Cancer doctors call for reform: National treatment network urged

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CANCER services in England and Wales are outdated and inadequate and have not been organised properly for 40 years, according to experts who propose a radical national structure for treatment.

Their proposed service would give everyone specialist cancer care within an hour's drive from their home. Another 45 cancer consultants would have to be appointed.

One in three people will suffer from cancer and 250,000 new cancers are diagnosed each year in the UK. At least half will receive drug therapy, yet medical oncologists, the cancer physicians, are few and far between.

Some estimates suggest that only half of cancer patients are treated by doctors specialising in cancer care and that 10 per cent of cancer patients' lives could be saved if they received the best possible treatment.

'There are rather less than 50 whole-time doctors in medical oncology in the country,' Professor Michael White house, chairman of the Association of Cancer Physicians, said. 'That means there is one medical oncologist per million of the population and that compares with one per 100,000 in the United States.'

The plans announced yesterday by the association reveal the gaps and inequities in cancer provision. Two health regions, Oxford and South Western, have no major expert cancer centre. There are 15 such centres, only 9 of them outside London.

The report describes a new system in which major centres with at least eight full-time medical oncologists would be linked to about 30 local units, based on general hospitals.

Professor Whitehouse, director of the Cancer Research Campaign Wessex Medical Oncology Unit, University of Southampton, said there had been no real organisation for cancer services since radiotherapy centres were developed from the 1930s to the 1950s.

'Fifty per cent of all patients eventually now have some form of chemotherapy. It is very likely that the medical management of cancer will become much more complex . . . We are much more likely to be able to manipulate cancer cells in a way we never dreamed about 10 years ago. This means we must have an infrastructure in place,' he said.

The major cancer centres would be linked to research and provide advanced treatment, training and treatment assessment.

Review of the Pattern of Cancer Services in England and Wales; Association of Cancer Physicians; Department of Medical Oncology, Southampton General Hospital.