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Celebrating 75 years of NHS cancer care

Tim Gunn
by Tim Gunn | In depth

5 July 2023

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Aneurin Bevan, founder of the NHS, visits a patient on the service's first day.
Aneurin Bevan, Minister of Health and founder of the NHS, visits a patient on the service's first day.


On 4th July 1948, people in the UK had to pay to see a doctor. On 5th July 1948, they didn’t.  

That’s thanks to the National Health Service (NHS). It’s 75 years old today. 

From the moment the NHS was born, every woman in the UK going through childbirth, and every child they’ve brought into the world, has had a right to the same level of care. Every infection, illness or broken bone has been as worthy of a doctor’s time as any other. And every doctor has had access to some of the world’s best tools for treating them. 

It’s healthcare for those who need it, no matter where they live, who they are, or what they earn. 

As remarkable as that was in 1948 – and still is today – there’s much more to say about the NHS. When we’re well as much as when we’re sick, it helps define what it means to be British.  

You can’t tell the story of the country’s last 75 years without it. You couldn’t tell the story of the last 5 years – the past hour – without it, either. The NHS interacts with patients 1.6 million times every day. 

With over 1 million staff from more than 200 different nationalities, it’s a mirror of the nation’s care, commitment and diversity. We’re proud to have it, and we’re incredibly thankful.  

Tracking 75 years of world-leading NHS cancer care

Since 1948, the NHS has worked tirelessly to prevent, diagnose and treat cancer. If anything, it’s got more tireless as time’s gone on. Between November 2021 and October 2022, it started treating a record-breaking 320,000 people for the disease.  

To celebrate the NHS’s birthday, and its lifesaving legacy, we’ve put together a timeline showing some of its biggest contributions to how we prevent, diagnose and treat cancer.  

Read on to see our highlights – some we were part of – along with personal perspectives from a few of our supporters.  

1954 – The British Doctors Study links smoking and lung cancer

A broken cigarette on a yellow background
Credit: nawamin/Shutterstock.com

Sir Richard Doll and Sir Austin Bradford Hill are the first researchers to conclusively prove that smoking causes lung cancer. They do it by studying NHS doctors. 

The study wouldn’t have been possible without the NHS’s centralised records system.  

With our funding, the study continued for 50 years, giving the evidence needed to reduce smoking rates and prevent lung cancer – as well as pioneering a new way to do medical research.  

You can trace our current work to make the UK smokefree (and reduce cancer inequalities) back to the British Doctors Study. 

Gower’s story

Gower Tan in front of the UK Parliament

Gower started smoking when he was 13 years old. He’s now overcome his addiction.

“I watched my father die of lung cancer, knowing that smoking had caused this.

“I was still smoking at the time and was scared that my daughter would be watching the same thing in years to come.”

Now, Gower’s continuing what Doll and Hill started – helping more people give up smoking.

“The aim to make the UK smokefree is an important target. I’m proud to work and volunteer with Cancer Research UK. I hope that together we can make the UK completely smokefree.”

 

1961 – The first clinical trial testing lumpectomies for breast cancer

Three NHS surgeons operating under theatre lights.
Credit:: Adrian Wressell, Heart of England NHS Foundation Trust. (CC BY 4.0)

Researchers at Guy’s Hospital in London launch the first clinical trial testing breast-conserving surgery for early breast cancer.  

Over the next decade, they found that surgically removing the tumour is as effective as removing the whole breast and the surrounding lymph nodes (radical mastectomy). 

That study, which we helped fund, is later backed up by others in the UK and elsewhere. Since the early 1990s, lumpectomy has been the standard surgical treatment for early breast cancer. 

Alex’s story

Alex

In 2009, after finding a pea-sized lump in her breast, Alex was diagnosed with early-stage breast cancer. Her treatment included surgery, chemotherapy and radiotherapy.

“My surgeon told me I was going to have a lumpectomy. He explained that during the surgery he would take just the tumour and a bit of healthy tissue from around it. The idea was to leave behind as much healthy breast tissue as possible, while at the same time removing the tumour. He described a lumpectomy as ‘breast-conserving surgery’, and I thought that sounded fantastic!”

“My scar is amazing. I’m proud of my breasts as they are now, and I feel that I have a lot to be thankful for!”

 

1970s – The NHS’s first cancer medicine departments 

Professor Gordon Hamilton Fairley opens the UK’s first medical oncology department at St Bartholomew’s Hospital in London, shaping cancer care for years to come.  

But, as his former colleague, Professor James Malpas, told us in 2015, “A lot of people, including doctors, didn’t believe there should be such things as specialised cancer doctors.” 

That’s hard to imagine now. Hamilton Fairley and his team laid the groundwork for the integrated way cancer patients are treated in the NHS today, with medical oncologists working in partnership with other experts to provide the best care and treatment. 

