On the News last night, they said that although cancer survival rates in the UK have been improving since the 1990s and the the Government’s National Cancer Plan, we are still trailing behind Nordic countries and the rest of Europe. 60% of people with cancer can expect to survive a year. Depressing stuff. Does anyone know what other countries are doing that’s so much better?
The media’s interpretation of these results has been rubbish. If you want the real thing you can get the 2007 results here statistics.gov.uk/statbase/prep/14007.asp
I am not convinced that in regards of breast cancer (survival rate has gone up by 0.9%) that there is much else that can be done - we seem to be at the boundaries of what science currently offers. I just don’t subscribe to the idea that somewhere else cancer patients are flourishing and being cured. All the current treatments have their limitations.
It is just plain misleading to lump all cancers together. We know that with breast cancer alone it is at least 4 different diseases with sub-groups of their own.
There are a good few of us on this forum that have had their treatment in different countries.
I am in France,and had all my treatment here.
When i asked my onc a couple of years ago how many people get BC here he said it was about the same figure as the uk but then added that France does have a much better survival rate.
I rememebr at the time i was having my chemo, people in the UK were fighting to get herceptin and i remember thinking that people get it here whenever they need it - they get the drugs here earlier than the UK and they get a drug if they need it. So thats one benefit.
I also beleive the check ups afterwards are much better here too.
My freind in the UK that had bc just before me has never had a cancer marker blood test done and when she asked they wouldnt do one - saying they were no good. So maybe that another factor.
I dont know about the Uk (not lived there for 20 years)but when you have your 50th birthday here you get a letter from your health care asking you to go for a colon inverstigation to check for colon cancer. Keep putting mine off and every 2 months i get another letter from them.
My consultant is always going to USA for whatever. So maybe the other countries are better on early detection? i cant think of much else.
It would be good to hear from ladies having treatment in these other countries so we can compare.
I haven’t posted on the new site so here’s hoping it works.
You might find the link to the following article of interest.
Lead researcher Professor Michael Coleman said: We know many cases are being diagnosed too late and this is a major reason for our poor survival. As a four year misdiagnosed breast cancer patient I have every sympathy for people who are “cancer aware” but cannot get into the system for further investigation because of their GP. The article also states that better survival rates in Europe are partly due to the fact that patients in many countries can have direct access to a specialist, while in Britain they must go through their GP.
Since I was diagnosed I have been campaigning for better training for GPs - falls on deaf ears by almost all campaign groups. I would also like to see the same standard of care throughout the country and easier access to the system.
In France you still go to the GP first then he finds a specialist for you.
I think it’s also so misleading when they add those with secondaries to the ‘survival’ stats. I’m a 5 year + ‘survivor’ but I was diagnosed with stage 4 bc from the very beginning.
x
Hi
I’ve been treated in both the UK and France for breast cancer.
What’s different?
As Pineapple says, availability of drugs doesn’t seem to be an issue here, so whatever is deemed appropriate is available without question or prevarication. This includes fitting Portacaths unless the patient wishes otherwise (I haven’t yet come across anyone who has). I imagine that the most recent UK statistics could be affected by previous wrangling over drugs that had been adopted earlier than on the Continent. For myself, I haven’t yet received any drug that doesn’t appear to be standard issue in the UK as well, either, except perhaps for slow release dexamethasone, which I think went a long way towards helping me sleep at night.
Everything does happen more quickly, appointments for scans, tests, availability of results, follow-ups appts, commencement of treatment. Whether this speedier approach translates into lives saved, I have no idea. What is clear however is that agonizing waits are kept to a minimum, which has to be good for a patient’s state of mind.
For me, treatment has often been pro-active rather than reactive. My first consultant went looking for (and found) a problem, despite a clear mammogram and ultrasound.
The treatment environment is less stressful. Shorter waits, comfortable ensuite rooms, good food, free and ample car-parking.
Any other factors? Here’s a random few that sprang to mind and have, at various times, been mentioned in association with cancer. I’ve come up with…
In my part of France, it’s very rare indeed to see a fat, let alone obese, person.
Tha air quality is excellent - power needs are met by nuclear, wind and solar.
French women have more children than most others in Europe. (Not sure whether they have them earlier, or not, tho’?)
There is more sunshine (Vitamin D), especially in the southern half of France.
