The forgotten cancer victims: Lung charity hits out over survival rates no better than 1970s
There have been many hints that “self-inflicted” illness might not be treated on the NHS. It looks like it is happening. Most lung cancer is caused by smoking. Treatment for fatties will probably be cut next — if it isn’t already happening. That would be a lot of untreated people
Tens of thousands of people with lung cancer are being neglected, with their chances of surviving the disease hardly better than in the Seventies, it has emerged. Only half of sufferers receive any kind of active treatment, and in some areas just one in ten is offered surgery, chemotherapy or radiotherapy, a damning report has revealed. Less than 30 per cent of patients survive longer than one year after diagnosis, and this figure falls to five per cent after five years.
The disturbingly low survival rates are partly due to lack of screening and late diagnosis, according to the latest report from the Roy Castle Lung Cancer Foundation. The charity found that the 39,500 a year diagnosed with the disease – Britain’s biggest cancer killer – are getting a poor deal. About 35,000 lung cancer sufferers die each year, a figure which accounts for more than 20 per cent of all cancer deaths.
The medical research charity, which is dedicated to prevention of lung cancer, gave an F grade – the lowest score possible – to the Government for the survival figures. The rates have barely changed since the Seventies, a fact which the charity condemned as ‘completely unacceptable’.
Patients face a postcode lottery on active treatment, it found, with on average only 54 per cent receiving surgery, chemotherapy or radiotherapy. But this figure can range from 10 per cent to 80 per cent depending on where in the UK a patient is treated.
Research funding was also found to be ‘woefully insufficient’.
The charity found some advances in public awareness of the signs and symptoms of the disease. Dr Rosemary Gillespie, its chief executive, said ‘For the third year running, the report has highlighted that lung cancer must remain a priority on the Government’s health agenda. ‘While we are pleased to see some improvements in areas such as awareness raising, there is still much to be done.
‘We understand the current financial pressures on the Government but the scale of the problem merits a much greater investment in lung cancer for all patients and their families.’
Despite being labelled a ‘smoker’s disease’, about one in eight lung cancer patients has never smoked, according to the UK Lung Cancer Care Coalition.
Pharmacists are being encouraged to answer questions about the early signs of lung cancer. Graham Phillips, community pharmacist and Royal Pharmaceutical Society board member, said: ‘Pharmacists are on the front line of public health and therefore well placed to suggest that people see their GP if they present with relevant symptoms, such as a persistent or worsening cough.
‘In fact, if you have noticed any change in your health over a period of time it’s a good idea to ask your pharmacist for advice. ‘Early detection leads to swift diagnosis. Both are vital to improving patient survival.’
Lucy Sargent, who was diagnosed with lung cancer in January at the age of 32, said: ‘There does not seem to be the same impetus for research that there has been with other cancers. ‘As a lung cancer patient, you can often feel like a second-class citizen due to the stigma associated with the disease and it’s important the Government addresses this.’
Figures last month showed that only 14 per cent of lung cancer patients in their 50s are offered surgery, falling to two per cent of the over-80s, compared with 20 per cent in other countries.
Professor Sir Mike Richards, the Government’s national cancer director, said: ‘We know that earlier diagnosis can save lives – that is why we are launching a new campaign from January to alert people to the early signs and symptoms of lung, bowel and breast cancer.’
The British schools where English is a foreign language for 80% of pupils
Children who speak English as their first language are in a minority in a rapidly growing number of schools, figures reveal. The surge has been most pronounced in London, where in some boroughs youngsters with a different mother tongue make up nearly 80 per cent of primary pupils.
However it is not confined to the capital. In Birmingham, Bradford and Leicester more than 40 per cent of pupils across all primary schools do not count English as their first language. Nationally, English is a foreign tongue to nearly one in six youngsters in primary schools.
The figures, to be published this week, have almost doubled during the past decade and are projected to increase to 23 per cent – 830,000 out of 3.5million – by 2018.
There are concerns that the increases will place school finances under strain as a growing number of youngsters require help with English. MigrationWatch, which conducted the study using figures from the Office for National Statistics, believes that over the next five years more than 500,000 extra school places will be needed for the children of immigrants who arrived in Britain after 1998. This will cost the Treasury £40billion, equal to a penny in the pound on the basic rate of income tax.
