Advanced bowel cancer patients denied surgery to extend their life
Wednesday 27 September 2017
Advanced bowel cancer patients are losing out on the opportunity to live longer because NHS clinical specialists are not included in treatment decisions and as a result are denied surgery that could extend their life, a survey for our new report, ‘Get Personal: Unlocking treatment options for advanced bowel cancer’, has found.
This research launches today on World Metastatic Colorectal Cancer Day.
Every year 41,200 people in the UK are diagnosed with bowel cancer, with 10,000 people (23-26%) diagnosed at stage four. Many more people who are diagnosed at an earlier stage progress to stage four. Survival rates for people diagnosed at this stage are poor. Less than one in ten people (8%) with advanced bowel cancer survive for five years or more, compared with more than nine out of ten people (98%) diagnosed with stage 1 bowel cancer.
Advanced bowel cancer, also known as stage four, secondary or metastatic disease, is when the cancer spreads from the bowel to other parts of the body, most commonly the liver or lungs.
Around a fifth of patients with advanced bowel cancer (20%) have liver-only metastases. Clinical guidance recommends referring these patients to a liver specialist. It’s important that liver surgeons are consulted because research shows patients treated with chemotherapy alone survive for around six to 22 months, compared to 44-74% of people surviving five years following liver surgery. In addition, patients treated at a hospital with a specialist liver MDT [multidisciplinary team] were also associated with improved survival rates.
Our survey of advanced bowel cancer patients found wide variation in the involvement of specialists in their treatment decisions. A fifth of patients surveyed (21%) with liver metastases did not have a liver specialist involved in their treatment plan, whilst 37% did not have liver surgery.
The survey results echo an earlier study from Aintree University Hospital NHS Foundation Trust that show of 53 patients with liver metastases who had not been reviewed by a specialist surgeon and were being treated with palliative chemotherapy, 63% could have had curative liver surgery. Patients with liver metastases that do not have a liver specialist in their multidisciplinary team can lead to patients being denied potentially curative treatment.
Our healthcare systems must take significant proactive steps to ensure people are diagnosed at the earliest stages of bowel cancer when it is more treatable.
One survey respondent said: “The first MDT I saw said my liver metastases were inoperable after 18 cycles of chemotherapy. I had to seek a second opinion from another MDT, but was very far from home. This MDT said I was operable.”
We are calling on the Government, the NHS and professional bodies to work together to ensure all bowel cancer MDTs have access to and include established regional advanced bowel cancer MDTs in treatment decisions, including lung; liver; and pelvic specialists. An advanced bowel cancer MDT is made up of specialists (based at the hospital or a regional centre) who represent the range of specialties needed to effectively manage and treat every aspect of advanced bowel cancer.
Mr Stephen Fenwick, Consultant Hepatobiliary Surgeon at Aintree University Hospital, Liverpool, says: “The evidence is clear. The involvement of specialist surgeons in treatment decisions can increase the chance of advanced bowel cancer patients being offered potentially curative treatment options. This can lead to patients’ lives being extended or even cured. To deliver the best outcomes for patients we need to establish and formulise advanced bowel cancer MDTs to ensure no patient misses out on the best life-saving treatment options.”
Deborah Alsina MBE, Chief Executive of Bowel Cancer UK, says: “The exclusion of specialists in treatment decisions can have devastating consequences for people with advanced bowel cancer. These patients have poor survival rates; less than one in ten people survive for five years or more so they must not be denied access to surgery that could extend their life and in some cases offer hope of a cure. We must do more to transform survival chances for advanced bowel cancer patients and access to specialist surgery is a vital component to ensure lives are not needlessly lost.
“Bowel cancer is the second biggest cancer killer in the UK, many of these deaths can be attributed to patients diagnosed at the latest stage of the disease, but it doesn’t have to be this way. Our healthcare systems must take significant proactive steps to ensure people are diagnosed at the earliest stages of bowel cancer when it is more treatable. They must also ensure people who are diagnosed late are given treatment that is right for them and maximises their chance of surviving the disease.”
Watch the full campaign video
- Find out more about our Get Personal campaign
- Ask your MP to become a Bowel Cancer Champion and help us unlock treatment options for advanced bowel cancer
- Read our blog from Mr Stephen Fenwick, Consultant Hepatobiliary Surgeon on why access to specialists is vital
- Read our blog from Stacey Heale – her partner has advanced bowel cancer
- Share your story of advanced bowel cancer
What is World Metastatic Colorectal Day?
World Metastatic Colorectal Day is an international day to raise awareness and understanding of advanced bowel cancer.
We’ve joined forces with Bowel Cancer Australia, Colon Cancer Alliance (US), Fight Colorectal Cancer (US) Colorectal Cancer Association of Canada, Europa Colon and Foundation A.R.CA.D. (France) to increase survival rates, improve quality of life and reduce variation in access to best treatment and care for people living with metastatic colorectal cancer around the world.