patient hospital

File photo: Almost 2.5million patients have missed out on vital cancer tests and treatment because of the pandemic
Almost 2.5million patients have missed out on vital cancer tests and treatment because of the pandemic.

The NHS faces the shocking backlog of cases as it tries to return to normal - and also cope with new victims of the disease.

Cancer Research UK says 2.1million patients are awaiting crucial screening for breast, cervical and bowel cancer.

Another 290,000 have missed out on urgent referrals to confirm or rule out tumours.

And at least 21,600 patients have had surgery, chemotherapy or radiotherapy postponed in the past nine weeks.

Some of these procedures would have saved lives or extended them, granting precious extra time with loved ones.

It is also thought patients with warning signs of cancer have avoided seeking help because they are worried about contracting coronavirus in a surgery or hospital.

With the lockdown being eased today to allow friends and family to meet up, for some shops to reopen and pupils to return to school:
  • Ministers stressed primaries are safe amid fears some pupils will be kept away;
  • Britons were urged to remain sensible and not overdo interactions with others;
  • Police were forced to issue dispersal orders to crowds on beaches in Bude, north Cornwall, after social-distancing rules were flouted;
  • Up to two million vulnerable patients who have been shielding will be allowed outside for the first time in two months;
  • A further 113 virus deaths were reported yesterday, the lowest figure during lockdown;
  • Some scientists warned restrictions were being eased too early with infections and deaths still high;
  • A poll suggested the Conservative lead over Labour had crashed by eight points following the Dominic Cummings saga.
The numbers awaiting cancer treatment are extremely worrying, according to Sarah Woolnough, policy chief at Cancer Research UK.

She added: 'We're going to have this huge backlog to clear. It's a massive backlog of services and treatment to deliver. It's absolutely huge, it's thousands and thousands and thousands.'
I'm at risk after crucial drugs had to be stopped


Fears: Joanna Addis lives with her husband Volky in Stockport
For three years Joanna Addis has received cutting-edge drugs to keep her breast cancer from growing.

But in April the 54-year-old was told her treatment was to be paused for three months.

Her treatment - a combination of the drugs palbociclib and letrozole - was thought to be too dangerous to take during the pandemic because it depresses the immune system.

Mrs Addis, who lives in Stockport with husband Volky, had been taking the treatment since 2017 after surgery failed to control her cancer.

'I try not to think about what will happen over the next two months, but I do worry about what my scan in June will show,' she said. 'If my disease was to progress, I'd feel like I had wasted a treatment option and the time it could have given me.

'Striking off such a valuable treatment not because of my cancer becoming unresponsive, but because of the risk of the virus, doesn't seem fair. I ended up in hospital soon after I came off palbociclib as pain in my right hip became so severe that I couldn't walk, which felt like too much of a coincidence at the time.

'Thankfully, no cancer progression was found, but I do really worry what may happen if I need to stay off the treatment for even longer.

'Everything just feels so out of my control at the moment, which is really difficult.'
Professor Charles Swanton, the charity's chief clinician, said: 'My colleagues and I have seen the devastating impact of this pandemic on both patients and NHS staff. Delays to diagnosis and treatment could mean that some cancers will become inoperable.'

The longer a patient waits to be diagnosed and treated for cancer, the greater the likelihood their tumours will spread to other tissues and organs to the extent they become inoperable.

Cancer Research's data shows that across the UK, 12,800 patients have missed out on surgery, 6,000 on chemotherapy and another 2,800 on radiotherapy.

The figures for surgery are particularly worrying because these procedures would otherwise remove tumours that may now have grown or spread.

Many hospitals have delayed chemotherapy, radiotherapy or operations to remove tumours to enable them to cope with a surge in virus cases, as well as to cut cancer patients' risk of becoming infected when they come in.

Comment: And that's just cancer; what about heart disease, diabetes, and the raft of other diseases and issues that require medical treatments?

At the same time, patients with worrying symptoms, including lumps on their breasts or frequent urination, which could be a sign of prostate cancer, have been reluctant to make appointments with GPs.

Some family doctors have not been sending patients to hospital for certain diagnostic tests as they have also been halted, particularly procedures to detect bowel cancer.

Comment: Some doctors asked vulnerable patients to sign Do Not Resuscitate forms so as not to burden the shockingly empty hospitals during the contrived crisis.

Routine screening for breast, cervical and bowel cancer has been suspended in most areas over the past two months despite being crucial for detecting early stage tumours.

