A recent NHS report has brought to light a concerning disparity in kidney cancer care throughout different regions of England. The report reveals that patients in rural areas are nearly half as likely to receive life-saving drugs compared to those in more developed areas like London. According to the NHS documents obtained by The Mail on Sunday, patients who received these drugs were three times more likely to still be alive two years after their diagnosis compared to those who did not receive the drugs.
Shadow Health Secretary Wes Streeting, who is a kidney cancer survivor himself, referred to the findings as “inexcusable.” Streeting, who was diagnosed with the disease in 2021, expressed his dismay at the fact that patients are unable to access life-saving treatments based on their geographic location. He emphasized that the NHS should be available to all individuals when they are in need of medical care.
The discrepancy in access to these medications is believed to be due to the lack of guidelines for kidney cancer treatment. The National Institute for Health and Care Excellence (NICE), which is responsible for creating guidelines for the top ten most common cancers in the UK, has yet to establish guidelines for kidney cancer.
Kidney cancer affects around 13,000 individuals in the UK each year, ranking it as the seventh most common cancer. It typically occurs in individuals in their 60s and 70s and is uncommon in younger individuals, although Wes Streeting was diagnosed at the age of 38. Symptoms often include blood in the urine, back pain, and lumps or swelling in various body areas. Risk factors include obesity, smoking, high blood pressure, late-stage chronic kidney disease, and genetic predisposition.
NICE has recently agreed to develop guidelines specifically for kidney cancer, but it is expected to take several years for these guidelines to be published. Kidney Care UK, a charity responsible for conducting the report titled Kidney Cancer UK Accord, is collaborating with NICE during the guideline development process. They are also urging doctors to improve diagnosis and treatment strategies for kidney cancer patients.
Early detection of kidney cancer can be effectively treated through surgery to remove the affected section of the kidney. However, treatment options for advanced kidney cancer have been limited until recently. In the past five years, a new class of drugs known as immunotherapy has emerged, which can significantly extend the lives of patients with advanced kidney cancer and even lead to a cure. However, administering these complex treatments requires specialized training that many consultants currently lack.
The report analyzed the provision of drug treatments across the 21 Cancer Alliances in England, focusing on advanced kidney cancer patients and their access to new drugs within the first year after diagnosis. The results revealed that in some districts, less than 40% of these patients were offered the new cancer-fighting drugs. The lowest-performing district only provided these drug therapies to 36% of patients, while the highest rate of drug access was 69%. On average, only around half of advanced kidney cancer patients were receiving these treatments.
The report also highlighted the significant impact of drug treatments on patient survival. Only 11% of patients who did not receive drugs survived for two years or more after diagnosis, whereas nearly 40% of those who received the treatments survived. However, it should be noted that not all patients are suitable candidates for these drugs, with around 15% being too old or sick to safely undergo treatment.
While the report does not explicitly name the regions with poor-performing Cancer Alliances, experts argue that it is clear where these areas are predominantly located. London appears to have a significantly higher likelihood of providing quality care to kidney cancer patients compared to rural regions.
Overall, addressing the postcode lottery in kidney cancer care is crucial to ensure equal access to life-saving treatments for all patients. The development of NICE guidelines specifically for kidney cancer, coupled with improved diagnosis and treatment strategies, will be vital in addressing this issue and reducing the number of lives lost each year due to unequal access to care.
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