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Innovating Healthcare: World Cancer Day

In recognition of World Cancer Day, we partnered with thought leaders across the NHS, civil society and life sciences to discuss breast cancer and improvement to care pathways.

In the most recent episode of Innovating Healthcare, Chamber UK called attention to breast cancer for world cancer day. The session was chaired by former Deputy National Medical Director at NHS England, Professor Mike Bewick. The discussion included three highly qualified panellists who brought their experience to enlighten us concerning the disease, its impact and potential solutions.

The panellists for the session included:

Beginning of the journey

Starting the discussion, Dr Victoria Harmer gave an overview of diagnostics, prevention and screening of breast cancer patients. She noted that in her experience as Consultant Nurse at Imperial, around 50 percent of breast cancer diagnoses are through screening, with the other 50 percent through symptomatic. Around 1 in 7 women will get breast cancer in the UK, the vast majority of those being post-menopausal – therefore targeting of these patients is essential to ensure early diagnosis.

She noted the importance of tailoring treatment and care pathways around the patient, personalising treatment plans around the specific patient and cancer. Progress in this area has “sharpened the tools” the NHS has, contributing to the progress seen in breast cancer care.

On screening, Dr Harmer explained the 50-70 age group have always been the priority target for routine screening, although some NHS Trusts are extending to include a younger age bracket. Pre-pandemic, patients above the age of 70 were able to request screening but given the record backlogs this service has been reduced to a minimum. However, if patients have a genetic history of breast cancer there are yearly screenings and diagnostic services that are offered yearly.

Professor Bewick asked the justification to not screen younger women as part of NHS service. Dr Harmer explained that “around 80 percent of all breast cancers are found in the post-menopausal age bracket” and the use of mammograms is less effective in identifying mutated cells in younger women.

Patient experience

For a patient perspective Professor Bewick asked Ms Wroe, a patient representative from the Pink Ribbon Foundation, how she was diagnoses and her care pathways unfolded.

Ms Wroe explained how she became symptomatic and seeked advice from a GP, followed by specialist screening, ultrasounds and biopsies before being diagnoses with triple negative breast cancer. She noted she was fortunate to have a quick diagnoses from primary care into specialist screening – taking around 3 weeks in total. Ms Wroe explained triple negative breast cancer is an aggressive form that grows quickly, adding to confusing experience and worry for patients.

“There are so many different types of breast cancer, it a mind fog. You get told you’ve got cancer and you can’t take anything in – you’re thrown lots of information” – Charlotte Wroe

On Professor Bewick’s question on what support was available, Ms Wroe said the NHS clinicians and staff were incredibly supportive and filled her with confidence. Following her chemotherapy, she had a mastectomy which led to difficult after care. However Ms Wroe noted the support she has had from civil society groups like the Pink Ribbon foundation has been incredible. Charities are vital in providing information for every step of the patient journey.

Developments in screening and research

Professor Bewick asked Julia Levy on developments seen in clinical research to combat breast cancer with early interventions. Ms Levy noted the identification of genes was a major breakthrough, but the research sector is learning more about mutations and new treatments which is aiding genetic profiling.

“We can understand which treatment will be effective or have a higher chance of being effective, and which have a lesser chance. This means patients don’t need to go through treatment which may not have a good outcome for them. There is huge amounts of innovation and huge amounts of insight into the right therapies” – Julia Levy

Ms Levy noted these developments allow better morbidity rates and health outcomes to patients, but also wider clarity for the clinical community as well as the patient.

Final thought

The discussion from thought leaders in breast cancer provided incredible insights into the landscape of screening and research, and the impact of the disease on patients. The panel agreed to keep patients at the heart of treatment and care is essential to personalise patient pathways and ensure outcomes continue to improve.

Given the overall slipping of cancer targets across the UK, the Government must learn from the developments seen in breast cancer to ensure solutions are spread across oncology.

To watch the session, see below:

NHS Innovation & Life Sciences Commission

Following the successful launch of the 2022 report, the NHS Innovation and Life Sciences Commission is going to hold dedicated inquiries into oncology. Applying the methodology of thought leadership and practical implementation of policy, the Commission will find solutions to slipping cancer targets and improve population health and reduce health inequalities.

To find out more about the Commission, see here.

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