7 images that defined cancer policy in 2022

Cancer Research UK – December 27, 2022

This year we have seen three different Prime Ministers and UK governments. Amongst the political turbulence, we’ve accomplished a lot in cancer policy and campaigning in all four nations of the UK and globally. From research and prevention to diagnosis, we’ve been advocating for change to beat cancer. Here are some highlights.

• Cancer Plans across the four nations
• Launching our campaign for a #SmokefreeUK
  Tobacco tax rises in Sri Lanka & Nepal
• Junk food price promotions legislation in Scotland and Wales
• Cancer research benefits the economy
• New research into inequalities and cancer
• Progress on the horizon for NHS workforce shortages

Further details – 7 images that defined cancer policy in 2022

Early cancer diagnosis and COVID-19: unpicking the impact of the pandemic

Cancer Research UK – 22nd December 2022

One of the best ways to help people survive cancer is to find it early. That’s why NHS England has a target of diagnosing 75% of cancer cases in stage 1 or 2 by 2028.

Unfortunately – despite the tireless work of NHS staff, as well as a range of national strategies and initiatives – it looks like we’re going to fall well short of that target. The proportion of people diagnosed early had been stuck at around 54% since 2013. In 2019, it was already clear that we needed to do more, and that we needed the right workforce and equipment to make progress. And then COVID-19 happened.

The pandemic disrupted cancer services and changed people’s behaviours. In England, screening programmes were effectively paused for several months, far fewer people visited the doctor for cancer symptoms and services struggled with increased restrictions and reduced capacity.

And one question we’ve been asked regularly over the last couple of years is: how has the pandemic affected early diagnosis?

Research from earlier in the pandemic tried to model its impact, but the evidence was very limited.

Now, though, we have good quality data for 2020, which means we can begin to answer the question.

Further information – Early cancer diagnosis and COVID-19: unpicking the impact of the pandemic

New device to revolutionise prostate cancer diagnosis

National Health Executive – 21st December 2022

New research has helped shine a light on a “revolutionary” new device that could improve prostate cancer diagnosis and patient safety for the future.

The standard practice for diagnosing prostate cancer patients currently involves a needle that passes through a patient’s bowel wall to reach the prostate, requiring a general anaesthetic. Not only is this process painful, it can also lead to urinary infections and perhaps even more deadly infections like sepsis.

The Cambridge Prostate Biopsy Device (CamPROBE) on the hand takes the biopsy sample through the perineum, which reduces the overall risk of infection and can be done using local anaesthetic. The device is also anticipated to cost less than half than the crop of devices used for current prostate diagnosis practices.

The research, which has been published in the Journal of Clinical Urology, highlights how the CamPROBE is “safe, transferable and maintains high diagnostic yields.”

More information – New device to revolutionise prostate cancer diagnosis

Innovative skin cancer service leading the way in the North West

National Health Executive – Dec 21st 2022

An innovative skin cancer service at Blackpool Teaching Hospitals NHS Foundation Trust has helped clinicians boost output and avoid appointment cancellations.

The trailblazing Teledermatology service has been running since 2021 and, such has been its success, staff have been asked to present at the NHS’s Faster Diagnosis Collaboration Event in February.

The service was initially set up in 2019 as a pilot and involves medical photographers documenting a patient’s suspected skin cancer. Once the images are taken, they are then reviewed by either a lead nurse or a doctor within two days.

This process has allowed the trust to double the amount of patients seen and cut the amount of appointments being cancelled, and, despite the ongoing shortage of dermatologists, the Teledermatology service has allowed the trust to keep within national targets even in the face of ever-increasing demand.

More details – Innovative skin cancer service leading the way in the North West

NICE recommends Enhertu for more people with advanced breast cancer

NICE – 20 December 2022

Hundreds more people eligible for breast cancer drug Enhertu as NICE recommends it for earlier stage disease, in final draft guidance.

Today’s decision means NICE has recommended all 18 treatments for breast cancer it has looked at since 2018.

There is no cure for advanced breast cancer, so treatment aims to stop the disease getting worse, extend life, and maintain or improve quality of life for as long as possible.

Clinical trial evidence shows that Enhertu increases how long people have before their cancer gets worse compared with standard care with trastuzumab emtansine.

