Cancer Mortality

Well Crun, they threatened to publish GPs' diagnosis rates on the Internet in an attempt to make them sharpen up, and that was rightly condemned for the rubbish idea that it was.
I admit that when I heard this latest idea on the news this morning, my reaction was 'what the ^%# will they think of next'.
Can't wait for Dr Rant's response on Facebook.

But they already have published the rates for cancer patients being admitted as emergencies, and the huge variation between the best and worst would suggest that there's ample room for improvement.

Nor the one about ignoring a persistent cough, as far as my GP is concerned. I made an appointment after coughing for 4wks "Oh, I'm sure will clear, if you still have it in a fortnight, make another appointment"

Correct me if I am wrong but is it not also being reported that Macmillan have said

There is a record 2.5 million people living with cancer in the UK. 400.000 more people are surviving cancer since 2010 .

The reasons being put forward for the increase are quicker detection, ageing population and better treatment.

Macmillan comment "It is a double -edged sword. The NHS will soon be unable to cope with the huge increase in demand".

The NHS is trying to ram the square peg in the round hole .

That isn't what I was referring to Crun.
Jeremy Hunt said he was going to publish GPs' rates of cancer diagnosis. GPs don't actually make the diagnosis - consultants do, after the diagnostic tests have been carried out.

jane No, I realised that it's not quite the same, but the reason it's being used as a performance indicator is that it's quite a good guide as to which practices are failing to make timely referrals.

POGS there are 2.5 million more people surviving cancer than there were a couple of centuries ago too, but the point that's being reported is that there are currently more people surviving in the majority of other European countries than in the UK.

Gerry Robinson is a fairly well respected senior manager, but when the Open University called him in to sort out the NHS he reported that the problem wasn't a lack of money, but the stubbornness and refusal to change.

Remember he found that the surgeons were all going off to play golf on a Friday afternoon? He tried to put a stop to it, but couldn't. When they filmed a follow-up program a year later, the surgeons had the arrogance to turn up wearing T-Shirts printed with a slogan gloating about defeating him. How many other employers would put up with their staff doing that?

Isn't not the case that many people are not diagnosed because they do not see a doctor, even when they have clear signs that something is 'not right'?

"Isn't not the case that many people are not diagnosed because they do not see a doctor, even when they have clear signs that something is 'not right'?"

Yes, that's clearly an issue too, but a separate one. If one practice has far more cancer patients fetching up at A&E than another, it's stretching credibility a bit to think that the 'ostrich' patients with their heads in the sand have all homed in on that one practice in particular.

If 'ostrich' patients are distributed evenly around the community on average, then there's no reason they should be disadvantaging some practices over others.

But patients aren't evenly distributed Crun. Practices in some areas will have a disproportionate number of patients who wouldn't know a worrying symptom if it stared them in the face, whereas others will be overloaded with those who research every little thing via Dr Google and jump to the most alarming conclusion.

"But patients aren't evenly distributed Crun."

On what evidence?

Which areas have a cluster of 'ostrich' patients?

Why would they?

Where are you getting your information from?

Do the bad cancer referral figures apply to all the practices in these areas, or are these patients also conspiring to inflict themselves on the same unfortunate practice in each area?

If the 'ostrich' patients have indeed all found their way to the same practice, what are the doctors there doing to attract them all, that the doctors in other practices aren't? If a patient has been fobbed off by a prejudiced doctor all his life, he may indeed wait until going to the doctor is a last resort.

The'ostrich' patients do not end up in A&E, they just go to see their GP too late, when the cancer is too advanced for treatment.

DFiL had a GP who had him into the surgery every month to get his high blood pressure prescription renewed because the GPknew there was something else wrong but DFiL wouldn't admit to anything. When finally he did crack he was diagnosed within the day with Parkinson's Disease. DFiL nearly threw a party with delight. He had been hiding his symptoms from his GP for over a year because he thought they were symptoms of cancer!

crun I would have thought it obvious that patients from a GP practice in a deprived inner city area are going to have different attitudes to their healthcare from those in a practice in a leafy suburb.

I do find your tone rather aggressive, and no I personally have not carried out academic research into the subject.

But here is a link to a scholarly article about potential barriers to the use of healthcare within ethnic minorities.
m.fampra.oxfordjournals.org/content/23/3/325.full
And no, I haven't read the entire thing, before you ask.

My husband had loads of MRI scans and CT scans because he had a degenerative brain disease. They discovered cancer markers in his blood but could find no trace of cancer in any of the scans.
When he started having fits they found he had a brain tumour, from which he died four months later. It was an aggressive one, which had not shown up, but the markers in his blood were not for a brain tumour.

When it was eventually discovered one GP was quite upset that they might have missed signs of it earlier. If brain cancer specialists cannot find a brain tumour, what chance do GPs have. We told the GP it was not her fault. She had to redeem herself by giving my husband permission not to eat or drink any more.