Lynda Thomas of Macmillan Cancer Support said: 'Long before the pandemic hit, cancer waiting times were at their worst. Since the coronavirus outbreak, it is has become even harder for people with cancer to get the care and support they need and their anxieties have multiplied.'
Two months on, and still waiting for vital surgery

Glynne Pugh, 68, pictured above with his son Brad, has bowel cancer and was given 12 months to live last November. He was due to have an operation at St James's University Hospital in Leeds on March 23
A father with terminal cancer is still waiting for surgery two months after it was cancelled the day before it was due to take place.

Glynne Pugh, 68, has bowel cancer and was given 12 months to live last November. He was due to have an operation at St James's University Hospital in Leeds on March 23.

His family were told the postponement was due to the closure of the operating theatre for coronavirus training.

Mr Pugh's son Bradley, 32, said at the time: 'It was just devastating - mum and dad were completely in shock and obviously tearful. As a family we understand how much pressure the NHS is under, but we feel that, as dad's operation is life or death, the cancer might spread. There is only about six months left, that's the problem.'

His father has survived cancer twice before and his family insist he is strong enough to endure treatment again, but the operation remains vital.

'There was hope there for the whole family, which was everyone was holding out for,' said Bradley, of Stroud, Gloucestershire.

'What the NHS must be going through is absolutely terrible. They are all doing a fantastic job, but we still feel dad deserves the operation because he is our hero. This is a man who has worked extremely hard all his life.'

Mr Pugh worked as an engineer from the age of 18.

Baroness Delyth Morgan of the charity Breast Cancer Now said: 'It's extremely concerning to hear of the major impacts the pandemic continues to have on thousands of people affected by cancer. The outbreak has led to many people's cancer treatment being paused or delayed, an extremely worrying drop in the number of people being referred to see a cancer specialist, thousands of screening appointments being cancelled and some clinical trials being paused.'

Figures from Cancer Research UK in April showed 2,700 cases were being missed a week, partly because patients were shunning their GPs and missing out on screening.

The charity says that - thanks in part to a Daily Mail front page on April 22 - the numbers contacting family doctors with warning signs has begun to increase, although many are still staying at home.

A more recent estimate of missed cases from Macmillan put the number at 2,000 a week. But officials are now anxious that the NHS will be unable to cope with the huge surge in patients who will start coming through the system for diagnosis or treatment once the pandemic abates.

Even before the virus took off in the UK in March, cancer waiting times were at their worst since records began in 2010 with understaffed hospitals struggling to cope.

This means that patients who have already waited months for a cancer diagnosis or treatment will face a 'bottleneck' in accessing care.

Hospitals will be further constrained by strict infection control measures that mean only limited numbers can have CT or MRI scans each day as machines will have to be thoroughly cleaned. Chemotherapy will also be restricted to a few patients at a time due to social-distancing rules.

Cancer Research UK is also calling on the Government and the NHS to dramatically increase testing for staff and patients within specialist treatment centres to ensure they are Covid-free.

The NHS launched these centres last month in private hospitals and NHS hospitals as a means of providing safe areas for cancer patients to undergo diagnosis and treatment far away from virus wards.

But the charity says that unless patients are tested every time they come for treatment, with staff also being tested very frequently, they cannot be reassured that these centres are clear of coronavirus.

An NHS spokesman said: 'Even though more people than ever started NHS cancer treatment in March, coronavirus has turned millions of lives upside down. Cancer services are largely now open, ready and able to receive all patients who need care, so the critical point is that anyone who is concerned about a possible cancer symptom should contact their GP practice and come forward for a check-up.'

Plight of mother in limbo after clinical trials paused
Karen Hilton was due to marry Alistair, her partner of ten years, in April but the lockdown scuppered their plans.

The decision to cancel the event was all the more galling as the 48-year-old fears she may be running out of time to treat her breast cancer.

After first being diagnosed in May 2016 and then again in 2017, Miss Hilton, from Dalkeith in Scotland, was found to be suffering from secondary cancer in September 2018 after noticing lumps on her collarbone.

Karen Hilton
Miss Hilton, a former senior consultant for HSBC, is having chemotherapy but fears she may have to stop if it compromises her health.

She said: 'I've been on my current treatment for a few weeks now, but it could compromise my blood count and if it drops too low, I may have to stop.'

She had hoped to take part in clinical trials for new drugs, but many of these are on hold due to the outbreak.

