of NHS care for people diagnosed early who survive long-term in poor health, with inpatient hospital care for people in this group who have the three most common cancers amounting to around £270 million per year in England[iv].
Last month Macmillan research revealed that 1.8 million people living with cancer also have at least one other long term health condition[v], further emphasising the critical need for care and support for 70 per cent of the 2.5 million people[vi] currently living with cancer in the UK.
Juliet Bouverie, Director of Services & Influencing at Macmillan Cancer Support, says:
“Life is never the same again for many after a cancer diagnosis, and we have to do more to acknowledge that fact. Carrying on with life as if nothing has happened after cancer treatment is just not possible for thousands of people. Improvements to survival rates – while not as advanced as they should be – mean that people may live for years, even decades after their diagnosis. But many are living with the consequences of their cancer treatment. Our health system has to recognise that people with cancer still have needs years after they are currently being discharged from active treatment.
“Early diagnosis is a crucial component in tackling cancer, but it is sadly not the sole solution. There are 2.5 million people living with cancer in this country, and we need to look at effective solutions beyond early diagnosis. Macmillan wants to see every one with cancer have access to the right care and support, to live well after treatment. This should include a recovery package, including a holistic needs assessment, to ensure that people are able to manage their health, and achieve the best possible quality of life.”
Angela Armstrong, 49, from Essex, thought she had put cancer behind her, after being diagnosed early and undergoing a mastectomy, chemotherapy and radiotherapy in 2005, resulting in hospital treatment for lymphoedema. She even had a preventative hysterectomy a year later and was given the all clear. However the cancer came back 10 years later.
She said: "After having such aggressive treatment 10 years prior, I obviously didn't think it would ever come back. I was just devastated.
"It had been such a long, hard, journey through gruelling treatment and so it was overwhelming to think that I would be going back through it again. I wondered what I had done wrong, but it is just one of those unfortunate things. This is what happens for some people."
For further information, please contact:
Patrick Pringle, Media & PR Officer, Macmillan Cancer Support
0207 840 4891 (out of hours 07801 307068)
Notes to Editors:
[i] New unpublished Macmillan analysis from the Routes from Diagnosis research programme, undertaken by Monitor Deloitte for Macmillan Cancer Support. The three most commonly diagnosed cancers in the UK are breast, lung and prostate cancer. 31% of people diagnosed with non-metastatic prostate cancer that doesn’t spread live seven years or more and in good health, defined as follows:
• Not developing metastatic disease or experiencing a second cancer, and having no serious health conditions after diagnosis. ‘Serious health conditions’ are defined as a range of health conditions that the Routes from Diagnosis programme’s clinical advisory group felt were clinically important for people living with each type of cancer, according to the following three inclusion criteria: common conditions likely to be more prevalent for people with that type of cancer compared with the general population; common conditions likely to affect treatment decisions; or common conditions related to complications or long-term consequences of cancer or its treatment. The condition is then only included in the Routes from Diagnosis analysis if it is recorded in the patient’s hospital record (specifically their inpatient Hospital Episode Statistics (HES) entry). Therefore although this list is comprehensive, due to data availability it will not identify morbidity which presents outside of a hospital setting - which includes e.g., anything which may be seen by a GP but not the hospital, and any condition that is not reported to a doctor.
The same percentage for people diagnosed with non-metastatic breast cancer is 26%, and 1% for non-metastatic lung cancer [ii] 66% of men diagnosed with non-metastatic prostate cancer will survive seven years or more, compared to just 5% of men diagnosed with metastatic prostate cancer. This equates to a thirteen-fold difference. Of those who are diagnosed with non-metastatic disease and survive seven years or more, 53% are in poor health, defined as having at least one of the health conditions described in reference 1.
For breast cancer, 83% who are diagnosed with non-metastatic breast cancer will survive for seven years or more, compared with 18% diagnosed with metastatic breast cancer. This equates to a five-fold difference. Of those who are diagnosed with non-metastatic disease and survive seven years or more, 69% will be in poor health.
For lung cancer, 7% who are diagnosed with non-metastatic lung cancer will survive for seven years or more, compared with 2% diagnosed with metastatic lung cancer. This equates to more than a three-fold difference. Of those who are diagnosed with non-metastatic disease who survive seven years or more, 82% will be in poor health.
[iv]Inpatient hospital care for people with breast, prostate and lung cancer who survive at least seven years from diagnosis in poor health is £198.8m a year in England, compared with £23.6m for people who survive at least seven years in good health (definitions of ‘good’ and ‘poor’ health as per reference 1). Projection for 2015. Macmillan and Monitor Deloitte estimate based on known cancer prevalence (Maddams J, Utley M, Møller H. Projections of cancer prevalence in the United Kingdom, 2010-2040. Br J Cancer 2012; 107: 1195-1202). The cost comes from inpatient data only so excludes the large proportion of chemotherapy or radiotherapy delivered in an outpatient setting. It reflects the cost to the NHS budget, i.e. what commissioners pay hospitals to provide the care based on the NHS National Tariff, rather than the exact cost to hospitals of providing the care.
[v] Macmillan Cancer Support. The burden of cancer and other long-term health conditions. April 2015 http://www.macmillan.org.uk/Documents/Press/Cancerandotherlong-termconditions.pdf
[vi] Maddams J, Utley M, Møller H. Projections of cancer prevalence in the United Kingdom, 2010-2040. Br J Cancer 2012; 107: 1195-1202. (Projections scenario 1). Macmillan analysis based on extrapolation of 2010 and 2020 projections that the number of people living with cancer will hit an estimated 2.5 million in 2015.
About Macmillan Cancer Support
When you have cancer, you don’t just worry about what will happen to your body, you worry about what will happen to your life. Whether it’s concerns about who you can talk to, planning for the extra costs or what to do about work, at Macmillan we understand how a cancer diagnosis can take over everything.
That’s why we’re here. We provide support that helps people take back control of their lives. But right now, we can’t reach everyone who needs us. We need your help to make sure that people affected by cancer get the support they need to face the toughest fight of their life. No one should face cancer alone, and with your support no one will.
To get involved, call 0300 1000 200 today. And please remember, we’re here for you too. If you’d like support, information or just to chat, call us free on 0808 808 00 00 (Monday to Friday, 9am–8pm) or visit macmillan.org.uk