Obsessing over cancer is less than charitable

Copperfield on how political and charitable preoccupation over cancer eats into valuable NHS resources and time

Did anyone pick up the whiff of irony emanating from the recent ‘thousands overtreated for prostate cancer’ story?

This stemmed from Prostate Cancer UK highlighting that men are having unnecessary treatment when they should be managed with surveillance. Hang on, though. Many of these men probably wouldn’t be in the urology system at all had it not been for years of various charities banging drums and thereby stoking up prostatophobia and indiscriminate testing – turning general practice into a satellite urology clinic for unfunded PSA monitoring.

Well, now it’s going to get even worse, and not just with prostate cancer: charities are doubling down, and the DHSC’s response fills me with dread. Because – according to One Cancer Voice, a cancer charity coalition – there will be ‘one cancer diagnosis every ten minutes within the next 15 years’. Cue a six-point plan including, inevitably, new earlier diagnosis targets and improved screening. And a response from the Government suggesting that the forthcoming new national cancer plan will include more tests, checks, scans and DIY screening kits.

The problem with obsessional checking, scanning and monitoring is: seek and ye shall find. Occasionally, this helps the patient. But very often it doesn’t. Finding a cancer ‘early’ only helps if it improves the prognosis. It may not, in which case the illusion of prolonged survival translates into a reality of knowing you’ve got cancer for longer, and dying when you would have done anyway. Thanks for that.

Plus, as any GP who has ploughed through countless letters a day asking us to ‘kindly follow up’ this adrenal swelling, that ovarian cyst and the other lung nodule knows: every body is a Pandora’s box and a scan lifts the lid. Hence any spare time around our primary care PSA monitoring service is spent in our new, also unfunded, incidentaloma clinics.

All of which prolongs outpatient waits, lengthens investigation delays for those in real need, and creates workload for us and stress for patients. In obsessing over cancer, with all its political and charitable baggage, we create a monster that eats the rest of the NHS.

Not that I expect One Cancer Voice to stop shouting about it until they’re hoarse. Actually, they should get that checked.

Dr Copperfield is a GP in Essex. Read more of his blogs here