15 April 2016
• The average cancer patient still needs thousands of pounds of hospital treatment nine years after diagnosis
• Macmillan Cancer Support is urging the NHS to offer early, comprehensive support to give patients the best care and to avoid long-term mounting costs of hospital treatment
Cancer survivors diagnosed almost a decade ago still cost the NHS in England five times more than someone without the disease, according to new research published this week in the British Journal of Cancer.
A new study conducted by City University London and commissioned by Macmillan Cancer Support reveals that hospital care for the average patient diagnosed with the four most common cancers (breast, colorectal, prostate or lung cancer) costs the NHS in England £10,000 in their first year of diagnosis – but nine years on is still costing £2,000 a year.
The NHS in England spends more than £1.5billion every year on hospital care for patients with breast, colorectal, prostate and lung cancer, a third of which is spent on cancer patients who were diagnosed more than six months ago. At this stage, their treatment is less likely to include expensive interventions such as chemotherapy and more likely to involve managing their recovery.
Costs many years after diagnosis may include treating people for illnesses which have been caused by their cancer treatment. Around 150,000 people experience urinary problems as a result of cancer treatment. Other costs could be to treat other illnesses which are complicated by the disease. For example 70 percent of people with cancer already have another long-term condition when they are diagnosed.7 And another cost is likely to be treating people whose cancer has come back or who are dying from it.
With the numbers of people living with a cancer diagnosis in England set to soar to 3.4 million by 2030, Macmillan argues that if the NHS fails to act now to slow down the escalating costs of care, it could unnecessarily spend an extra £420million over the next five years at a time when budgets are already tight.
The charity says NHS England needs to invest in earlier support for patients as well as put in place the other recommendations in the Cancer Strategy for England in order to avoid the devastating and costly complications which often follow a person’s cancer treatment.
Macmillan believes that if the NHS spends its money wisely by assessing the needs – physical, emotional and practical - of a patient once they have finished treatment and signposting them to available support, it would empower patients to better manage their own health and know where to go to if they need help. This could reduce the number of hospital admissions for problems which could have otherwise been avoided.
The charity argues that if a patient is given advice on managing or reducing the side effects of their condition, they are more likely to get medical help from their GP or community nurse at an earlier stage preventing them from getting so ill they end up in hospital, or need more invasive treatment.
Clare Wheatley, 51, from Shropshire was diagnosed with breast cancer in 2011. She says:
“The surgery, chemotherapy and radiotherapy I had to treat my cancer left me with considerable physical and emotional long- term side effects such as osteoporosis, permanent swelling of the limbs and fatigue. It’s five years on and I’m still constantly in and out of hospital, having check-ups, counselling and treatment.
“The swelling in my right arm is so severe that it’s likely that the only option left is surgery. People think that once your cancer treatment is over and you’ve survived, that’s it, but the reality is that I’m going to need hospital treatment for the rest of my life.”
Fran Woodard, Executive Director of Policy and Impact at Macmillan Cancer Support, says:
“The fact that cancer patients are receiving hospital treatment so many years after diagnosis is yet another sign of the mammoth challenge cancer poses to the NHS now and in the future. That’s why we need urgent action before the struggling system reaches crisis point.
“Cancer can leave people with debilitating side effects such as heart problems, incontinence and chronic pain which can result in long-term hospital treatment that is distressing for the patient, and expensive for the NHS. But if NHS England invests in early and rounded support for cancer patients it has an opportunity to give cancer patients great care and make its money go further.
“We’re urging NHS England to assess the needs of cancer patients and provide them with information and advice so they can fully understand their cancer, any long-term side effects and where to get help. They need support on all the other issues that cancer can bring, such as how to keep active, have a healthy diet and deal with money worries caused by their illness. This will give them the best chance to recover or live well. By acting now, NHS England has a chance to stem the tide of escalating cancer costs.”
Dr Mauro Laudicella, a Senior Lecturer in Health Economics at City University London and lead author of the report, says:
“There is no doubt that the NHS in England is facing a huge challenge to provide care to an ever-increasing population of cancer patients, and our new study has shown just how expensive hospital treatment is for cancer patients years after diagnosis.
“With the additional costs of care for the main four cancers amounting to £1.5 billion in England in 2010, our evidence can be used to encourage the NHS to slow down the spiralling cost of care by investing in patients early on in their cancer journey. It is the only way that the NHS will ensure that in the future, everyone who has cancer will be able to get the care they need.”
Macmillan provides information and advice, through its website, information centres and telephone helpline, so people get help from the moment they are diagnosed with cancer and beyond. It also works with local partners to provide health and wellbeing clinics in some areas.
For further information, please contact:
Catherine Jones, Senior Media & PR Officer, Macmillan Cancer Support
0207 840 2453 (out of hours 07801 307068)
Notes to Editors:
1. Laudicella M et al. Cost of care for cancer patients in England: evidence from population-based patient-level data. British Journal of Cancer (2016), 1–7. doi: 10.1038/bjc.2016.77. Available from: www.nature.com/bjc/journal/vaop/ncurrent/pdf/bjc201677a.pdf. Before a patient is diagnosed, the cost of their hospital treatment is around £400 per year.
2. As above. £10,000 based on weighted averages
3. As above
4. As above. Hospital treatment for people diagnosed with just the top four cancers in the past five years costs the NHS at least £1.5 billion More than £530million a year is spent on care beyond initial treatment (more than six months from diagnosis, excluding the last 12 months of life)
5. As above
7. Research undertaken by Monitor Deloitte, commissioned by Macmillan Cancer Support. An extensive review identified ‘best available’ data from different care settings and perspectives. No single source provides definitive data on the prevalence of LTCs amongst the UK public and people living with cancer. UK-wide estimates in this document are therefore derived from the following ‘best available’ sources to estimate the population living with with cancer and another long term condition. Detail as per reference i. 70% of people with cancer are living with at least one other LTC, compared with 55% of the general population (rounded figures). The figure for people with cancer is around 15 percentage points, or 31% (for the non-rounded figures), greater than the figure for the general population
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