Sir Andrew Green, chairman of MigrationWatch UK, said the trend will lower education standards for native English-speaking children. He said: ‘These pupils will of course continue through the education system but it is primary schools where the effect is being felt most acutely at present and where English-speaking children are bound to suffer as immigrant children require extra help.’
The figures reflect a more than four-fold increase in immigration since Labour came to power. Net annual immigration has increased from 48,000 in 1997 to 215,000 in 2009. Across London as a whole, children who speak English as a second language total nearly a half of all pupils – 44.6 per cent.
But in inner London, they number 55 per cent of primary school pupils, and in boroughs such as Tower Hamlets, Westminster and Newham, they form nearly eight in ten of primary pupils.
The lowest populations of youngsters with English as a second language are in the South West and North East. Outside London, the area with the biggest proportion of pupils without English as their first language is Slough, Berkshire. The education authority to record the sharpest increase in the past decade was Luton, Bedfordshire, where almost half have a different mother tongue.
However, while the figures show the number of pupils who are not native English speakers, they do not take into account their fluency in English. Recent Government figures on reading and writing skills among 11-year-olds, show, on average, that children of Indian and Chinese ethnicity outstrip their white British counterparts.
Hazel Blears, a Communities Secretary under Labour, was involved in the party’s immigration policy. She said the figures should be treated with caution. ‘They may be first-generation immigrants and their parents may not speak English, but they [the children] might do.
‘That said, you have to recognise that where you have a large surge in the number of people coming from other countries then you have to deal with that by, for example, having more teaching assistants,’ she said.
Labour has been criticised for almost doubling the number of teaching assistants in schools while the number of qualified teachers remained relatively static.
UK shivers in record low temperatures
Obviously caused by global warming. EVERYTHING is caused by global warming
PARTS of Britain have experienced record low temperatures, including minus 17 Celsius in Wales, forecasters say, amid warnings of more heavy snow to come. “You are seeing some ridiculously low temperatures – it has been a bit like it is in the middle of Scandinavia,” weather forecaster Michael Dukes said.
The temperature in Llysdinam near Llandrindod Wells in Wales plunged to minus 17.3C at the weekend – the principality’s lowest ever temperature for November and Britain’s coldest for the month since 1985.
The Met Office, Britain’s national forecaster, issued severe weather warnings yesterday for large chunks of eastern and southern Scotland and eastern England, warning of heavy snowfalls.
Ireland also experienced heavy snow and Dublin airport was disrupted, with Finance Minister Brian Lenihan among those delayed as the weather made him late for crucial EU talks in Brussels on an international bailout for his country.
Drivers have been urged to be careful in badly-hit areas, and roadside emergency firms in Britain reported a huge surge in calls for help.
The weather has also disrupted several sporting events – Dundee United’s match against Rangers in Scotland’s Premier League was abandoned and several FA Cup second round fixtures were postponed.
Parts of Scotland and north-east England have already seen well over 30cm of snow since the start of the cold snap last week, and forecasters say the flurries could reach London in the coming days.
New wisdom from the British Met office: Pollution is good and the sun DOES affect global temperature
The latest figures from more than 20 scientific institutions around the world show that global temperatures are higher than ever.
However the gradual rise in temperatures over the last 30 years is slowing slightly. Global warming since the 1970s has been 0.16C (0.3F) but the rise in the last decade was just 0.05C (0.09F), according to the Met Office. Sceptics claim this as evidence man made global warming is a myth.
But in a new report the Met Office said the reduced rate of warming can be easily explained by a number of factors. And indeed the true rate of warming caused by man made greenhouse gases could be greater than ever.
One of the major factors is pollution over Asia, where the huge growth in coal-fired power stations mean aerosols like sulphur are being pumped into the air. This reflects sunlight, cooling the land surface temperature.
Dr Vicky Pope, Head of Climate Change Advice, said pollution may be causing a cooling effect. “A possible increase in aerosol emissions from Asia in the last decade may have contributed to substantially to the recent slowdown,” she said. “Aerosols cool the climate by reflecting the sunlight.”
Another factor that has reduced the rate of warming is a prolonged minimum in the solar cycle, meaning the Earth is receiving slightly less heat from the sun.
Also short term weather patterns such as the tropical storms El Nino and La Nina.