“[Gordon] got medical oncology recognised as a sub-speciality of general medicine,” said Malpas. “That was an important advance because it meant that young people could train in that area and look to having posts in the future. It was very, very far-sighted.” 

Fairley and Malpas were also instrumental in bringing combination chemotherapy to the NHS. This approach can be much more effective than using single drugs. It can also help minimise side effects. 

1971 – The world’s first CT scan

The first CT scan, carried out by the NHS in 1971.
The first CT scan, carried out by the NHS in 1971. Medical Imaging Systems: An Introductory Guide (CC BY 4.0)

The world’s first clinical CT (computed tomography) scan is carried out on a patient at Atkinson Morley Hospital in Wimbledon (now part of St George’s Hospital).  

After a 30-minute scan, a quick drive across London to the nearest suitable computer, and 150 minutes waiting for it to load the results, doctors were shaking a Polaroid revealing the location of a tumour in a living person’s brain. Medical imaging was never the same again. 

Invented by Sir Godfrey Hounsfield, who won the Nobel Prize in medicine in 1979, CT scans use multiple X-rays to create 3D images of our internal organs. They make it possible to diagnose more cancers without surgery, and they allow doctors to see how well cancer treatments are working. 

That’s not all

Later in the 1970s, Professor John Mallard’s team at the University of Aberdeen built the world’s first full-body MRI (magnetic resonance imaging) scanner.

Another huge advance in medical imaging, MRI uses magnets and radio waves to create images of our insides. It’s better than CT at detecting certain cancers.

Mallard’s machine captured the first clinically useful MRI scan in 1980 and was later used in the NHS.

1973 – Tamoxifen pushes back against breast cancer

A breast cancer cell seen through an electron microscope.
A breast cancer cell. Credit: LRI EM department

Tamoxifen, one of the first targeted cancer therapies, is approved to treat breast cancer in the NHS before anywhere else.  

First trialled at Manchester’s Christie Hospital in 1970, it was later called ‘the most important drug in the history of medical oncology’.  

Tamoxifen has become more important since 1973. By funding large trials through the 1980s and 1990s, we helped doctors work out how best to use it. 

Steve’s story

Steve
Photo by: Carsten Windhorst

“I don’t think we should underestimate these incredible life-changing advances in cancer treatment and drug development,” says Steve, who was diagnosed with an aggressive form of breast cancer in 2010. After noticing pain around his left nipple, he was sent for a mammogram and then a needle biopsy.

“I was completely gobsmacked that it could happen to me,” he says. “My advice to anyone would be if you have any pain in your chest then go and check it out – hopefully it is nothing, but you never know.”

He underwent a full mastectomy, which left a 10-inch scar across his chest. After that, he took tamoxifen for five years to stop the cancer returning. That way of using the drug is informed by our research.

 

 

1979 – Cisplatin brings platinum chemotherapy 

Crystals of cisplatin
Cisplatin crystals. Credit: Larry Ostby, NCI

Cisplatin, the first platinum-based chemotherapy drug, is approved for use in the UK. It quickly becomes the ‘gold standard’ treatment for a range of tumours.  

In particular, cisplatin has revolutionised how doctors treat testicular cancer. The death rate from the disease has fallen by around 80% since the early 1970s. 98% of people now survive it for 10 years or more.

Our researchers helped develop and test cisplatin. We’ve also contributed to platinum-based chemotherapy drugs that cause less severe side effects and ways of calculating the best dosages for different patients. 

Alim’s story

Alim with his CRUK Flame of Hope Award
Alim won a CRUK Flame of Hope Award in 2021.

Alim was diagnosed with testicular cancer three times between 2001 and 2004. He was treated with surgery, radiotherapy and cisplatin.

“Cisplatin saved my life,” he says. “Knowing that Cancer Research UK is responsible for a lot of research behind it gives me a lot of hope for the future.”

Alim and his wife now have two children. That’s thanks to IVF, which was also pioneered by NHS doctors in the 1970s.

“We are proof that there is always hope. Cancer doesn’t have to mean the end of your dreams. I look at my children and see them as my little miracles.”

 

1988 – National breast and cervical screening programmes

A doctor examining a mammogram.
Okrasiuk/Shutterstock.com

The NHS sets up its first two national screening programmes to help spot early warning signs for cancer and diagnose cases when they’re most likely to be treated successfully. 

The free breast screening programme for women over 50 was the first of its kind in the world.  

Cervical screening had been available for some UK women since the 1960s, but it hadn’t helped lower deaths from the disease.  

By introducing an integrated system with regular screening and follow-up appointments, the new programme helped reduce cervical cancer incidence by a third in 25 years. 

Gem’s story

Gem

Gem was busy preparing for her best friend’s wedding when she found out that a cervical screening smear test had found cancer cells. She says it saved her life.

