Early last year, I instigated a debate in the House of Commons on the most advanced form of radiotherapy, Stereotactic Radiotherapy (SABR), after a friend of mine from Somerset, Kerry Dunn, was refused it for a very serious cancer.
I was interested in where this cutting-edge treatment was available across the UK, especially here in the South West, particularly as cuts had forced Plymouth Hospital to cancel its purchase of a CyberKnife machine, one of the most advanced SABR systems in the world.
So I used the Freedom of Information Act to contact each of the UK's cancer centres, asking if they were using SABR to treat patients. The replies were depressing, and for us in the South West, shocking. The nearest place patients from the South West can receive this treatment is London.
This is a very important issue for cancer patients because many clinical experts in America and Europe believe SABR will be used to treat 80 per cent of all relevant cancers by the end of the decade. The largest radiation oncology society in the world, the American Society for Radiation Oncology, now recommends the use of SABR for cancers of the lung, liver, kidney, pancreas, pelvis, head, neck and prostate. It is the fastest growing method of treating cancer patients with radiotherapy in most developed countries. So, 12 months on, I wanted to know whether the situation had improved for cancer patients in our region.
Once again, I sent a Freedom of Information request to all the cancer centres in England asking them a series of questions about their ability to deliver SABR. Once again, they all answered with remarkable openness, especially here in our region, and I'd like to put on record my gratitude to them. Once again, their data showed that here in the South West we are still missing out.
Last year's Freedom of Information data was revealing as it showed much of what I was being told by NHS officials about treatment rates in the South West and across the country was at best misleading, at worst untrue.
However, by comparing last year's data with this year's, I have been able to lay bare the appalling lack of progress in getting this vital new treatment for the fight against cancer in this region. Furthermore, I've discovered that the little progress being made in the rest of England is planned so badly it is costing the NHS millions of pounds more than it should – meaning millions of pounds are wasted – some of which could have been spent here in the South West treating our cancer patients. I am making this information public here for the first time.
I discovered that only 17 of England's 50 cancer centres are treating patients with SABR. Of those, only half comply with the Department of Health's recommendations on undertaking a minimum of 25 procedures each year. There are still none treating cancer patients with SABR in the South West.
Between them, the centres treated 633 patients with SABR during the last year. I don't have the number of patients from the South West, but the data shows that some local patients were sent as far as Leeds, 300 miles away, for treatment. Only three of the UK's centres used the advanced CyberKnife system, the kind that should have gone into Plymouth two years ago, but those three centres treated almost half of all patients; the other 14 old style gantry systems treated the remainder between them. As with the year before, the old style gantry systems could only effectively treat early stage lung cancer, so they focused on just that. The CyberKnife systems treated cancers of the lung, liver, prostate, spine, kidney, pancreas, urinary tract, ovary, bone, head and neck. On average, each CyberKnife system treated 88 patients over the course of the year, while the old style gantry systems managed just 26.
For the second year running, the objective data from the cancer centres shows the only cost-effective and clinically appropriate way to deliver SABR to cancer patients is by using a CyberKnife system. The data shows that these machines are remarkably efficient. So much so that it is likely we would only need one to service all the current SABR needs of our region.
The NHS has refused to purchase a single CyberKnife. But some of our world-leading cancer centres have been raising charitable donations to purchase CyberKnife systems for their patients.
What is alarming is that last year, the NHS purchased ten more old style gantry systems in its attempt to increase the use of SABR in England. The total cost of the gantry systems? About £22 million. And between them, these machines managed to treat just 116 patients with SABR. That's an astonishing £190,000 per patient. Some centres bought machines and treated fewer than five patients with SABR. One centre bought a machine and has been unable to treat a single SABR patient with it.
Now, the manufacturers of these gantry machines will tell you that when they're not delivering SABR, they're delivering conventional radiotherapy. In my opinion, that's the economics of the madhouse. Why on earth would you spend £2.2 million on a machine that spends 95 per cent of its time delivering a treatment that another machine at half the price could deliver just as effectively?
I'm not blaming the cancer centres for this debacle, far from it. If anyone is to blame, it is the claims made by the manufacturers of these machines, supported, unwittingly, by officials at NHS England who are more concerned about claiming they're expanding SABR services to meet David Cameron's targets than they are about the quality, cost-efficiency and benefit to patients of those services. The data clearly shows these gantry machines are a waste of money as far as increasing the level and quality of SABR availability to cancer patients. What is even more worrying is that NHS England plans to spend another £20 million buying more gantry machines this year – one of which is scheduled for the South West. Whilst having a gantry machine locally will undoubtedly help some of the region's lung cancer patients, it will be of no help at all to those patients needing SABR for all the other cancers. They will still be travelling all over the country for treatment. Besides wasting staggering amounts of money, surely this is not the way a caring society and a modern NHS looks after its cancer patients?
Instead, the NHS appears to be embarking on a programme where many different hospitals will each pay £2.2 million for machines that will deliver SABR to a handful of patients with one kind of cancer, but few centres will have high enough patient numbers to build up the necessary specialist expertise for this technology. Collectively this will waste millions of pounds of our money.
I think that what we really need here in the South West is one specialist SABR centre with the very latest CyberKnife technology, so the NHS can treat the greatest number of patients across the broadest range of cancers. Fully operational, such a centre could treat around 250 patients a year. Rather than the usual extended periods away or trips involving hundreds of miles for patients when they are most vulnerable, such is the advanced nature of this technology that the vast majority would be treated as outpatients, coming in for their treatment in the morning and going home for lunch – commuting over a course of just four or five days. Pie in the sky? I think not. Three months ago, a brand new SABR centre with the latest CyberKnife technology opened in Birmingham, serving the West Midlands. Yet again, like the three Cyberknife systems in London, it was purchased with charitable donations from the public. The good news for us in the South West of course is that Birmingham is much, much closer to go for treatment than London or Leeds.
It seems extraordinary that our cancer treatment centres, like the world famous Royal Marsden Hospital, must rely on volunteers and charitable fundraising to ensure their investment in next generation technology while the NHS turns its back on the benefits for patients.
In March this year, after a long, hard struggle, my friend Kerry Dunn died of cancer. She was 47. She left a husband and a six-year-old daughter. In September 2011, her oncologist had said only CyberKnife could save her, but she and her husband then had to spend months fighting for her to have treatment in London. If she hadn't had to waste that time and energy fighting the system to get treatment, her health might not have deteriorated and she might still be with us today. We will never know.
What we do know is that unless we get our own specialist SABR centre here in the South West, many other cancer patients will face the same terrible struggle that Kerry and her family did. And for that reason alone, we should do everything possible to bring this technology to the South West.