Another Little Rant: Cancer Care

Every time I read of some new attempt by the government of the day to improve cancer survival rates by setting targets for this, that and the other, my heart quails. With the best will in the world, setting referral or diagnosis targets isn’t necessarily going to change things. Not all cancers announce themselves openly in time for a cure to be attempted, and even medical professionals can misinterpret the signs that a cancer is present. Mistakes happen, and unless one believes they are always avoidable — which I don’t — we are going to have to face up to the fact that late referrals and late diagnoses are going to continue to occur.

Surely a more fruitful approach would be to look again at funding for medical research, not just into cancer, but into a host of deadly diseases that currently offer little or no scope for pharmaceutical companies to make a profit? At the moment our response to most cancers is still slash it, burn it, poison it (surgery, radiotherapy, chemotherapy), but genetic profiling of tumours and research into the immune system have both begun to suggest potentially useful approaches. The problem is such research is enormously expensive and results do not come all at once.

I am a greedy person, I have two rare diseases, not just one, and research into them is largely the province of university researchers who attract little funding from the pharmaceutical industry or other corporate donors. Diseases with a more emotional pull or wider range, such as breast or prostate cancer, are obviously of more interest. I have no quarrel with that. Whether one person is affected by something or one million, each individual has to come to terms with life as it is. What worries me about the present government’s target-setting is that it is generating both unreal expectations and, in some cases, unhelpful attitudes towards NHS staff. There isn’t an easy solution, and if someone you know and love is dying before your eyes, you will inevitably want the best you can for them. Sometimes, however, the best isn’t what we think is best. One of the differences between a medieval world-view and a more modern one is that in the Middle Ages the group had more importance than the individual. We, by contrast, exalt the individual. I wonder whether we need to re-think that, too?

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