Saving lives and averting costs? The case for earlier diagnosis just got stronger

It’s a terrible waste of life. The Deceased’s family rarely forgives the NHS.

I had blood tests done 24/12/2013 – fast tracked 30/12/2013 – test carried out Jan 2014 diagnosed with Smouldering Mulitiple Myeloma (incurable cancer but can be managed!) on Feb 12 2014. At diagnosis I was told it was a little known cancer, which was incurable but treatable with varying options unfortunately the treatment at the smouldering stage is worse than the illness – all said as if they were doing me a favour – and so I am classed as a watch and wait candidate – living with the knowledge that at any one of my 2 monthly appointments I could be told I need the treatment – living with the anxiety and stress of being on watch and wait is unbelievable! the further you go down the line and the more ill you begin to feel the angrier you become – with this condition you feel its more a case of “oh well it is incurable – why spend the money”!!!! what about people with the cancer suffering the treatment side effects early after diagnosis in the hope of up to 7 years remission, before having to start treatment again and at least not being left feeling like they are already on the scrap heap – I used to say if you had to have cancer mine is the best sort to have – now I say why could’nt I have had a cancer that could be cut out/ shrunk and treated from the off – why wont they pay to treat these cancers in the earliest stages – Myeloma is cancer of the bone marrow – it damages from the inside out, apart from all the other symtoms!!

Hi – thanks for the comments on the blog. The comments by Susan Cowley, Marion Leslie SRN RSCN NDN, Alexandra Rose and Maryam all demonstrate how important earlier diagnosis is for patients. Put simply, diagnosing patients earlier gives them a greater range of treatment options, including ones that are less invasive or intensive. What is more, it gives a much greater chance of long-term survival. That we have shown that earlier diagnosis can also avert treatment costs makes the case even stronger. I firmly believe this is something that the NHS cannot afford not to do.

Sandra Benson made an important point about oesophageal cancer. We focused on bowel, lung and ovarian cancer in our study. We chose these cancers because they have affect large numbers of people (and so there’s good data), there is clear national guidance on treatment pathways and they have all been subject to activity to encourage earlier diagnosis. However, a similar approach could be taken to oesophageal cancer. Diagnosing oesophageal cancer earlier can play an important role in improving survival. If any reader is concerned about the symptoms, Cancer Research UK has more information here.

VeniceLaura mentioned the issue of ‘lead time bias’ with survival. This is when someone would have died at the same time, but being diagnosed earlier means that they appear to have ‘survived’ for longer with their cancer, when in fact they just survived for longer after being diagnosed. Lead time bias shouldn’t be a factor in our report, because we looked at the stage of cancer at the point of diagnosis (not the point in time when the diagnosis occurred). As I mentioned earlier in this comment, earlier diagnosis means that patients have a greater range of treatment options and a better chance of survival, so the impact on outcomes is a real one.

Thanks for all your comments and interest. If anyone else wants to leave a comment, I’ll check back in a couple of days and try to address them.

Mike
Incisive Health

It is even more obvious if you think about early diagnosis skin cancers and super inexpensive treatments (mole removal) compared to treating advanced melanomas that will cost more than $150k

Survival is not the same as mortality. Has any of this research taken into account lead time bias? And if so, where is the explanation?
http://t.co/peGmDLZW5C

Totally agree with the early diagnosis. But how do we get doctors to listen to us? I was treated with sympathy and politeness, displaying all the symptoms of Ovarian cancer for years, but no one seemed to take it seriously. Now I have OC and have had to have much more serious surgery and chemotherapy which must be costing the NHS far more in the long run, and live with the horrible knowledge that the cancer may not have gone, or may come back and require more expensive and quality of life destroying chemo. It’s madness.

I’ve have said this all along, since my daughter’s diagnosis was delayed, even though she was showing obvious signs. She was fobbed off by GPS, who told her she had gastritis and IBS, and only examined once when she was in so much pain and could hardly walk! It makes me extremely angry. Surely earlier diagnosis has to be cost effective, although gps seem very reluctant to refer or scan. I think the government should be making provisions for earlier diagnosis, but is unlikely at the moment with their austerity measures in place.

Agree with all of the above but what about esophageal cancer you must start talking about this cancer as it is very prominent in the north of England

Having lost my parents to bowel cancer and non-Hodgkin’s lymphoma, both of which I believe should have been detected much earlier, the human costs are incalculable. Perhaps the financial argument will have more influence on politicians to take action.