At least one in four people living with cancer – over 500,000 in the UK – experience a wide range of long-term debilitating health conditions caused by their cancer, according to a new report by Macmillan Cancer Support.
The Cured – but at what cost? report – which looks at the long-term consequences of cancer and its treatment – shows that cancer survivors have an increased risk of other serious conditions. Women living with or after breast cancer are almost twice as likely to get heart failure compared to those who have not had it, while men who have had prostate cancer are 2.5 times more likely to get osteoporosis compared to those who have not had it.
The report also reveals that at least 200,000 cancer survivors are estimated to be left with pain,  often with nerve changes after surgery, radiotherapy or chemotherapy. In particular around one in five diagnosed with breast, colorectal or prostate cancer report moderate or extreme pain or discomfort up to five years after initial cancer diagnosis.
Other cancer survivors face urinary and gastrointestinal problems which affect their quality of life. More than one in three (39%) men diagnosed with prostate cancer up to five years previously reported urinary leakage. While one in eight (13%) people who had colorectal cancer surgery at least two years previously needed to wear a pad in case of bowel incontinence all or most of the time during the day.
Richard Surman, 68, London, says:
“I was diagnosed with anal cancer in 2007 and had chemotherapy and radiotherapy. I felt like I had been burnt to a crisp inside and out and was in agony for months afterwards. Using the lavatory became a nightmare. Then I was hit with bowel incontinence – although it’s more controlled now, I still suffer from periodic bowel incontinence six years later. Having changed my own children’s nappies, it’s ironic that at 68 I’m now the one who needs nappies.”
The report also looks at the other troublesome consequences of cancer and its treatment such as: chronic fatigue, mental health issues, sexual difficulties and lymphoedema.
Professor Jane Maher, Chief Medical Officer of Macmillan Cancer Support, says:
“Put simply, the better we get at treating and curing cancer patients, the more people we will have living with the long-term effects of cancer and its treatment. In other words, progress is a double-edged sword.
“Many of these problems can be managed using simple and inexpensive interventions by health professionals, while other more complex issues require specialist services. Too many cancer survivors are suffering in silence. If they do speak up, doctors and nurses need to be confident in discussing such problems, so consultations are helpful – otherwise it is a poor use of precious NHS resources.”
CiarÃ¡n Devane, Chief Executive of Macmillan Cancer Support, says:
“For far too long the NHS has underestimated the severity of this issue and is woefully unprepared to help cancer survivors now and in the future. We are urging them to ensure that all cancer patients receive a ‘cancer recovery package’ at the end of their treatment offering ongoing support. No-one should be left to face the long-term consequences of cancer alone.”
Macmillan Cancer Support is urging health professionals and service commissioners to adopt the recommendations in the Cured – but at what cost? report.
Bowel Cancer UK’s statement in response to the above:
Deborah Alsina, CEO, Bowel Cancer UK said: “The long-term effects of treatment for cancer are often absent from public debate in the UK so this report is welcome. Survival rates for bowel cancer are high if caught early. So as we make progress on improving these rates, it is imperative that those people living with and beyond bowel cancer have the support and information they need to make sure they have a good quality of life.
Returning to a ‘normal life’ is an important step in recovering from having had cancer. It is vital that people are given all they need to manage the late effects of treatment, so they are not prevented from doing things such as returning to work, maintaining healthy sexual relationships and being able to participate in leisure activities.
Good quality health and well-being services, such as those around diet, physical activity and psychological support not only help people move on from treatment from cancer but also improve general quality of life and reduces risk of recurrence and improves general well-being.”
If think you might be suffering from the long-term consequences of cancer and its treatment, or are worried about someone who is, please call 0808 808 00 00 or visit www.macmillan.org.uk.
1 Macmillan estimate based on known cancer prevalence (Maddams J, Utley M, MÃ¸ller H. Projections of cancer prevalence in the United Kingdom, 2010-2040. Br J Cancer 2012; 107: 1195-1202) and expert consensus, see Macmillan Cancer Support (2013) Throwing light on the consequences of cancer and its treatment.
2. Based on data reviewed as part of Macmillan Cancer Support (2013) Throwing light on the consequences of cancer and its treatment: Khan NF Mant D, Carpenter L, Forman D and Rose PW. 2011. Long-term health outcomes in a British cohort of breast, colorectal and prostate cancer survivors: a database study. British Journal of Cancer 105, S29â€“S37.
3. Estimate based on data reviewed as part of Macmillan Cancer Support (2013) Throwing light on the consequences of cancer and its treatment: van den Beuken-van Everdingen MHJ, de Rijke JM, Kessels AG, Schouten HC, van Kleef M & Patijn J. 2007. Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol 18, 1437-1449 and UK cancer prevalence data.
4. Based on data reviewed as part of Macmillan Cancer Support (2013) Throwing light on the consequences of cancer and its treatment: Department of Health. 2012. Quality of Life of Cancer Survivors in England. Report on a pilot survey using Patient Reported Outcome Measures (PROMS). Majority of respondents (96%) had completed treatment.
5. Knowles G, Haigh R, McLean C, Phillips HA, Dunlop MG, Din FV. 2013. Long term effect of surgery and radiotherapy for colorectal cancer on defecatory function and quality of life. Eur J Oncol Nurs.
Bowel Cancer UK