A postcode lottery in kidney cancer care costs hundreds of lives every year, an NHS report found.
In some rural parts of England, patients with the disease are nearly half as likely to receive life-saving drugs as patients in the most developed areas such as London.
Those given drugs were about three times more likely to be alive two years after their diagnosis than patients who didn’t, according to NHS documents reviewed by The Mail on Sunday.
Shadow Health Secretary Wes Streeting, himself a kidney cancer survivor, labeled the findings “inexcusable.” The Labor MP, who was diagnosed with the disease in 2021, said: ‘I was lucky that my kidney cancer was caught early and treated quickly. It is inexcusable that patients cannot receive life-saving treatments because of where they live. The NHS should be there for all of us when we need it.’
Experts believe that the disparity in access to these drugs is due to the fact that there are no guidelines on what treatment to offer kidney cancer patients.
SURVIVING: Labor MP Wes Streeting was treated for kidney cancer in 2021
These guidelines, produced by the NHS spending watchdog, the National Institute for Health and Care Excellence (NICE), apply to each of the ten most common cancers in the UK, except kidney cancer.
The disease affects 13,000 Britons each year, making it the seventh most common cancer. It usually occurs when people are in their 60s and 70s and is very uncommon in people under the age of 45, although Wes Streeting was diagnosed at age 38.
The first signs are often blood in the urine, back pain, and nodules or swelling in the back, under the ribs, or in the neck. Obesity, smoking, high blood pressure and late-stage chronic kidney disease – which affects nearly 70,000 people in the UK – are all thought to increase the risk. Genetics also play a role.
This year, NICE agreed to produce its first kidney cancer guidelines, but they are not expected to be published for years to come.
‘Our work has shown that the treatment of kidney cancer patients is likely to vary depending on where they live in England,’ said Malcolm Packer, director of the charity Kidney Care UK, which carried out the Kidney Cancer UK Accord report.
‘We are now working with NICE and are involved in the development of the guidelines, but that will take two years. We are also asking doctors to look at how they can better diagnose and treat patients.’
If kidney cancer is caught at an early stage, it can be cured by surgically removing the affected part of the kidney. Until recently, there were very few effective treatments for the disease if it spreads beyond the kidney.
Yet in the past five years a number of new immune-boosting drugs – collectively known as immunotherapy – have become available for these advanced kidney cancer patients that can significantly extend their lives and even cure them. However, training is needed to administer the complex treatment that experts say is not provided by many consultants.
“This report is deeply disturbing,” said an oncologist, who asked to remain anonymous. ‘Cancer consultants in some parts of the country clearly don’t have the time or expertise to carry out complex life-saving drug treatments [such as those needed for kidney cancer]. I don’t think new NICE guidelines will be enough to solve this problem.’
The new report compared the supply of drug treatment across the 21 Cancer Alliances – the NHS districts for cancer care in England. It looked specifically at patients with advanced kidney cancer and whether they were offered the new drugs within the first 12 months of diagnosis.
It doesn’t name the specific alliances, but says three, less than 40 percent of this patient group, have been administered new cancer-fighting drugs. The worst-performing district offered only 36 percent of patients these drug treatments. The highest rate of drug use was only 69 percent.
According to Dr Kate Fife, oncologist consultant at the University of Cambridge and lead author of the report, on average only about half of patients with advanced kidney cancer received these treatments.
‘While the numbers vary by alliance, it is clear that there are NHS patients who are not receiving medicines that can prolong or even save their lives,’ says Dr Fife.
Kidney cancer affects 13,000 Britons each year, making it the seventh most common cancer (stock photo of treatment)
The report also found that only 11 percent of patients who received no drugs survived two years or more after diagnosis, compared with nearly 40 percent of those who received the treatments.
‘Not all patients can take these drugs,’ says Dr Fife. ‘About 15 percent are too old or too ill to start treatment safely. But then there are still many patients left who would need to be treated.’
While the report doesn’t name specific parts of the country, experts say it’s clear where the underperforming alliances are based.
“The data clearly show that kidney cancer patients in London are much more likely to receive quality care than people in rural areas,” said an oncologist.