Dr Pope pointed out that the global temperature is still rising and 2010 is set to be the second warmest year on record, according to the Met Office. Other groups, including Nasa, think it will be the hottest year on record at about 0.5C above the 1961-1990 average of 14C. [More false prophecies. But they know that the media will cover for them when it does not come true]
Dr Pope warned that the world should not be lulled into a false sense of security because the warming trend has recently slowed down. In Britain especially, people have been persuaded that global warming is slowing down because of a run of cold winters, including blizzards this weekend. But this is just a short term trend.
In the long term the whole world, including Britain, is warming, according to Dr Pope. “In the grip of a cold spell people find it difficult to understand global warming. But if you look at the long term trends we are in fact experiencing fewer freezing winters and more heatwaves,” she said.
At the moment global temperature rise is 0.8C (1.4F)above pre-industrial levels. [Wow! A fraction of one degree. That’s a BIG rise over a couple of hundred years! I’m shaking in my boots!]
Aspirin: is it really a wonder drug?
Last week, researchers claimed everyone over 45 should take an aspirin a day to prevent cancer and heart disease. I pointed out how weak the evidence for that is on 25th. Now we see below a much more extensive coverage of the issue — JR
Should aspirin be added to the water supply? This was the vision which sprang to mind last week when academics advised that the benefits of taking a small daily dose of aspirin far outweigh any side-effects for most healthy people aged 45 and over.
The pronouncement by a panel of experts speaking at the Royal Society of Medicine, comes a month after research from Oxford University, published in The Lancet, showed that taking 75mg of aspirin – a quarter of the standard over-the-counter pill – daily for five years reduces the risk of getting bowel cancer by a quarter, and deaths from the disease by a third. Research is expected to be published shortly showing similar effects for other cancers.
This simple painkiller has many well established benefits. It thins the blood, which is why it is routinely prescribed for people who already have heart disease or who have had a stroke. It is also often prescribed for people who may be at high risk of these illnesses – because of high blood pressure or diabetes, for example. And it’s used widely for blood-clotting disorders and to help prevent recurrent miscarriage, migraines, cataracts, gum disease and pre-eclampsia (a serious complication of pregnancy).
But should low-dose aspirin now be taken daily by healthy people who want to stay that way? Is this a watershed in the history of public health medicine – a ‘put it in the water’ moment?
No is the simple answer, since it cannot be taken by certain people (including most children under 16). But Professor Gordon McVie, senior consultant at the European Institute of Oncology, Milan, is evangelical about the benefits of aspirin. ‘For me this is clear cut,’ he says. ‘Aspirin is cheap and effective, and there is huge potential to cut the cases of illness particularly colon cancer.’
In agreement is Peter Elwood, Professor of Epidemiology at the University of Wales in Cardiff, who led the first randomised trial into the benefits of aspirin for heart disease patients in 1984 (and who has himself taken aspirin daily for the past ten years). ‘Breakthrough is an overused word but in this case it is justified,’ he says.’ There is disagreement around the peripheral issues – how much to give, should there be an age range – but overall it seems clear to me that the latest work proves taking aspirin every day will increase your chance of survival against important diseases.’
The study which seems to have tipped the scales is principally the work of Oxford neurologist Professor Peter Rothwell (who has also started taking low-dose aspirin daily). He believes that aspirin’s effect on bowel cancer is unlikely to be an isolated phenomenon, given the similarities in how cancers of different types develop. Last week he also advised that with the risk of cancer rising between 40 and 55, 45 would be an optimal age to start taking it.
But despite the excitement, not every doctor is reaching for the prescribing pad just yet.
For one thing, aspirin’s usefulness in warding off heart attacks and strokes in healthy people is in doubt. The latest research, published in the Journal of the American Medical Association in March and involving almost 30,000 men and women, found it had no significant effect on heart attacks and strokes in low-risk populations.
And last year, the influential Drug and Therapeutics Bulletin (DTB), warned aspirin should not be used to prevent future heart attacks and strokes in people with no obvious sign of cardiovascular disease, as the risks outweigh any potential benefits.
The biggest drawback of taking aspirin is that it can irritate the lining of the stomach. Although for most people this side effect is mild, it can occasionally cause ulcers and in a small number of cases, serious bleeding, particularly in elderly people.
But what of the recent study on bowel cancer, the third most common cancer in Britain and which kills 600,000 people worldwide annually? Some doctors point out that while the study shows thousands of lives might indeed be saved by aspirin, the reduction in absolute risk of bowel cancer is about 1.5% (from 4% to 2.5%) .