However, there is not enough evidence yet to show how much longer people live with Enhertu compared with trastuzumab emtansine because the clinical trial is still ongoing. This means the cost-effectiveness estimates are highly uncertain and Enhertu cannot be recommended for routine use in the NHS.

The independent appraisal committee concluded that Enhertu could be cost-effective if further evidence from the ongoing trial and from NHS practice can show how much longer people live with treatment. So, Enhertu is recommended for use within a managed access arrangement

More information – NICE recommends Enhertu for more people with advanced breast cancer

Our most important cancer research stories of 2022

Cancer Research UK – 14th December 2022

Our 20th anniversary year has been about much more than looking back. 2022 has been full of research and advances that are worth celebrating in themselves. 

Further information – Our most important cancer research stories of 2022

Men’s choice of treatment for prostate cancer is influenced by their travel time

NIHR – 15th Dec 22

Men with prostate cancer may have to choose between surgery or radiotherapy treatment. Research found that their decision was influenced by how far they needed to travel. If the alternative treatment was an extra 15 minutes away (or more), men were more likely to receive the option closer to home.  

Surgical services for cancer are being centralised. This means specialist services are offered by fewer, larger centres. Centralisation can improve treatment outcomes (including better survival), but it also means that some people need to travel further for treatment.

This study analysed national data to determine where two of the most common prostate cancer treatments (surgery and radiotherapy) were available. Researchers assessed whether the treatment men received was influenced by how far they needed to travel.

It found that fewer than half of the hospitals provided both surgery and radiotherapy. Men’s travel time influenced the treatment they received, as did their age, ethnic and economic background, and the number of long-term conditions they had.

Full article – Men’s choice of treatment for prostate cancer is influenced by their travel time

This Alert is based on: Aggarwal A. and others. Impact of centralization of prostate cancer services on the choice of radical treatment. BJU International 2022

Human papillomavirus vaccination and cervical cancer risk

BMJ / 15th December 2022

Abstract

Persistent human papillomavirus infection is the central cause of cervical cancer, the leading cause of cancer death among women worldwide. Clear evidence from both randomized trials and population based studies shows that vaccination against human papillomavirus reduces the incidence of cervical pre-cancer. These data suggest that the vaccine reduces the incidence of cervical cancer. However, human papillomavirus vaccine coverage is inadequate in all countries, especially in low and middle income countries where disease burden is highest. Supply side strategies to improve coverage include increasing the availability of low cost vaccines, school located delivery, single dose vaccine schedules, and development of vaccines that do not need refrigeration. Demand side strategies include enhancing provider recommendations, correcting misinformation, and public awareness campaigns. The near elimination of cervical cancer is achievable through increased uptake of human papillomavirus vaccination and efforts to increase screening for cervical cancer, especially when enacted to reduce disparities in access across the world.

Full text: Human papillomavirus vaccination and cervical cancer risk

Improving patient experience in clinical trials using Trialmap

Cancer Research UK – Dec 22

Cancer Research UK has partnered with Stitch, a digital startup, to create the Trialmap app for clinical trial patients. The app provides patients with information about their trial, appointments, and the opportunity to give feedback on their trial experience. The app has recently gone live for its first clinical trial.

Trialmap has been co-created with input from ECMC research nurses and over 40 patients. The feedback that Stitch collects will be made available to help improve future Cancer Research UK studies, making them better for patients and more effective at investigating novel treatments.

Find out more

Cancer mRNA vaccine completes pivotal trial

BBC News – 13 December 2022

Researchers say they have successfully completed a trial of a personalised cancer vaccine that uses the same messenger-RNA technology as Covid jabs.

The experimental vaccine, made by Moderna and Merck, is designed to prime the immune system to seek and destroy cancerous cells.

Doctors hope work such as this could lead to revolutionary new ways to fight skin, bowel and other types of cancer.

Moderna and Merck called it “a new paradigm” moment.

Other pharmaceutical companies are looking to run similar studies.

But this is the first phase-IIb randomised clinical trial to test the investigational mRNA vaccine in patients.

More information – Cancer mRNA vaccine

Background Research – Lancet Oncol 2022; 23: e450–58 – Clinical advances and ongoing trials of mRNA vaccines for
cancer treatment