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Health Series: Research Spotlight

Care for cancer patients still expensive almost a decade after treatment

New report on the cost of cancer authored by Dr Mauro Laudicella and colleagues


Cancer survivors diagnosed almost a decade ago still cost the NHS in England five times more than someone without the disease, according to new research published this week in the British Journal of Cancer.

A new study conducted by Dr Mauro Laudicella and Dr Brendan Walsh at City University London - and commissioned by Macmillan Cancer Support - reveals that hospital care for the average patient diagnosed with the four most common cancers (breast, colorectal, prostate or lung cancer) costs the NHS in England £10,000 in their first year of diagnosis – but nine years on is still costing £2,000 a year. Academics from Imperial College London also contributed to the report.

The NHS in England spends more than £1.5billion every year on hospital care for patients with breast, colorectal, prostate and lung cancer, a third of which is spent on cancer patients who were diagnosed more than six months ago. At this stage, their treatment is less likely to include expensive interventions such as chemotherapy and more likely to involve managing their recovery.

Costs many years after diagnosis may include treating people for illnesses which have been caused by their cancer treatment. Around 150,000 people experience urinary problems as a result of cancer treatment. Other costs could be to treat other illnesses which are complicated by the disease. For example 70 percent of people with cancer already have another long-term condition when they are diagnosed. And another cost is likely to be treating people whose cancer has come back or who are dying from it.

With the numbers of people living with a cancer diagnosis in England set to soar to 3.4 million by 2030, Macmillan argues that if the NHS fails to act now to slow down the escalating costs of care, it could unnecessarily spend an extra £420million over the next five years at a time when budgets are already tight.

The charity says NHS England needs to invest in earlier support for patients as well as put in place the other recommendations in the Cancer Strategy for England in order to avoid the devastating and costly complications which often follow a person’s cancer treatment.

Macmillan believes that if the NHS spends its money wisely by assessing the needs – physical, emotional and practical - of a patient once they have finished treatment and signposting them to available support, it would empower patients to better manage their own health and know where to go to if they need help. This could reduce the number of hospital admissions for problems which could have otherwise been avoided.

The charity argues that if a patient is given advice on managing or reducing the side effects of their condition, they are more likely to get medical help from their GP or community nurse at an earlier stage preventing them from getting so ill they end up in hospital, or need more invasive treatment.

Dr Mauro Laudicella, a Senior Lecturer in Health Economics at City University London and lead author of the report, says:

“There is no doubt that the NHS in England is facing a huge challenge to provide care to an ever-increasing population of cancer patients, and our new study has shown just how expensive hospital treatment is for cancer patients years after diagnosis.

“With the additional costs of care for the main four cancers amounting to £1.5 billion in England in 2010, our evidence can be used to encourage the NHS to slow down the spiralling cost of care by investing in patients early on in their cancer journey. It is the only way that the NHS will ensure that in the future, everyone who has cancer will be able to get the care they need.”

Fran Woodard, Executive Director of Policy and Impact at Macmillan Cancer Support, says:

“The fact that cancer patients are receiving hospital treatment so many years after diagnosis is yet another sign of the mammoth challenge cancer poses to the NHS now and in the future. That’s why we need urgent action before the struggling system reaches crisis point.

“Cancer can leave people with debilitating side effects such as heart problems, incontinence and chronic pain which can result in long-term hospital treatment that is distressing for the patient, and expensive for the NHS. But if NHS England invests in early and rounded support for cancer patients it has an opportunity to give cancer patients great care and make its money go further.

“We’re urging NHS England to assess the needs of cancer patients and provide them with information and advice so they can fully understand their cancer, any long-term side effects and where to get help. They need support on all the other issues that cancer can bring, such as how to keep active, have a healthy diet and deal with money worries caused by their illness. This will give them the best chance to recover or live well. By acting now, NHS England has a chance to stem the tide of escalating cancer costs.”

Macmillan provides information and advice, through its website, information centres and telephone helpline, so people get help from the moment they are diagnosed with cancer and beyond. It also works with local partners to provide health and wellbeing clinics in some areas.

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