- New research reveals that 40% of people with cancer in the UK have struggled to access treatment or care because of where they live.
- Cancer patients talk of long journeys, increased stress and exhaustion and having to be “in the right place, at the right time” to get the treatment they need.
- The leading cancer charity is calling for urgent action to tackle variation in cancer care, with Dr Anthony Cunliffe, Macmillan’s Lead Medical Adviser, saying: “We need to see urgent action taken to make cancer care fair. Everyone with cancer should get the best possible care the UK has to offer. Everyone should get the treatment that is right for them. No-one should get left behind simply because of where they live.”
Macmillan Cancer Support is warning that almost 1.4 million people with cancer across the UK (40%) have been let down by a ‘cancer postcode lottery’, as people struggle to get the treatment and care that’s right for them, simply because of where they live[i].
The charity says inconsistent cancer care is leaving some people with cancer with fewer treatment options, and very little choice but to travel long distances for the treatment they need[ii]. Many face increased costs, stress, anxiety and exhaustion as a result[iii].
At its most extreme, the UK’s ‘cancer postcode lottery’ could be putting an estimated 100,000 lives at risk, with the charity’s latest survey showing some people with cancer (3%) have had to turn down critical cancer tests and treatment simply because they lived too far away[iv].
The charity says that urgent action is needed to make cancer care fair, with additional analysis revealing how an estimated 60,000 more people each year across the UK would get the timely cancer treatment they so desperately need, if cancer waiting times where they lived matched the same standards being set by the best performing areas in the country[v].
Macmillan’s new data suggests that inconsistencies in the availability of well-established cancer treatment and care options, as well as differences in the roll-out of innovative new treatments, could be having a very real impact on people’s experiences, the outcomes that can be achieved for them as well as their long-term recovery and quality of life.
Lisa Martin, 45, from Lancashire was diagnosed with head and neck cancer in 2018 and was one of the ‘lucky few’ who was able to benefit from robotic surgery. She said:
“All I can say is that I was in the right place, at the right time and was given the option to explore robotic surgery — without that, I don’t think I would still be here today.
“My surgery took just 45 minutes, helping me to avoid hours of radical surgery and so many of its life-changing and life-long side effects. Without it I could’ve lost my teeth, had no saliva for life, lost a lot of feeling in my face and I might’ve had to live my life being fed through a tube.
“I know the treatment I received might not be the best medical option for everyone, but I do believe that everyone with cancer should at least have the same access to all the possibilities that exist in cancer care. Where you live should never limit what is available to you, reduce your chances, or make life with and after cancer so much more difficult to cope with.”
Macmillan’s new survey reveals that 54% of people with head and neck cancer have been affected by variations in cancer treatment and care, significantly higher than the average for people with cancer[vi]. The charity says that while newer treatments such as robotic surgery might not be the right option for everyone, they should be made available for those who would benefit.
Shaun Doherty, 38, from Strabane in Northern Ireland, underwent traditional and invasive surgery for head and neck cancer in 2025. He said:
“After discussing my treatment, a potential 18-hour surgery involving removing part of my jaw and rebuilding it using bone from my leg, I realised how serious it was and was grateful for the experience and skill of the team I was under.
“I knew the potential for complications, but I decided to go ahead with the operation. The operation involved a surgeon opening my neck and removing my original jaw and lymph nodes, while another surgeon removed the fibula from my left leg to aid in the reconstruction of the jaw that had been removed, along with the insertion of a titanium plate.
“This treatment was the only option available to me, and I’d never even heard of robotic surgery until recently. The experience has had a big impact on my life. The structure of my jaw has changed, so my ability to chew will never be the same. Additionally, the nerves in that area have been removed, so something as simple as a kiss with your partner is different now. We jokingly call them 50% kisses as I only feel on my top lip, but I am so grateful to be here. 50% kisses beat no kisses any day of the week.”
Macmillan has committed itself to achieving a revolution in cancer care and says tackling the UK’s ‘cancer postcode lottery’ will play a vital role in achieving this.
Only recently, the charity teamed up with AstraZeneca to look at biomarker testing — a type of cancer testing that can help make peoples’ cancer treatment much more precise. Their research found widespread variation in the speed of biomarker testing results across the UK, which means some people might get highly effective and tailored cancer treatment, while others might start cancer treatments that may never even work for them. The charity is now working in partnership to deliver solutions to improve the situation across the UK.
