Macmillan’s Cancer Comparison: 1970s to Now

Yesterday, Macmillan published a fascinating report on the changes in cancer care over the last 40 years, comparing diagnosis, treatment and survival in the 1970s to now. Live Better With’s Dr Zahra Neshat has read the 23 page article article and picked out the most important and interesting parts to give you a useful summary of the improvements in cancer care, and those still needed.

We’ve pulled out four major messages:

  1. People with cancer are living longer and longer

  2. There has been a step change in the level of information, advice and support to deal with the practical and emotional challenges

  3. Care for cancer survivors is also a priority

  4. Cancer Statistics: Then and Now

 

  1. People with cancer are living longer and longer

Breakthroughs in cancer research mean that people diagnosed with cancer are now twice as likely to survive cancer than they were 40 years ago. Improved screening and treatments mean that cancer is more often life changing rather than life ending. For those cancers that remain incurable, they are now being better ‘controlled’ with newer treatments such as biological agents, meaning more people are living longer with cancer.

Chemotherapy

Advances -

  • New drugs have revolutionised cancer treatment and survival e.g. the use of Cisplatin a chemotherapy drug increased testicular cancer survival to 98%

  • In the 1970's and 80's chemo was still experimental with even worse side effects than now, e.g. strokes and heart attacks

  • Patients receiving this harsh new treatment did not know what to expect and often drugs to help ‘less significant’ side effects were not used in the same way they are now e.g. giving preventative anti-sickness medications  

Areas to improve -

  • Long term side effects e.g. fatigue and bowel problems, are still significant and these can have a huge impact on the quality of life for cancer survivors

Radiotherapy

Advances -

  • Old radiotherapy machines have been replaced with more advanced Intensity Modulated Radiation Therapy which focuses radiation more accurately, sparing healthy tissue

  • Brachytherapy - Internal radiotherapy devices have been developed which have significantly improved treatment for prostate, womb and cervical cancers

Areas to improve -

  • Whilst radiotherapy is now less crude, progress has been slow and there is still room for improvement

Surgery

Advances -

  • Surgery is now less invasive and more precise, this means that risks and complications of surgery are reduced e.g. fewer breast cancer patients now suffer from lymphoedema than in the 1970s.
  • Advancements in surgical technology also means we are now able to operate on previously inoperable tumours e.g. the NanoKnife and pancreatic cancer

Areas to improve -

  • Access to surgery - fewer people have surgery in the UK for cancer compared with the rest of Europe, even across the UK there are significant variations in access to surgery an overall trend of older people being less likely to receive surgery

Biological Therapy

Advances -

  • This is a new treatment option developed over the past decade which includes immunotherapy. It has been particularly effective in treating melanomas and kidney cancers

Areas to improve -

  • Further research and clinical trials are needed to help identify more biological agents to improve treatment options and outcomes for people with cancer  

  • Whilst biological agents are helping people live longer with incurable cancers, proper support needs to be in place to make sure a good quality of life is also achieved.   

 

2) There has been a step change in the level of information, advice and support to deal with the practical and emotional challenges

In the 1970s, awareness and support for patients living with cancer was minimal with little recognition that cancer can have an impact on the emotional well being of the individual and their family, as well as the impact it has on their work and finances. Over the last 40 years there has been significant improvement in access to patient-directed information, advice and support to help with both the practical and emotional challenges of living with cancer. There are now specific grants and financial support available and in 2015 Macmillan secured £280.9m worth of financial support for people living with cancer. Macmillan are on an ongoing journey to make sure that every cancer patient knows what they can access that can help with their day-to-day life - and here at Live Better With, this is at the heart of our mission too, and we will do everything we can to support this.

 

3) Care for cancer survivors is also a priority

For many, the end of cancer treatment is not the end of their cancer journey. The treatment they received can have a long lasting impact from symptoms such as lymphoedema and fatigue to depression or anxiety. With more people surviving cancer our attention now needs to turn to providing better care for cancer survivors. Macmillan believe, and Live Better With agrees, that with more people living longer after cancer, improving the quality of life for cancer survivors needs to be a priority.  

That’s why Macmillan, in partnership with the Department of Health, are rolling out a ‘Recovery Package' aimed at providing tailored support to cancer survivors. It includes things like advice on exercise which has been proven to help reduce side effects like fatigue and depression, as-well-as reducing recurrence of the disease amongst survivors.


4) Cancer Statistics: Then and Now

 

1970’s

1980’s

Now (*)

 

35,000 People still alive in the UK who were first diagnosed in the 1970s

136,000 People still alive in the UK who were first diagnosed in the 1970s

Total number of people living with cancer in the UK is 2.5million

352,000 new cases of cancer were diagnosed in the UK in 2013

Gender

24,000 Women

11,000 Men

93,000 Women

43,000 Men

173,000 Women

179,000 Men

Age at diagnosis

17,000 = 40-69 years old

18,000 = <40 years old

4,600 >70 years old

85,000 = 40-69 years old

45,000 < 40 years old

>50% are over 70 years old

But 0-24 year olds have seen a 43% increase in cancer rates compared with the 1970s

Cancer Type

Breast cancer - 8,000

Lung Cancer - 800

Bowel cancer - 2,500

Prostate Cancer - 160

Breast cancer - 35,000

Lung Cancer - 3,000

Bowel cancer - 12,000

Prostate Cancer - 1,500

Breast cancer - 53,696

Lung Cancer - 45,525

Bowel cancer - 41,112

Prostate Cancer - 47,3000

References:

* Data taken from Cancer Research UK, http://www.cancerresearchuk.org/health-professional/cancer-statistics, Accessed [Aug 2016].

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