Thousands of Cancer Patients Die Over Delay in Referral to Specialist

At least 2,400 cancer patients die needlessly every year because their GP does not refer them to a specialist quickly enough, research has suggested.

The two-week wait means patients should see a specialist for their first appointment within two weeks of seeing a GP with suspected cancer symptoms.

But new research has found a higher number of deaths in cancer patients whose GPs do not regularly use the pathway.

Published in the British Medical Journal (BMJ), the study, which was funded by Cancer Research UK and National Institute for Health Research, examined data from 215,284 English cancer patients in 2009.

Death rates increased by 7% for patients whose GP practices used the two-week wait least often compared with practices with a typical referral rate.

Meanwhile, patients from the best performing practices had a 4% lower death rate compared to those with a typical rate.

The data was gathered from 8,049 general practices in England where patients were diagnosed or first treated in 2009 and followed up to 2013.

Lead author Professor Henrik Moller, an epidemiologist at King's College London, said 2,400 excess deaths occurred in the worst performing practices but this figure was likely to be conservative.

He added: " Increasing a GP's cancer awareness and their likelihood of urgently referring cancer patients could help reduce deaths.

"There's a fine line to tread between using the urgent referral route regularly and using it too much - which the NHS isn't equipped to respond to.

"But if GP practices which use the two-week route rarely were to use it more often, this could reduce deaths of cancer patients."

Sara Hiom, Cancer Research UK's director of early diagnosis, said. "This crucial evidence shows that the earlier a cancer patient is diagnosed the better the chances of survival. "Earlier cancer can be treated more effectively with a wider range of treatment options.

"And tumours can progress if there's a delay in time to diagnosis and starting treatment.

"It's never been clearer that reducing late diagnosis saves lives and this research adds to our understanding of what can be done about it."

Dr Rosie Loftus, joint chief medical officer of Macmillan Cancer Support, said: " GPs encounter cancer comparatively rarely, but will see large numbers of patients with a variety of symptoms which may or may not be to do with cancer, making diagnosis more difficult.

"It is therefore critical that GPs have tools available to help them spot cancer at the earliest possible stage."

Professor Sean Duffy, national clinical director for cancer at NHS England, said: "The number of patients referred to hospital for urgent cancer checks is up by over 600,000 over the past five years, and we now want it to go up even more, so as to diagnose suspected cancers earlier."

I had a PSA of 5.4 in August of 2013. My insurance company’s protocol on when a man should have a biopsy makes no mention of any specific PSA level at which point one shoud be ordered.

13 months later, it was 9.7 and I got one; and, I was diagnosed with metastatic prostate cancer. There is no cure. Had I gotten the biopsy when I should have, Iwould have been completely cured.

Educate yourself. Insurance compnie don’t care if you live or die. They only care about profits. Anyone who thinks doctors determine what care you get are naive like I was.

That doubling in 1 year is alarming. With a PSA like that they should have at least been doing blood work quarterly. Don’t give up.

Twenty years ago, just a few days before we walked down the aisle, the love of my life was diagnosed with prostate cancer. His PSA was 29, and his Gleason score was 9/10. We opted for surgery with a 75% chance that they would find it in his lymph nodes and close him back up. They opened him up and after a quick look at the lymph nodes they didn’t find cancer, so they went ahead with the surgery. Within a couple of weeks, they had done further path work on the lymph nodes (still didn’t find any) and there were clear margins.

Immediately after the surgery, his PSA went to undetectable (<0.1). Five years later, his PSA remained undetectable, so I asked his urologist if he could be considered cured. He told me that we *never* say that with prostate cancer. Truth be known, they only expected him to live 3-5 past the surgery.

Thirteen years after his surgery, the PSA was once again detectable at 0.1, so the waiting game began to see how long it would take it to double. It took four years to get to 0.2, but then it doubled again in two years, so picking up speed. We are still at tiny amounts at that point, 0.4. They pass him off to radiology, and that doc wants him to think about radiation. Very confusing to me, because it too small of an amount to located, so how do they know where to aim the radiation?

She wanted to get started right away, but hubby told her he wanted to wait 6 months, which would be last month in October. He went in for and MRI, blood draw, and then the appointment with the radiologist. First the radiologist’s understudy comes in, and goes over the MRI, and says it all looks good. Then he tells us “we don’t have any explanation for this, but your PSA dropped from 0.4 to 0.1.” The radiologist comes in and says “this isn’t the way that prostate cancer works, it doesn’t go down without treatment, we can’t explain this. Have you been doing ANYTHING different?”

We couldn’t come up with anything on the spot, but on the way home I realized that after his April appointment that he had stopped exercising indoors at the gym and instead was walking outdoors with me. He was getting about 6 hours of sunshine a week and making a lot more vitamin D for the last 6 months.

There are lots of studies on the affects of vitamin D and prostate cancer. Prostate cancer is more common and there are more higher grade tumors the farther north you go. https://www.google.com/webhp?sourceid=chrome-instant&ion=1&espv=2&ie=UTF-8#q=prostate%20cancer%20vitamin%20d

We did get back in touch with his urologist who said that his improvement could be tied to vitamin D, and that was better than any explanation that he had.

Get some sunshine on your skin or take some vitamin D supplements, it certainly could not hurt. I’m not saying it’s a cure, but there is a lot of evidence that it can slow it down and at least hold it in check.

My prostate cancer is metastatic because it has spread to eight spots on my skeleton.

I’ve been on Lupron therapy for the past year and my PSA has gradually gone down to 0.4. Doctor said it could work for another 3-6 years, but it could be sooner or longer. My latest CT continues to show no spreading to other organs and there was a slight improvement in my bone scan.

I take some supplements, including 10,000 iu of vitamin D, and hve elimintrd almost all sugar. Aso in the process of losing weight. Also taking 1 tsp of baking soda since there are some arguments that cancer needs an acidic environment to survive and grow. Not sure if it works, but my doctor said it wouldn’t hurt.

Ws at a patient-focused semainar at MDA in July, and the researchers are very optimistic that there will be a cure in the foreseeable future. I will still be around for it.

You do realize that the Government has been overseeing the health insurance companies since Obamacare was passed? The cuts in preventative medicine have come directly from the Government. In my field, women were allowed a pap smear a year as a well-woman screening. Since the Government became involved, now the coverage is once every three years for women ages 30-65; once every five years for women between 49-65; and a pap smear only if you are having symptoms after age 65. Having worked in the cancer detection field for 40+ years, I can tell you that if a woman over 65 is having symptoms (bleeding, etc), she will likely not survive her cancer. We are told ‘you don't need them as often’ and ‘they are uncomfortable and embarrassing’. I'd rather be uncomfortable and embarrassed than have to live through the pain of genital cancers. Please understand that now, the Government has taken over the regulations that the health insurance companies have to obey. And it is not going to end well for the citizenry.

Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.