Patient self-referral is also another ridiculous idea. How can you have GPs being blamed, when they are being omitted from the chain?

@ninathenana Back in late 2006 I developed a cough that wouldn't quit...
I am, like many men, loath to 'bother the doctor', but in February 2007 I did, and was immediately on a fast-moving conveyor belt - chest X-ray, CT scan, percutaneous biopsy - diagnosis: lung cancer. I was chivvied along through PET scan and cardiograph and by 1st April my left lung had had one of its two lobes, and the cancer that rode in on it, removed. They had told me that once cancer was diagnosed, the clock started - and they had to deal with things in the prescribed time frame.

That was almost eight years ago, and I am still here - short of breath, but alive - to tell the tale. So reporting that cough was a life-saver - and yes, the important factor was that it was caught early.

My husband's cancer took at least a couple of years to diagnose. Partly because he refused to do anything about it when it was first suggested because he hadn't got time to be ill! When even he had to admit he was ill it took ages to diagnose as the only thing that it would show up in was a bone marrow biopsy which is a bit of a last resort. However during the two years we did find quite a lot of cancers that he definitely hadn't got. If every cancer was a large tumour that showed up in a simple X ray diagnosis would be easy, but many of them are far more complicared.

Jane I don't think crun sounds aggresive in the least. I think her questions were simply asking for clarification. As someone pointed out on another thread, it's easy to get offended without reason.

what category do I fall into, I was an ostritch with my head in the sand because I knew I was an hyperchondriac and I kept thinking that if I went to the doc I would be ok, or he would find something else, at any one time I knew I had a dozen cancers or other equally serious diseases.
Even now I wonder can you have 2 or maybe more different cancers and I still look up symptoms on the net.
So I have added to statisics as my cancer is advanced, although only just beginning to spread, but if I was a bit braver I would have been to the doc every week with something new. lol and now I think that after my treatment is over if Im ok, how many days will it be after giving the all clear until I start to imagine another symptom and this time I will not delay so I will be one of the ones bypassing the doc (my GP is useless).
This is something we will never solve

ethel Change your GP. This is what DH did when we were worried that his usual GP was being dismissive about worrying symptoms. We stayed in the same (big) practice but he waited several weeks for an appointment with another GP in the practice who had been recommended to us. He saw him and within minutes had a diagnosis of diabetes.

I do think that sometimes it is the circumstances of our lives that lead to delay. I went through a very stressful period a few years ago, which included, for some months, caring on a daily basis for an elderly relation with dementia whose spouse had had a stroke. I had some worrying symptoms and I phoned the surgery but the receptionist was unhelpful and told me to ring back at 8.00am if I wanted an appointment, and we all know what this is like, or come to the surgery at 8.30.

I just couldn't do it, I was making 1, sometimes 2, 40 mile round trips a day in the opposite direction to visit and care for my relation, take them to visit their spouse in hospital and another round trip of 10 miles just to make a doctor's appointment was too much.

I did see the doctor a few months later when my relations were in a care home and the pressure reduced. After extensive tests it was decided my symptoms were stress related, but if there had been anything wrong, diagnosis would have been delayed by nearly 3 months.

Our local hospital (Norfolk and Norwich) has just applied to extend their day care chemo treatment wards to nearly double the number of beds to accommodate the projected increase so more patients are being diagnosed. I just wish they would extent the rest of the hospital too!

HI, dumpling, I wish our hospital would modernise its chemo day care centre, as they have to sit in a semi circle with other patients. I feel this is embarrassing to have others watching you while you have an IV drip. There is no other type of treatment you can have where there are other patients in the same area. It would not cost much to have cubicles added surely, if anyone vomits while Im there I will have hysterics I cant stand anyone vomiting or I will vomit too, I retch if I clean my teeth or see poo on the pavement.
Also I haven't told many people my condition and I know I will see someone I know and the cat will be out of the bag.

Which hospital are you going to Ethelbags?

I'm exactly the same about vomiting ethelbags but on the few occaisions when DH has had to go for tests or treatment in the room where they do the IV chemo nobody has vomited! It tends to be quite friendly with everyone sitting round drinking tea .

I don't remember anyone vomiting when Dh was getting chemo, and I sat with him through every session. What DID drive us potty was the ding-dong of the IV machines whenever someone's drip needed attention - which seemed to be every two minutes or so - but you got used to it. Take a book or a musicplayer with earphones to pass the time.

They DO have a few cubicles, but they are for people who really need the privacy - if they "come over queer" and need to lie down, or have to undress for some reason. The staff can keep a much better eye on everyone else with them all sitting together and not each hidden away in their own little corner.

Some seats are in places more private than others - try to get there a bit early for your session, so that you get more of a choice of where you sit.

In my experience no one talked to anyone else anyway - everyone had a book, magazine or headphones on.

And no one ever vomited!