The chances of cancer going undiagnosed until it reaches its most life-threatening stage have increased by as much as 100 per cent during the pandemic, exclusive research by this newspaper has revealed.
At the James Paget University Hospital (JPUH) in Gorleston 17 per cent of cancers were caught at the latest phase - Stage 4 - in early 2019, but that number has doubled, hitting 36pc in July.
The Norfolk and Norwich (NNUH) and Queen Elizabeth (QEH) hospitals also saw spikes in the percentage of cancers caught late during the pandemic.
NHS figures show just half of cancer patients are being treated within the target time of two months at the NNUH, but other hospitals are meeting cancer targets and treatments have returned to pre-pandemic levels.
The findings are part of a major investigation by this newspaper into the crisis facing the NHS - for patients and staff alike - as it braces for winter under huge strain. Covid, staff exhaustion, and huge waiting lists are combining to form a perfect storm.
Our investigation, which will be published every day over the next week, has found:
- The NNUH is the worst hospital in the country for breast cancer referrals
- Waiting lists at Norfolk’s hospitals for diagnostic tests and surgeries are the longest since comparable records began
- Paramedics are facing unprecedented pressure, with absences on mental health grounds now higher than at the peak of the pandemic
- We could not find any dentist in the county taking on new patients
We have taken our findings to the Department of Health and Social Care which said: “We are committed to ensuring people get the treatment they need.
“We’ve dedicated an extra £1 billion this year (nationally) and £8 billion over the next three years to transform elective services, which could deliver the equivalent of around nine million more checks, scans and procedures.”
It comes after the NNUH briefly issued a so-called ‘black alert’ on Wednesday afternoon, with staff asked to discharge patients “safely and quickly” after the hospital became “extremely pressured.” It has since moved down an escalation level.
Cancers caught late
Freedom of Information requests have revealed that for patients at the JPUH, the pandemic seems to have had a knock-on effect on the chances of catching cancer in Stage 1 or Stage 2. An early diagnosis significantly improves a patient’s prognosis.
Throughout the whole of 2019, for those cancer diagnoses for which the Trust holds records of the cancer’s progression, only 18.5 per cent were caught as late as stage 4. By contrast, nearly 35 per cent or over a third were caught at stage 1.
But these numbers worsened (see chart) and by spring of 2021 the stage 4 diagnosis percentage had risen as high as 36 per cent.
A JPUH spokesman said they had been aware of a slowdown in people attending who might need treatment, and produced a video interview with medical director Dr Hazel Stuart which they published on the Trust's website and on Youtube in April 2020 to encourage people to come forward - but the video has had only 234 views.
A spokesman for the NHS in Norfolk and Waveney added: "It is absolutely vital that people contact their GP as soon as possible if they are concerned about cancer symptoms. Our teams have been working hard to manage the rise in cancer referrals and to reduce waiting times, including running additional clinics where possible."
The data from the Queen Elizabeth Hospital (QEH) in King’s Lynn and from the NNUH is harder to quantify, since both hospitals have only recorded the cancer’s stage at diagnosis for around half of their patients.
At the QEH there is no clear negative trend, although some of the hospital’s worst figures came in the middle of 2020.
At the NNUH in 2019, 442 cancers were recorded as being caught at stage 4, a total of 14 per cent. For 2021, that has risen slightly to 15.5 per cent.
Just over half of patients were treated within the target of two months at the NNUH in July this year, the last month data is available for. That compares to 80pc at the QEH, 76pc at West Suffolk and 65pc at the JPUH.
Minesh Patel, head of policy at Macmillan Cancer Support, said: "A cancer workforce that was already exhausted and overstretched before the health crisis is now contending with a surge in caseloads as more people come into the NHS for cancer diagnosis and treatment.
“It’s vital the government urgently invests further in cancer services if our health service is to clear the backlog in cancer treatment and diagnosis.”
‘We just watched the cancer take over’
Former table tennis champion and county cricketer Mick Broughton, from Great Yarmouth, died of cancer last May aged 77.
His step-daughter Jane Beale, a former nurse, said: “Towards the end of 2019 he developed symptoms. He had chest infections and so on, which he’d never had, and then he started getting pain in his side and developed a lump on his side - he was backwards and forwards to the GP.
“But the delay by the GP in referring him for further investigations, despite his suspicious symptoms, caused him to be caught in the total shutdown of cancer services and delayed diagnosis.”
Mr Broughton was told after a chest x-ray that he had a malignant tumour and he was referred to the JPUH for a biopsy in February 2020.
“All we got from the hospital between then and his death in May was ‘sorry the biopsy result is not back yet’, Mrs Beale said.
“It was absolutely unbelievable. I am a qualified nurse with nearly 40 years' experience and I could not get him any help at all.
“We just watched the cancer take over. He had no treatment, no radiotherapy, no chemotherapy.
“He had two massive tumours on each hip bone, no palliative care until two days before his death, and my 86-year-old mum was left to cope.
She added: “I cannot begin to explain the frustration of that time and it will stay with me forever.
“It was horrendous and to witness suffering like that in this day and age was extremely traumatic especially when you know as a medical professional what care should have been received.
“He paid into the system all his life and I feel he would have got better care in a third world country or the local vets.”
His wife Glenda said: “He was neglected - like a lot of other people.
“We were waiting and waiting to find out what kind before treatment, and then he didn’t get any treatment.
“Eventually he got a scan, and by then the cancer was terminal and all over him.
“He had these massive tumours on his sides, like Easter eggs, they were huge and they were breaking down and I kept asking for a dressing to put on it and that was only put on the day before he died. It was shocking.”
“I had cancer two and a half years ago and my treatment was absolutely first class, I’ve got no complaints, they were wonderful - I don’t want to knock the Paget in that respect, but they let my Mick down very, very badly.”
A hospital spokesman said: "We offer our deepest condolences to Mr Broughton’s family – and are sorry for any delays in treatment experienced by our patients during the pandemic.”
Additional reporting by Pete Raven
On Monday: How has the pandemic impacted breast cancer treatment?
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