Alongside its funding for local community groups, increased numbers of Macmillan badged professionals working across the UK, and the launch of a range of specialist new services like a dedicated head-and-neck service in Northern Ireland, the charity says it is not only working to support those who need them the most today, but also looking to tackle the root causes of poor cancer care to improve things for people in the future.
Macmillan is now calling for urgent action from governments and partners across the UK who are involved in delivering cancer care to help tackle widespread variation in cancer diagnosis and treatment — to make sure every person with a cancer diagnosis can get the best possible care, no matter where they live.
Dr Anthony Cunliffe, Macmillan’s Lead Medical Adviser, said:
“As a GP, the fact that where you live can have such a huge impact on your cancer experience really does worry me. But the reality is that for too many people with cancer it has begun to feel like a game of chance — a ‘flip of a coin’ and a need to be ‘in the right place, at the right time’ — when it comes to getting the treatment and care they need.
“We need to see urgent action taken to make cancer care fair. Everyone with cancer should get the best possible care the UK has to offer. Everyone should get the treatment that is right for them. No-one should get left behind simply because of where they live.
“At Macmillan, we are trying to bring UK decision-makers, people with cancer and local communities together to make sure that well-established cancer treatments and tests are made equally available to everyone.”
For information, support or just someone to talk to, call Macmillan Cancer Support on 0808 808 00 00 or visit macmillan.org.uk/whateveryouneed
The charity says inconsistent cancer care is leaving some people with cancer with fewer treatment options, and very little choice but to travel long distances for the treatment they need[ii]. Many face increased costs, stress, anxiety and exhaustion as a result[iii].
At its most extreme, the UK’s ‘cancer postcode lottery’ could be putting an estimated 100,000 lives at risk, with the charity’s latest survey showing some people with cancer (3%) have had to turn down critical cancer tests and treatment simply because they lived too far away[iv].
The charity says that urgent action is needed to make cancer care fair, with additional analysis revealing how an estimated 60,000 more people each year across the UK would get the timely cancer treatment they so desperately need, if cancer waiting times where they lived matched the same standards being set by the best performing areas in the country[v].
Macmillan’s new data suggests that inconsistencies in the availability of well-established cancer treatment and care options, as well as differences in the roll-out of innovative new treatments, could be having a very real impact on people’s experiences, the outcomes that can be achieved for them as well as their long-term recovery and quality of life.
Lisa Martin, 45, from Lancashire was diagnosed with head and neck cancer in 2018 and was one of the ‘lucky few’ who was able to benefit from robotic surgery. She said:
“All I can say is that I was in the right place, at the right time and was given the option to explore robotic surgery — without that, I don’t think I would still be here today.
“My surgery took just 45 minutes, helping me to avoid hours of radical surgery and so many of its life-changing and life-long side effects. Without it I could’ve lost my teeth, had no saliva for life, lost a lot of feeling in my face and I might’ve had to live my life being fed through a tube.
“I know the treatment I received might not be the best medical option for everyone, but I do believe that everyone with cancer should at least have the same access to all the possibilities that exist in cancer care. Where you live should never limit what is available to you, reduce your chances, or make life with and after cancer so much more difficult to cope with.”
Macmillan’s new survey reveals that 54% of people with head and neck cancer have been affected by variations in cancer treatment and care, significantly higher than the average for people with cancer[vi]. The charity says that while newer treatments such as robotic surgery might not be the right option for everyone, they should be made available for those who would benefit.
Shaun Doherty, 38, from Strabane in Northern Ireland, underwent traditional and invasive surgery for head and neck cancer in 2025. He said:
“After discussing my treatment, a potential 18-hour surgery involving removing part of my jaw and rebuilding it using bone from my leg, I realised how serious it was and was grateful for the experience and skill of the team I was under.
“I knew the potential for complications, but I decided to go ahead with the operation. The operation involved a surgeon opening my neck and removing my original jaw and lymph nodes, while another surgeon removed the fibula from my left leg to aid in the reconstruction of the jaw that had been removed, along with the insertion of a titanium plate.
