The South West has almost five and a half million people and the oldest population of any region in the UK.
A fifth of people are over 65 and a 14% of those are over 85. The median age for cancer diagnosis in our country is 70-74 for men and 65-69 for women.
The importance of having first class cancer treatment available in this region is therefore pretty clear!
We have a much older population and consequently, a higher rate of cancer. In contrast there are just under eight and a half million people living in London and only 11% of them are over 65.
I want to highlight this contrast because whilst London’s average population age is about half of the South West's, the capital has almost all the country’s most advanced radiotherapy machines for treating cancer patients, particularly Stereotactic Ablative Radiotherapy (SABR) machines.
SABR is the most advanced method of delivering radiotherapy in the world. SABR is more accurate than any other form of radiotherapy, it can treat cancerous tumours that conventional radiotherapy cannot, and it causes less damage to surrounding tissue and reduces the number of patient visits to hospital from an average of 25 to an average of 5.
After my long campaign with Lawrence Dallaglio, last week NHS England agreed that, as of April, patients suffering from cancers of the head, neck, pancreas, kidney, liver, spine, pelvis and oligometastatic disease (cancer that has spread to another part of the body) can now be treated with SABR.
Prostate cancer can already be treated through a trial called PACE led by the Royal Marsden, and early stage lung cancer is also funded for treatment. If you add to this the SABR trials to be conducted by Cancer Research UK, from April around 1,500 patients a year will be eligible to be treated with SABR in England.
As we know 5% of the population of England lives in the South West, even if we discount our disproportionate average age, that still means around 150 patients from our region will be able to access SABR treatment each year from April.
The question that I have to ask is where will these patients be treated?
Where in this region is there a radiotherapy machine that can treat over 150 patients each year for all the cancers that NHS England has agreed to fund?
Ten years ago, cancer patients with complex tumours and those close to vital organs were mostly considered untreatable with radiotherapy and their prognosis was grim.
SABR has changed that.
Conventional radiotherapy does a great job with the majority of cancer tumours and I am not critical of the conventional treatments we have in the South West.
What concerns me is that our hospitals are starting to pay extra for modified conventional machines that can offer only limited SABR treatment. So when they’re not delivering the first class conventional service - which they do - they can dabble in a bit of SABR.
I would caution strongly against this. It is NHS England’s policy that if a machine cannot deliver over 25 SABR procedures a year, it will not be allowed to carry on treating with SABR. NHS England has already closed down the SABR service in four hospitals for this very reason.
These hybrid machines are not the answer. I have been looking into this for some time. I've spoken to oncologists, questioned radiologists and listened to patients. I have been to see conventional radiotherapy machines, and I have seen the CyberKnife. And I have drawn one conclusion from what I've heard and learned: CyberKnife is the only dedicated SABR machine that can treat all the cancers I listed above, and it's the only machine that can treat 150+ patients with SABR each year.
We must have one in the South West or even more of our patients will be faced with the long trip to London for treatment.