Cancer battle is lost if patients fail to act

VIEWPOINT Professor Nick Lemoine Barts Cancer Centre and Institute

Up to 10,000 people a year in England die needlessly from cancer within five years of diagnosis.

Black women, on average, develop breast cancer earlier

In this week's Scrubbing Up, leading cancer expert Professor Nick Lemoine says the battle against cancer will never be won unless patients are more proactive.

Encouraging patients to face their fears and see their doctor early is vital if figures are to improve, he says.

We have an experimental cancer medicine centre offering treatments such as stem cell and gene therapies, not yet available elsewhere.

No matter how excellent our facilities, we are fighting a losing battle if people ignore their symptoms, either through ignorance or fear.

Up to 10,000 people a year in England die needlessly from cancer within five years of diagnosis.

A significant number of these deaths are due to patients not presenting earlier with symptoms.

Better diagnosis

Late diagnosis is a particular challenge for Barts and The London NHS Trust, which serves east London including Tower Hamlets, one of the most deprived communities in Britain.

We are working with our colleagues in primary care to change attitudes and encourage local people to come forward for screening and early diagnosis of cancer at a stage when it is treated more easily.

We are fighting a losing battle if people ignore their symptoms Read your comments

To do this we have to dispel myths and preconceptions by showing that the diagnosis of cancer is not necessarily a death sentence.

The reasons for deprived communities having generally poorer health include the effects of unemployment, low income, poor housing and low levels of literacy, as well as lifestyle choices.

Smoking rates are high, particularly for Bangladeshi men, while a significant proportion of Bangladeshi women, chew tobacco increasing the risk of mouth cancer.

Low uptake

Add to this low levels of health knowledge, and fatalism about life and poor health in middle age, and it may not be surprising that there is a poor uptake of health services.

Breast screening uptake in London is below the Government's target of 70% and while deprivation is a significant factor in explaining low breast screening coverage, ethnicity may be even more important.

To improve coverage levels, it is very important to work with all communities and overcome the cultural, language and other barriers that they face.

A programme, taking the message in the form of games and quizzes into pubs, bingo halls and community halls, places used by the older population in whom cancer is most common, has already delivered positive early results.

Also men can be reluctant to pick up and read leaflets, but in an area where bowel and lung cancer symptoms were displayed on beer mats, all the mats were taken.

To address minority communities, links were made with mosques, temples and faith groups to understand how best to reach these groups.

During Ramadan, we had noticed a spike in missed screening appointments as Muslim patients focused on their religious obligations.

Last year we worked with local imams who reminded their congregations of the importance of looking after their health by attending scheduled appointments.

The scheme was so successful, it is is now in the process of being rolled out to other Muslim communities elsewhere in the UK as part of the government's Cancer Reform Strategy.

While we are extremely proud of our centre at Barts, education, communication and reassurance are equally important if we are to be successful in tackling this disease.

As healthcare professionals, we need to continue to explore imaginative ways of raising awareness of symptoms, as well as the importance of screening, so that as many people as possible can benefit from those advances.

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