These are just a few stray thoughts. I have no idea whether any of these (except maybe drug availability) individually, collectively or interactively, amount to anything at all…
X
S
Sorry Pineapple but that was Gallic bunkum from your onc! According to the latest data France has the 2nd highest incidence of breast cancer in the world. The UK is 5th. Given that fact I don’t think the environmental factors you cite Bahons play any role in prevention or treatment of BC over there.
But yes their survival rate is marginally better - or it was as of 2002 - I’ve no idea what it is like now.
There is a school of thought which says that if the NHS don’t embrace something then they must be penny pinching and depriving people of something which could be life saving. Certainly that was the case with Herceptin and other meds.
However I also think that the rigorous testing of NICE means that half-baked and unproven and expensive tests and treatments don’t filter into the system and gobble up millions. I am staggered by the amount of pointless nonsense that US women cough up for.
I have a friend in Montpellier with skin cancer who has had a terrible experience with the French health system and has returned to the UK. As with most things it is luck of the draw where you happen to be and who you happen to see.
I have received medical treatment in various countries over the years - USA, Belgium, Germany, Ukraine, Ireland, Spain - I cannot fault this experience with the NHS - it has been efficient, responsive, patient-led. I have had everything that is on offer for women with my kind of breast cancer. (And unlike France we don’t have to pay top ups on anything). I have had my travel costs paid for and all sundries such as wigs and prosthetics - and free prescriptions now. If the b*gger comes back, it won’t be the NHS’s fault.
Cancer specialists have been saying for ages that primary care medics need to refer people faster and I agree with Jeannie that this should be a key area of attention because it is the frontline for misdiagnosis. And the direct access to specialists that is common in Europe is something we really should embrace.
So msmolly, what were the figures for BC incidence in France 2 or 3 years ago then?
We dont pay top up (or need it) for anything cancer related in France.
We get taxi service to all our appointments (completely free) and everything thing else is covered 100% for the next 10 years when they then renew it. Dont pay a single cent for femara etc even my flight socks are free!
I think one of the main reasons for UK appearing to have poorer survival rates than other European countries is because UK worse at earlier diagnosis…partly caused by bureaucratic NHS problems, partly variability in GP referral practices, and partly due to Anglo Saxon reluctance to go to doctor with symptoms. Earlier diagnosis will often lead to improved 5 year survival statistics but not necessarily to improved overall survival.
As Belinda points out 5 year survival stats for breast cancer in particular can be very misleading. A lot of women survive 5 years (myself included) but will die subsequnetly of their cancer (as I will.)
Some European countries have better access to drugs than UK (avastin often quoted here) but the evidence is very limited that it is this access which leads to better overall survival…or indeed that overall surviavl is better.
I agree with msmolly that UK journalists are very bad at reportng evidence based scientific and medical information (there’s another article in the Bad Science Guardian column today about misleading reports on PSA test for prostate cancer).
The real questions we should be asking is why, given the millions spent on research aren’t the causes of cancer understood and the treatments for cancer better. Sniffing around tiny percentage points differences betwen different countries doesn’t solve the problem of how to treat and cure cancer.
Jane
I think one of the most misleading things about this report is the fact that the figures date from 2002. That’s 7 years ago and they are reporting it as if it were the latest information!
I was diagnosed with bc after my first routine mammogram and as I have lobular cancer, I probably wouldn’t have found it myself, as it doesn’t form a definite lump. I would probably have gone on for several years with undetected cancer, if it were not for that mammogram. Yet there are still women out there who refuse to go for them because they are scared. I think it’s much scarier to find out a couple of years down the line that your cancer is advanced and your prognosis is grim, rather than being told, as in my case, that you only have to have surgery and rads, because they’ve found it early.
Women need to get their heads out of the sand, but reports such as these recent ones in the media make women more scared of detection, not less. We need more positive stories in the press, about women like me who are having the minimum amount of treatment because their cancer has been found early. What we seem to be getting though, is constant stories like Wendy Richard and Jade Goody. How can anyone feel positive about cancer when those stories abound in the British press?
I agree JaneRA. Cancer prevention, treatment and cure lies solely in the hands of research scientists - not NHS administrators, health policy quangos or statisticians.
I have no idea what the exact incidence rates in France were 2 or 3 years ago Pineapple. Cancer Research 2006 estimated figures for Europe had France 4th and UK 7th.
I think unfortunately that you have missed my point entirely.