“Although the cancer hadn’t spread, the surgeon removed lymph nodes from my abdomen and pelvis. It took me about six weeks to recover, and at a follow up appointment I was told I was clear of cancer and didn’t need further treatment.

“A year on, I feel great, and now I want to highlight the need for early detection. The test takes minutes, and if I’d left it a few more months, I might be facing a completely different outcome.”

1989 – Proton beam therapy reaches patients 

The NHS installs the world’s first hospital-based proton beam therapy machine at Liverpool’s Clatterbridge Cancer Centre, with our funding.  

Proton beam therapy is a type of radiotherapy used to treat some very rare cancers, as well as those close to vital or delicate parts of the body, especially in children, teenagers and young adults.  

The machine at Clatterbridge is used to treat some eye cancers. 

The NHS now has a national Proton Beam Therapy Service with more powerful machines at The Christie in Manchester and University College London Hospital. 

2008 – HPV vaccine protects a generation from cervical cancer

An unrecognisable young girl receiving a vaccination.
SeventyFour/Shutterstock.com

The cancer-preventing human papillomavirus (HPV) vaccine is made available for girls aged 12 to 13. It comes after decades of work from our researchers proving that HPV is responsible for almost all cervical cancers.    

Back in 1993, a team of our scientists at the Beatson Institute in Glasgow proved that an HPV vaccine was possible by using one to protect cows from their equivalent of the virus.  

The vaccination programme now covers 12 to 13-year-old boys as well. 

Our study in 2021 showed the vaccine cuts cervical cancer rates in young women by 87%. That’s not the only benefit. There’s also evidence that people who’ve had the vaccine could need fewer cervical screens throughout their lives. That would free up NHS resources.  

“It’s a huge achievement by lots and lots of people,” Professor Peter Sasieni, lead author of the 2021 paper, told us last year. “It’s nice to think that this next generation will probably never really have to worry about cervical cancer in this country.” 

Tara’s story

Tara
Tara

“I wish I’d had the chance to get the HPV vaccine to help prevent this from happening to me,” says Tara, who was diagnosed with cervical cancer in 2015.

Tara spoke about her experience with cervical cancer, and what it was like to explore her body and reconnect with her sexuality after treatment, on our podcast: That Cancer Conversation.

2011 – The launch of the Cancer Drugs Fund

The UK begins using the Cancer Drugs Fund (CDF) to give patients access to drugs that wouldn’t otherwise be available.  

After facing criticism for overspending on potentially ineffective drugs, the fund was overhauled in 2016, becoming the world’s first ‘managed access’ fund for promising cancer treatments.  

Today’s CDF pays to give patients new drugs for a set period before they’re definitively approved or rejected for use on the NHS. Once that time is up, regulators can use the information gathered by the CDF to make the best decision about whether to continue paying for the drug. 

So far, the CDF has given patients early access to over 100 innovative, lifesaving drugs, including abiraterone and olaparib, which we helped develop, and pembrolizumab. 

2018 – CAR-T cell therapy treats rare blood cancers

Microscopic image of T-cells attacking cancer cells.
T-cells, coloured red, attacking cancer cells. Credit: Rita Elena Serda, NCI

The NHS is the first health service in Europe to offer children with certain blood cancers a type of immunotherapy called CAR-T cell therapy 

This involves immune cells being taken from a patient’s blood and altered to recognise cancer cells as a threat. When they’re put back, these cells guide the immune system to attack cancers that it couldn’t even see before. 

It’s the beginning of a new era of cancer medicine, one of many brought to us by the NHS. It won’t be the last. 

The future of the NHS 

The NHS has spent 75 years looking after us. It deserves a huge celebration.

Then, for the next 75 years and beyond, it deserves looking after, too. 

That means money, and, where appropriate, reform.  

The UK’s population is getting older and cancer rates are rising, which means more of us will need more care.  

We can expect radical changes to what that looks like. Better data and new digital tools will make a big difference in the years to come. If the last 75 years have taught us anything, it’s that the NHS will do everything it can to make sure they benefit all of us. Look what it’s done already.

In 1948, there were two ways to treat cancer. Doctors could cut it out with cold knives, or burn it up with radiation.

If those options weren’t available, there was no option at all. 

They usually weren’t available. Often, people weren’t even told they had the disease. All the things we’ve listed above helped change that. 

In the 1970s, when the UK began collecting detailed statistics, 24% of people diagnosed with cancer survived for 10 years or more.   

By the 2010s, that proportion had doubled. Half of all people diagnosed with cancer now survive it for at least a decade.  

Technologies change, but, ultimately, it’s people that made those improvements happen.  

That’s why a fully funded workforce plan is so important to the future success of the NHS. To keep the advances going, we need to keep supporting and training everyone – from oncologists to housekeepers – that makes the NHS what it is.

To all of them: thank you.

Tim