The millions the NHS spends on breast cancer drug Herceptin could be used to treat thousands of people
using other therapies, a top specialist has said.
Dr Peter Kirkbride, the chief spokesman on radiotherapy
for the NHS, said the NHS spent £100m on the breast cancer drug Herceptin in 2006. (Review
of Herceptin below).
But he told Radio 4's The Investigation only about 500
patients had benefited - at a cost of about £200,000 each.
If that was spent on radiotherapy, it could have a dramatic
impact, he said.
Cancer survival in the UK is still below the European average, despite recent improvements.
Herceptin was approved for use in women with early stage
breast cancer in 2006 after a fast-track assessment by the National Institute for Health and Clinical Excellence.
But now some cancer doctors are concerned this focus
on new cancer drugs may not be a good thing.
Dr Kirkbride said: "There is a lot of publicity about
the role of chemotherapy but the consensus is of all cancers that are cured, half are cured by surgeries, 40% by radiotherapy
and only 10% by drugs.
"If I was to spend £100m
on radiotherapy, I could buy something like 90 machines, I could buy 30 simulators and I could probably benefit about 30,000
patients for the same amount of money."
Earlier this year, the National Radiotherapy Advisory
Group published a report which called for a 91% increase in radiotherapy treatments in England in the next 10 years.
But the trade body for the manufacturers of radiotherapy
machines has told the BBC that instead of seeing more business, it has all but dried up.
David Miles, the chairman of the radiotherapy specialist
focus group of the Association of X-ray Equipment Manufacturers which formed to highlight the problem, says there has been
a "collapse in critical investment".
He said: "We noticed after the government initiatives
to improve the established stock of radiotherapy equipment, it actually ended in April last year. And the sales of machines
then fell off drastically.
"One order has been placed in the last 20 months."
Because it takes around three years from when an order
is first placed until it treats its first patient, the radiotherapy focus group at AXrEM says the NHS should have bought 20
replacements machines by now instead of just one.
'Not sexy enough'
Dr Kirkbride thinks part of the problem is raising the
discipline's profile in the eyes of both the public and government.
He said: "We are not sexy enough. We don't have pharmaceutical
companies backing us in the same way that some of the drugs companies support campaigns for the use of their drugs."
Professor Mike Richards, the National Cancer Director,
said there should be room in the cancer budget for both.
He said: "There is no doubt that Herceptin is a good
drug. There is no doubt that it has been looked at carefully by NICE and it has been deemed to be both effective and cost-effective.
"Radiotherapy is also effective and we need to make sure
that it's not one or the other, but that we actually have a service that delivers both."
- The Sick Man of Europe
Radio 4, 2000GMT, Thu 29 November
Online from Radio 4's
Listen again page
Podcast from the File on 4 website
More on Machines
France for instance, which has some of the best cancer survival rates
in Europe, has 336 machines compared to the UK's 279 - 20% more for the same population, and the staff to match.
And while targets for treatment are being met, they do
not always give the true picture.
There may be a maximum 62 day wait from urgent GP referral
to treatment, but this simply means the start of treatment.
There are instances where people are waiting as long
as 16 weeks for post-operative radiotherapy, a key part of their treatment which can maximise their chances of being cured.