I was not wishing to engage in some kind of Breast Cancer It’s A Euro-Knockout. (Although I’d love to know why my chances of survival are so good in Lithuania or Slovakia!)
I was trying (and obviously failing) to point out how crass and ill-informed the media are when it comes to cancer and health stats. These recent statistics reveal that the millions poured in as part of the Govt’s cancer plan have had no effect on reducing mortality rates. This has somehow been distilled into “UK is crap at cancer and everywhere else is brilliant.”
Simply not true.
My treatment for breast cancer has been exceptional. I am very happy with all of it and I do not believe that I would find superior treatment anywhere else. You are happy with your treatment too Pineapple. Isn’t it good to live in countries with socialised healthcare, unlike the 50 million Americans who have no health insurance?
Whether I become a mortality statistic or a survivor statistic remains to be seen - but as things stand there is nothing, absolutely nothing that modern medical science can do for me that hasn’t already been done. If this disease gets me then it is not due to NHS inefficiency or poor Government health policies - it is because they haven’t found a cure for this s*dding thing yet.
(BTW Salopets, the stats are from people diagnosed between
2001 - 2006 and followed up to the end of 2007.)
I have no idea how poepl in the USA manage although i admit i dont really know much about their healthcare and how they pay or not!.
What i find alarming here is that all the young French smoke - it makes me very sad to see them. So this is going to greatly add to the figures in the follwoing years.
However on the plus side you dont see fat youngsters - i think the diet is alot healthyier over here, partly due to the fact there isnt alot of take away food available. there are the usual mcdo’s but on the whole the French culture of freshly cooked meals every day continues, its something we have enjoyed the last 9 years so i am sure that accounts for the lack of fat kids/teens and adults.
Thanks for all this - really interesting. I think too that the UK probably delivers much the same standard of treatment as anywhere else in Europe. The limiting factor is that cancer is still so poorly understood. In the 70s and 80s my dad used to have to operate on people with stomach ulcers because at that time the cause was unknown and taking them out was the only treatment. Now of course we can treat the underlying cause and operations are a thing of the past. It seems to me that we are in the same position now with cancer - doctors deal with the results but until the cause is understood, treatment can only be s a hit and miss affair. It’s exasperating though as progress seems so slow despite all the time and money spent on research.
Hi salopets, you mentioned the mammogram programme in your post and I agree women should definitely take up the opportunity but sadly the majority of us who post on the secondaries forum were diagnosed many years before our 50th birthday. There are many women posting on the secondary forum who are in their 30’s, even late 20’s. I was diagnosed stage 4 at the age of 44.
I guess it sometimes depends on which side of the fence you are but apart from Jade Goody the media seems, to me, awash with ‘positive’ stories, especially in October. (I personally can’t stand the Asda ‘Tickled Pink’ merchandise.) Stage 4 women are only just now beginning to get some recognition but it saddens me to often read of women attending bc support groups and not disclosing their stage 4 diagnosis for fear of upsetting others present.
Also I must mention I’ve had excellent care here in the UK. Even at stage 4 I’ve had very pro-active treatments and care.
Hi salopets I’m pleased that your cancer was diagnsoed when it was at an early stage and that your treastment was ‘just’ WLE and radiotherapy. (its still serious treatment.)
In some cases early diagnosis saves lives but fewer than perhaps you think. Many women have more treatment than you had because of the type of breast cancer they had…their cancer was agressive from the start.
Wendy Richard’s story is sadly only too common. She was originally diagnosed in 1995, had treatment, then a recurrence in 2002, and then the metastatic recurrence which killed her. I guess her breast cancer was originally diganosed ‘early’.
Breast cancer is not one disease but many, and women who die of it are not someohow to blame for not having mammograms.
best wishes
Jane
Hi Ladies
I have read this with interest. I feel that not enough is done for early diagnosis. I was 41 when diagnosed, and i was lucky that the cancer presented itself through the nipple. I didnt have a lump - I had DCIS and pagets. If my cancer been undetected via the nipple, the first time i would have known about it would have been because it would have developed into a lump. A cancer lump is usually indicative that it has developed into invasive cancer… and possibly spread. My cancer was picked up by mammogram.
I have met and spoken with many many women in their 30’s 40’s with breast cancer. If there is a small chance that a mammo can pick up DCIS before it becomes invasive, why are they not offered to younger women also. I know that the ‘younger’ breast is more dense, but on the day I went for my mammo, my period was due and they were very swollen… but they still picked up the microcalcifications.
