There are ‘insufficient specialists’ to serve the UK’s multidisciplinary lung cancer teams (LCMDTs) – and some healthcare professionals still hold a ‘pessimistic and outdated’ view of what can be achieved for patients – says a new, national report published today (20 November) by leading lung cancer experts.
According to the UK Lung Cancer Coalition (UKLCC), there are only around 70, specialist thoracic surgeons supporting over 200 LCMDTs; lung cancer nurses are overstretched; and many oncologists may not be fully up-to-date with the latest lung cancer management practices.1
“Poor MDT performance is hindering patient survival,” says Mr Richard Steyn, chair of the UKLCC and consultant thoracic surgeon. “It’s imperative that every lung cancer patient’s case should be managed by a fully-equipped MDT – and closer, and more effective, working across clinical specialties is vital.”
‘The Dream MDT for lung cancer’ sets out to challenge current lung cancer practices – and exceed current NICE guidelines – by setting out 30 ‘aspirational’ but hard-hitting recommendations for LCMDTs across the country.1
Among its detailed proposals are that all patients should have access to a lung cancer specialist nurse, GPs and hospitals must work more closely, and all cancer teams should have a thoracic surgeon as a core member.
The report was developed following an extensive, nationwide consultation across the lung cancer community, which included cancer nurse specialists, GPs, medical and clinical oncologists, respiratory physicians, surgeons, radiologists and palliative care.
“This report identifies a gold-standard practice for lung cancer – the sort of care clinicians would wish for their own families,” says Dr Mick Peake, NHS national clinical lead for lung cancer and consultant respiratory physician, who heads up the UKLCC’s clinical advisory group. “It is intended to stimulate discussion and sets out a number of standards for lung cancer MDTs to benchmark against their own current practices. As many as a third of UK lung cancer patients still do not have their case discussed by an MDT in some parts of the country. This simply isn’t good enough.”
Lung cancer continues to be the UK’s biggest cancer killer.2 There are almost 35,000 deaths every year,2 which amounts to a greater death toll than breast cancer, prostate cancer, bladder cancer and leukaemia combined.3It is reported that four people die from lung cancer in the UK every hour. 2
Despite improvements in services in recent years, wide variations in lung cancer treatment and care continue to persist across the UK and survival rates lag behind other comparable countries in Europe.4,5 Patients in the UK are diagnosed with more advanced disease than many other countries and almost 40% first reach specialist care via an emergency admission to hospital.,6
The UKLCC’S vision is to double lung cancer survival during the next eight to ten years, with the co-operation of health professionals, policy makers, local primary care organisations, NHS and Government.
“By improving MDT working and applying the best standards already being demonstrated in the best centres in Europe, we could save 3,500 lives each year,” adds Dr Peake.
For a copy of ‘The Dream MDT for lung cancer: delivering lung cancer care and outcomes’ please visit http://www.uklcc.org.uk
November is Lung Cancer Awareness Month.
The UK Lung Cancer Coalition (UKLCC) is the UK’s largest multi-interest group in lung cancer.Evidence from the recent National Cancer Patient Experience Survey (NCPES) 2011/12 reveals that over a third of lung cancer patients felt that the staff involved in delivering their care did not work well together.7
The National Cancer Peer Review Programme recently expressed serious concerns about specific issues in a number of lung cancer MDTs amounting to 12% of all the 158 MDTs reviewed. The most common problems in the teams included lack of CNS cover and high CNS workload; delays in CT scanning; bronchoscopy capacity leading to problems with access and delays; lack of fast track lung cancer clinic; delays in radiology (commonly CT guided lung biopsy) and pathology; lack of clinical oncology expertise and limited access to thoracic surgeons. These findings endorse the recommendations outlined in the UKLCC’s new Dream MDT for Lung Cancer Report. 8
1. The Dream MDT for lung cancer: delivering lung cancer care and outcomes,’ UK Lung Cancer Coalition, Nov. 2012
2. Figures from Cancer Research UK, accessed October 2012 and vailable at: http://info.cancerresearchuk.org/cancerstats/types/lung/mortality/
3. Figures from Cancer Research UK, accessed October 212 and available at: http://info.cancerresearchuk.org/cancerstats/mortality/cancerdeaths/?a=5441
4. National Lung Cancer Audit Report 2011. Accessed October 2012 and available at: http://www.ic.nhs.uk/services/national-clinical-audit-support-programme-ncasp/audit-reports/lung-cancer
5. ‘Cancer survival in Australia, Canada, Denmark, Norway, Sweden & the UK, 1995-2007’, The Lancet 377: 127-138, MP Coleman, D Forman, H Bryant, et al., 2011
6. Routes to diagnosis for cancer – determining the patient journey using multiple routine data sets. Elliss-Brookes L, McPhail S, Ives A, Greenslade M, Shelton J, Hiom S, Richards M. Br J Cancer. 2012, 107(8):1220-6.
7. Cancer Patient Experience Survey 2011/12 national report. Access October 2012 and accessed at: http://www.dh.gov.uk/health/2012/08/cancer-experience-survey/
8. National Cancer Peer Review Programme Report 2011/2012: Lung. Accessed October 2012 and available at: http://www.cquins.nhs.uk/documents/resources/reports/Lung_NCPR_Report_11-12.pdf
UK Lung Cancer Coalition