Dr Ike Iheanacho, the DTB’s editor, says that the reduction in risk is a ‘sizeable benefit’ from society’s point of view. ‘But one problem with this kind of data is that it’s often reported as if the benefit to the individual is huge,’ he says.
‘In effect, around 60 people would have to take the aspirin continuously for around 5 years to prevent one death from bowel cancer during a 20-year period,’ he says. ‘While that remains a considerable benefit, it could clearly put a very different perspective on things for an individual deciding whether to take aspirin for this purpose.
‘And this particular research didn’t report adverse events related to aspirin. Let’s not forget that the drug can cause major internal bleeding and this can kill. If you’re going to advise people to take aspirin, you have to factor in potential harms to give them a balanced view of the potential effects of treatment.’
The blanket prescribing of any drug is also at odds with the ‘stratified’ response that most oncologists predict will be the future of cancer treatment – in other words, medical interventions will be tailored to our genetic makeup and our individual risk.
One way forward might be to give aspirin only to those at high risk of bowel cancer, an idea Professor McVie has said he supports; he believes that in a few years a blood test to detect those at higher risk will become available.
Overall, with medical opinion divided, the feeling is that the public will need to make up their own minds about whether to take low dose aspirin. Professor Peter Whorwell, a gastro-enterologist at Manchester University, advises that anyone considering taking it on a daily basis should discuss with their GP whether they also need to take drugs to protect the stomach.
Back to Professor McVie who with a family history of heart disease, confirms that he too has been taking aspirin daily for more than 20 years. ‘I saw some data long before it was verified and published, and I was convinced,’ he says. ‘After this month’s data, I’m pretty chuffed with myself now.’
Who shouldn’t take aspirin?
• Aspirin should not be given to anyone under 16 unless under specialist advice. It can cause Reye’s syndrome, a potentially fatal disease, in this age group [This is a very rare and poorly understood ailment and there is some evidence that paracetamol also causes Reye’s syndrome — and the syndrome can occur in the absence of aspirin]
• Aspirin should be avoided if you have a stomach (peptic) ulcer, haemophilia or other bleeding disorder, or an allergy to aspirin or to other non-steroidal anti-inflammatory drugs (NSAID). These include ibuprofen and diclofenac
• Low-dose aspirin should only be taken with caution by certain groups, including those with asthma, allergies, liver, kidney or digestive problems.
• Pregnant and breastfeeding women should only take aspirin on the advice of a GP.
• Aspirin can interact with certain other medicines. Ask your doctor or pharmacist or read the patient information leaflet
“Breeding” is a naughty word in Britain
“We have entered an era of heavy-handed policing. No, I don’t mean the kettling of schoolchildren, though I don’t like that much. I mean the policing of public discourse.
We must be shielded from the remarks of Tory peers and the online musings of a bishop. The law must be invoked to clamp down on silly jokes on Twitter. It is as if we are all sensitive little flowers that will wither away should we hear anything a little robust.
I defended Lord Young’s right to say what he thinks [see below] last week not because I agree with him, but because I believe in free speech. If the penalty for speaking your mind in politics is now to lose your job, then we end up with a lot of awful coded jargon.
This is exactly what happened on tough issues such as immigration. And this is exactly why the BNP and now the English Defence League can make headway, because they promise to tell it like it is. Censoring language never quells real disquiet.
Class, far from having ‘disappeared’, is now an equally combustible subject. Howard Flight has been immediately slapped down for his comments on child benefit. He said: ‘The middle classes are discouraged from breeding because it’s jolly expensive, but for those on benefits, there is every incentive.’
The word ‘breeding’, with its eugenicist undertones, is what has caused trouble.
Flight’s sentiment may be lamentable, but it is commonly heard everywhere: scroungers and immigrants are having loads of babies and living the life of luxury on heaps of benefits. This may be false, but it is what some feel is happening. Flight’s crime was to say what many Tories think.
Lord Young was removed from his position after pointing out that low mortgage interest rates meant most people had been insulated from the effects of the recession. He put it rather bluntly, however, by saying that “You’ve never had it so good”. Only weeping and wailing and garnishing of teeth is allowed from British politicians at the moment (Yes. I know the word is “gnashing”)
There is a new lot of postings by Chris Brand just up — on his usual vastly “incorrect” themes of race, genes, IQ etc.