Karol Sikora: Millions of people are waiting for cancer services. That’s the second wave we should worry about.

Professor Karol Sikora is CMO of Rutherford Cancer Centres and Former Director of the WHO Cancer Programme.

Let me be clear, I have absolutely no interest in getting involved in politics. Despite being labelled a Government stooge on more than one occasion, one glance at my Twitter account will show that I have made my objections to Government policy clear, perhaps too frequently!

Before March I honestly had no idea how Twitter worked, I thought it was the sound birds made in the morning. The whole reason I signed up was to ensure cancer patients weren’t forgotten about in this Coronavirus whirlwind. To be honest, I failed.

We’ve tried everything; writing articles, doing media, lobbying ministers, online petitions. None of it has worked, there are still millions of people waiting for cancer services. Recent estimates put that number at 3,000,000 people, that is staggering. We’ve heard lots of words from Government, but not nearly enough action. Hopefully the message from this article may reach the right people.

Everyone reading this will have been touched by cancer in some way, we all know how relentless and insidious it is. It doesn’t stop for anything, never mind pandemics but we have given it far too much freedom to run riot over the last few months.

A delay of a few weeks in most cases will make no difference, and many cancer patients have had treatment delayed for appropriate clinical reasons, but lots have been delayed for operational reasons.

Sadly at the start of this pandemic I would always talk in hypotheticals about how many people could die from cancer delays. That is no longer the case; people have already lost their lives because the treatment they needed was not available.

We have far too often seen doomsday predictions thrown around by people who don’t fully understand the consequences. It is people of my age who are most petrified by this climate of fear and who are now unwilling to “trouble” the NHS. We’re the ones who need the help the most!

“Stay Home, Protect the NHS” was a brilliant slogan, but it was far too effective. People having heart attacks would refrain from ringing 999 and the numbers of people diagnosed with cancer this year has fallen off a cliff compared to the average. If anyone from the No 10 Behavioural Insights Team is reading this please understand you are playing long term with forces you don’t understand.

Oncologists have spent decades trying to get people to get persistent symptoms checked, so much of that progress has been undone in the last few months. I have neighbours who won’t even open their windows they’re so scared of catching the virus, if they find an unusual lump are they going to go and get a scan? I think not.

So what can we do? I’m acutely aware it’s all too easy to throw stones from the sidelines while offering no solutions. Isn’t that how politics works?

The approach has to be two-fold. First, we have to get cancer care prepared for the inevitable surge, but we also have to encourage that wave to come. If people won’t get checked at an early stage, sooner or later they will need treatment.

We need “COVID-secure” hubs to treat and diagnosis cancer. Weekly staff testing, temperature checks, ultra-caution within the building. We have to make cancer care as safe as possible to give people the confidence to come forward.

Embracing all available capacity seems obvious. My network, the Rutherford Cancer Centres, has increased our collaboration with the NHS during the pandemic and are willing to go further. There are other independent providers who have the capacity to help, it would be wrong to leave those machines empty whilst millions have cancer services delayed.

There is going to be a surge, we need to know exactly when that is coming to get ourselves prepared. I anticipate around September, so oncologists and our dedicated support staff should be getting ready for a very difficult autumn/winter.

What frustrates me the most is the fact that so many other countries have continued cancer treatment with not nearly as much disruption as us. An oncologist friend of mine has a Brazilian partner, even there they are dealing with cancer admirably in the face of a far worse situation than us.

The prospect of a second wave is one we have to take seriously and I have always said we are right to prepare for the worst, but we are already in this cancer crisis. In my mind, the second wave we have to worry about is the millions of neglected cancer, cardiac and other seriously affected patients who have been ignored.

History will not judge us kindly when the full damage of this disaster is visible. It isn’t too late to avert the worst of it, but we desperately need action, not more rhetoric and even worse dithering.

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Author: Professor Karol Sikora


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