Miss Hilton, who has a 13-year-old son, said: 'I want to see my son grow up and it's heartbreaking to think that might not happen. Unfortunately, I only have so many options left, and those options include trials for new treatments.'

She added: 'They could be the thing that keep me alive but at the moment due to Covid-19 I'm not getting access and I don't know how long it's going to take for clinical trials to come back.

'While it's a frightening situation, I'm also living with hope that I will get the treatment I need.'
A truly terrible toll for those left to suffer in silence at home
Analysis by Sue Reid for the Daily Mail
Patients with cancer, heart problems and other life-threatening ailments are feared to have died at home as the NHS turned its focus to the pandemic.

Alarmingly, delays in cancer surgery alone will cost more lives than the number of virus patients saved in hospitals, predicts Britain's Institute of Cancer Research, one of the world's most-respected health bodies.

The wake-up call, in an Institute report, warns a three-month delay in operations on the most common adult cancers risks 5,000 extra deaths. A six-month delay would push those excess fatalities up to 11,000.

The disturbing report follows shocking new figures released by Cancer Research UK that more than two million patients have missed out on vital cancer tests and treatment during the pandemic. Last week, Macmillan Cancer Support warned that nearly 2,000 cases of cancer are going undiagnosed every week due to the crisis.

The Mail revealed the unfolding tragedy of untreated patients last month. By the end of April, just a few weeks after the NHS switched its attention to Covid-19 sufferers, hospital referrals for cancer treatment in England had dropped by nearly 70 per cent.

Under 100 organ transplants were carried out in April, the lowest for 36 years, according to NHS figures. On a day in April, only six of its 24 liver transplant centres were open.

Professor Peter Friend, director of the Oxford Transplant Centre, says that liver, kidney, and heart patients were already dying on lengthy waiting lists before the pandemic. 'The effect of doing fewer transplants means that this mortality rate must increase,' he has warned.

Cardiac specialists have reported a 60 per cent decline in hospital admissions for heart attacks, a condition which the NHS says requires 'immediate' treatment in casualty.

Meanwhile, a death certificate count by the Office for National Statistics shows almost 13,000 more people than expected have died in England and Wales since mid-March from causes other than coronavirus.

Statisticians at Oxford and Cambridge are now calling for a national inquiry into the extra deaths amid fears that a lack of medical care is responsible.

Professor Sir David Spiegelhalter, chairman of the Winton Centre for Risk and Evidence Communication at the University of Cambridge, explained: 'There's a huge spike in non-Covid deaths at home very quickly into the epidemic.

'It's important to know how many might have been at least delayed if the normal (NHS) healthcare system had existed.' Visits to England's accident and emergency departments have halved since the outbreak, tumbling to the lowest since records began.

It means people displaying the early signs of serious diseases have stayed away in their thousands. A nurse and Mail reader has sent us reports with photos showing how many people were at four main casualty departments on a recent Monday afternoon.

The waiting rooms at the finest flagship hospitals in London - Chelsea and Westminster, St Thomas' in Westminster, St Mary's Paddington and the Royal London in the East End - had just a handful of patients.

It suggests people are afraid of going to casualty in case they break lockdown rules or catch the virus while there. The ordinary public seems to think that hospitals are dangerous places to be right now.

One allergy specialist told the Mail that in his north of England clinic, only the most seriously ill risk being infected by the virus.

'These are people who are desperate for help. They will take a risk. Others are afraid of coming to my clinic and could lose their lives because of that.'

NHS England has produced a complex 'road map' for opening up hospitals to all patients. Those accepted for treatment or operations will have to isolate for 14 days and be clear of any symptoms before admission. Inevitably it will mean more delays.

Comment: A complicated bureaucracy is just what the NHS does not need when millions are in desperate need for care, it's even more damning considering that the coronavirus has been confirmed as harmless for the vast majority.

Significantly, there will be tests on patients before they arrive to make sure they are Covid-19 free to 'protect' others working and being cared for in the hospitals.

But when the virus is defeated, children are back to school, shops reopened, and cities no longer in lockdown, what will happen to the countless numbers who are seriously ill and whose treatment has been delayed?

The NHS waiting list already stretches to many millions and now faces one of the steepest backlog of cases in its history.

Comment: That's the result of underfunding and ideological attack from successive governments.

The British Medical Association says that for doctors and all healthcare workers, this is a daunting prospect.

A spokesman said: 'They want nothing more than to provide the best care for their patients and avoid delays in essential treatment for diseases.'

One has to wonder whether the doctors' goodwill will really be enough.