“This treatment was the only option available to me, and I’d never even heard of robotic surgery until recently. The experience has had a big impact on my life. The structure of my jaw has changed, so my ability to chew will never be the same. Additionally, the nerves in that area have been removed, so something as simple as a kiss with your partner is different now. We jokingly call them 50% kisses as I only feel on my top lip, but I am so grateful to be here. 50% kisses beat no kisses any day of the week.”
Macmillan has committed itself to achieving a revolution in cancer care and says tackling the UK’s ‘cancer postcode lottery’ will play a vital role in achieving this.
Only recently, the charity teamed up with AstraZeneca to look at biomarker testing — a type of cancer testing that can help make peoples’ cancer treatment much more precise. Their research found widespread variation in the speed of biomarker testing results across the UK, which means some people might get highly effective and tailored cancer treatment, while others might start cancer treatments that may never even work for them. The charity is now working in partnership to deliver solutions to improve the situation across the UK.
Alongside its funding for local community groups, increased numbers of Macmillan badged professionals working across the UK, and the launch of a range of specialist new services like a dedicated head-and-neck service in Northern Ireland, the charity says it is not only working to support those who need them the most today, but also looking to tackle the root causes of poor cancer care to improve things for people in the future.
Macmillan is now calling for urgent action from governments and partners across the UK who are involved in delivering cancer care to help tackle widespread variation in cancer diagnosis and treatment — to make sure every person with a cancer diagnosis can get the best possible care, no matter where they live.
Dr Anthony Cunliffe, Macmillan’s Lead Medical Adviser, said:
“As a GP, the fact that where you live can have such a huge impact on your cancer experience really does worry me. But the reality is that for too many people with cancer it has begun to feel like a game of chance — a ‘flip of a coin’ and a need to be ‘in the right place, at the right time’ — when it comes to getting the treatment and care they need.
“We need to see urgent action taken to make cancer care fair. Everyone with cancer should get the best possible care the UK has to offer. Everyone should get the treatment that is right for them. No-one should get left behind simply because of where they live.
“At Macmillan, we are trying to bring UK decision-makers, people with cancer and local communities together to make sure that well-established cancer treatments and tests are made equally available to everyone.”
For information, support or just someone to talk to, call Macmillan Cancer Support on 0808 808 00 00 or visit macmillan.org.uk/whateveryouneed
Key facts
Variation in cancer treatment and care across the UK
Macmillan’s latest figures show that 40% of people with cancer have been affected by local variation in treatment and care. Across the UK, this breaks down as follows[vii]:
- England: 38% — approximately 1,070,000 people with cancer
- Scotland: 49% — approximately 140,000 people with cancer
- Wales: 44% — approximately 84,000 people with cancer
- Northern Ireland: 46% — approximately 45,000 people with cancer
How many people would benefit from reducing local variation in cancer waiting times
Additional analysis by Macmillan of official NHS data suggests that around 60,000 more people each year across the UK would start treatment on time if cancer waiting times where they lived matched the same standards being set by the best performing areas in the country. Across the UK, this breaks down as follows[viii]:
- England: almost 54,000 people
- Scotland: almost 4,000 people
- Wales: more than 2,000 people
- Northern Ireland: almost 300 people
Stories from around the UK
Daisy from Anglesey was diagnosed with Hodgkins lymphoma in February at just 17 years of age, and ‘rang the bell’ to signal the end of her treatment in August 2025. Her treatment meant a 4–6 hour round trip to a specialist cancer centre in Liverpool. She said:
“It was like a bomb dropped when I got my diagnosis — I was really active, studying for A-levels, really enjoying my life, and then suddenly everything just stopped.
“My treatment couldn’t be in North Wales due to my age, so I was referred to the specialist Teenage and Young Adults centre in Liverpool. Whilst the support I got in Liverpool was fantastic, things would have been so different if I didn’t have my Mum, who eventually had to stop work for a while to do everything and support me through my treatment.
“Sometimes we would be making the trip from Anglesey to Liverpool and back as many times as three times a week — feeling sick in the car, worried if I would get ill at home, worried about infections or reactions to my treatment, and worry that if anything did go wrong, the only option I might have would be go to my local A&E, which could mean long waiting times.