Also, getting past the GP can be difficult… just getting an appointment at mine is a full time task. How many women just give up trying and not bother? After my reconstruction (DIEP), I had to wait 12 days for an appt with my GP!! Needless to say, I now have a new GP!
Early detection is key to improved survivial rates.
Lisa X
The French have always been world-class smokers Pineapple.
I would imagine that the recent smoking ban would reduce the number of smoking-related cancer deaths in France - as is the trend across most of Europe now. About 5 years ago lung cancer deaths were plummeting in the UK while French rates had quadrupled - which is what prompted the French smoking ban in 2007.
I agree that early detection is key Lisa.
I think the debate about early detection has highlighted a few problems.
I think also that JaneRA, you have a good point when you mention Anglo-Saxon reticence in connection with visiting the GP. If you add difficulties in getting an appointment in many areas (Lisa) together with the pressures on GPs (I think they were offered a bonus) not to refer ‘too many’ patients onto consultants (there was a lot of Press coverage of this last year), it is possible to see how a patient with bc could be slow tracked by a combination of factors.
BTW, I think we should also be careful not to confuse ‘incidence’ (whether a country is 2nd, 5th whatever in Europe, the world) with ‘survival rate’ (a different statistic) . We have a high incidence of colds in Europe, but also a low death rate from them, if you see what I mean…
Finally, this statement, made by Harpal Kumal,Harpal chief executive of Cancer Research UK, was published in The Times today:
'Huge progress has been made over the past 30 years in beating cancer, both through reducing the numbers getting the disease in the first place and a doubling of the numbers of those who live for years after diagnosis.
But by the late 1990s it became clear that survival rates in Britain were not matching up to other West European countries. The main problem was the underfunding of cancer services that there had been over many decades.
The Government’s response was to draw up the NHS Cancer Plan in 2000, and it could be moving survival rates in the right direction.
Generally, survival rates continue to improve. But how much of an improvement is enough?
There are still regional variations — in part because of unhealthy habits such as smoking and heavy drinking, but also because of inequalities in access to healthcare services and GPs.
Cancer Research UK estimates that 5,000 more lives could be saved each year through earlier detection and diagnosis.
Some of the criticisms of the cancer plan are valid — everyone needs access to the world-class services that are available only in some parts of the country. Reducing waiting times for radiotherapy, investing in the training of surgeons, and increasing Britain’s expenditure on cancer drugs to the average of West European countries will make for further progress.
But it is hard to quantify whether the money has been well spent just by looking at survival rates one, three or five years after a diagnosis. The figures are a crude indicator of a complex disease, some types of which are eminently treatable if caught early, and others that are not.
Cancer Research UK will continue to invest in core areas of science to reduce cancer deaths — including greater investment in those areas where survival rates remain poor. Yet we cannot expect that underinvestment in services over decades will be fixed in six or seven years. Our spend on cancer services remains well below comparable European nations. A recent study in 2007 shows Britain’s spend at ¤132 (£124) per capita, compared with an average of ¤205 per capita across France, Germany and the Irish Republic.
We must also focus on preventing cancer, through promoting healthy lifestyles. The Government updated its 2000 plan with a Cancer Reform Strategy just over a year ago, which has shifted the emphasis from targets and capacity towards world-class services and better experience for the patient.
We need to take a closer look at which parts of the plan have worked and which parts have not’.
X
S
Similarly, survival rates should not be confused with mortality rates. Nor actual/absolute risk with relative risk - an area which the tabloid media always exploit to create maximum headline grab.
This is the clearest way I know of understanding the difference -
A certain type of cancer has a 1 in 10,000 risk. (Actual or Absolute risk)
A pesticide is known to increase that risk by 200% (Relative risk)
What that actually means is that instead of 1 person in every 10,000 getting it, 2 more people will get it - so a total of 3 people in 10,000.
This can also be expressed as “increasing your risk three-fold” or “three times as likely to get it.” Both of which sound much more alarming than 3 people out of 10,000 getting it.
Personally I think only incidence and mortality stats are worth bothering with - how many get it and how many die from it. (Cancer Research’s primary statistics are all about incidence in direct relation to mortality - not survival.)
Breast cancer incidence is on the up across the globe - even in countries which historically have low rates (e.g. China, India).
As far as I am aware not one country has seen its breast cancer incidence figures plateau or fall - regardless of how much cancer spend is per capita.