“But while we knew my treatment was going to be a tough challenge, I also wanted to go to the best place I could. I would say to anyone with cancer that they should not be afraid to push for the best possible care. I was lucky because my Mum works in healthcare and could help me ask the right questions, but not everyone will have that. People shouldn’t be afraid to challenge to get the care they think is right for them, and everyone should be able to get the care they need.”
Alex, 62, from Perthshire was diagnosed with bowel cancer in 2023, and while her own experience felt largely positive, she feels more can be done to make sure everyone with cancer has access to the best possible care. She said:
“I can’t tell you how many people we’ve lost through cancer. My husband and I have lost four godparents, my father, his sister and we have many friends and met so many people who have cancer through our own experiences.
“Living in rural Perthshire did mean that we had some distance to travel, but we were lucky — we had the transport and the means to do things ourselves. For others, you could be looking at buses that only run four times a day and have huge waits in between transfers just to get you where you want to go. I really couldn’t imagine having to go through treatment and its side-effects while having to navigate all that.
“We’ve also met so many people affected by differences in cancer care — how long they wait, how difficult it is to get diagnosed and we’ve even had friends who have been told by consultants to avoid hospitals in certain areas as local care just wasn’t up to scratch.
“With my own sister-in-law, who was desperately ill, there were times when she would end up in the hospital at 11 at night and not be seen till 5 in the morning, in pain and discomfort the entire time. Unfortunately, it does seem to come down to where you live, a bit of luck and often how bullish and confident you are to push for the care you need.
“It can’t be right that there are just so many differences in the type and quality of care people get. We should all have access to the best possible care, regardless of where you live and without having to push for it.”
Following the dedicated support their family and friends received, Alex’s husband Simon is now completing a fundraising challenge for Macmillan that will see him climb all the hills in Scotland over 600m.
“It was like a bomb dropped when I got my diagnosis — I was really active, studying for A-levels, really enjoying my life, and then suddenly everything just stopped.
“My treatment couldn’t be in North Wales due to my age, so I was referred to the specialist Teenage and Young Adults centre in Liverpool. Whilst the support I got in Liverpool was fantastic, things would have been so different if I didn’t have my Mum, who eventually had to stop work for a while to do everything and support me through my treatment.
“Sometimes we would be making the trip from Anglesey to Liverpool and back as many times as three times a week — feeling sick in the car, worried if I would get ill at home, worried about infections or reactions to my treatment, and worry that if anything did go wrong, the only option I might have would be go to my local A&E, which could mean long waiting times.
“But while we knew my treatment was going to be a tough challenge, I also wanted to go to the best place I could. I would say to anyone with cancer that they should not be afraid to push for the best possible care. I was lucky because my Mum works in healthcare and could help me ask the right questions, but not everyone will have that. People shouldn’t be afraid to challenge to get the care they think is right for them, and everyone should be able to get the care they need.”
Alex, 62, from Perthshire was diagnosed with bowel cancer in 2023, and while her own experience felt largely positive, she feels more can be done to make sure everyone with cancer has access to the best possible care. She said:
“I can’t tell you how many people we’ve lost through cancer. My husband and I have lost four godparents, my father, his sister and we have many friends and met so many people who have cancer through our own experiences.
“Living in rural Perthshire did mean that we had some distance to travel, but we were lucky — we had the transport and the means to do things ourselves. For others, you could be looking at buses that only run four times a day and have huge waits in between transfers just to get you where you want to go. I really couldn’t imagine having to go through treatment and its side-effects while having to navigate all that.
“We’ve also met so many people affected by differences in cancer care — how long they wait, how difficult it is to get diagnosed and we’ve even had friends who have been told by consultants to avoid hospitals in certain areas as local care just wasn’t up to scratch.
“With my own sister-in-law, who was desperately ill, there were times when she would end up in the hospital at 11 at night and not be seen till 5 in the morning, in pain and discomfort the entire time. Unfortunately, it does seem to come down to where you live, a bit of luck and often how bullish and confident you are to push for the care you need.
“It can’t be right that there are just so many differences in the type and quality of care people get. We should all have access to the best possible care, regardless of where you live and without having to push for it.”
Following the dedicated support their family and friends received, Alex’s husband Simon is now completing a fundraising challenge for Macmillan that will see him climb all the hills in Scotland over 600m.