Cancers of the food pipe in Britain have doubled in men over 25 years, figures from Cancer Research UK show. However, over the same period – 1983 to 2007 – cases in women only rose by 8%.
Researchers said the gender contrast in oesophageal cancer rates could be largely explained by the way men put weight on – as “beer bellies” – as well as genetic differences.

Men are also likely to have poorer diets, eating more fatty foods and lower amounts of fruit and vegetables.

Oesophageal cancer is the ninth most common cancer in the UK.

It is one of the most difficult cancers to detect and treat, with only 8% surviving for five years or more. The risk of developing the disease increases with age.

In 1983, about 2,600 men were diagnosed with oesophageal cancer (9.6 in every 100,000 men).

Latest figures show 5,100 men (14.4 in every 100,000) were diagnosed with the disease in 2007.  The number of cases in women rose from 5.1 to 5.5 per 100,000 people.

The most dramatic rise was among men in their 50s, where the rates rose by 67% over the period.
Poor survival

Professor Janusz Jankowski, an oesophageal cancer expert at Barts and The London School of Medicine and Dentistry, whose work is backed by Cancer Research UK, said: “One basic issue is that men’s diets are worse than women’s.

But Professor Jankowski said obesity may be a big reason behind the increase.

“Being overweight significantly increases the risk of adenocarcinoma – the main type of oesophageal cancer that’s on the up.

“Men tend to put weight on their abdomen as beer bellies and become oranges, – whereas women tend to put it on differently and become pears.”

He said having fat on the abdomen was riskier in this context because it put pressure on the stomach.

The researchers are also studying genetic changes that also appear to be linked to the disease.

Dr Lesley Walker, director of cancer information at Cancer Research UK, said: “These new figures are particularly concerning as oesophageal cancer is a very difficult cancer to treat.

“Oesophageal cancer rates have risen dramatically in the UK compared with many other Western countries so we need to determine the underlying causes.

“To combat the poor survival rate for oesophageal cancer, Cancer Research UK is funding research to find new ways to identify the disease earlier and improve treatment so that more people beat the disease.”

From: http://www.bbc.co.uk/news/health-11108218

Breast cancer rates are more than four times higher in the UK than in Eastern Africa, new World Health Organisation figures show.
Some 87.9 per 100,000 British women were diagnosed with breast cancer in 2008, compared to just 19.3 women per 100,000 in Eastern Africa.

The statistics come from the World Health Organisation’s global database of disease prevalence.

Eastern Africa includes countries such as Kenya, Uganda and Tanzania.

The World Cancer Research Fund (WCRF) said some of the difference is because British doctors are better at diagnosing and recording cases.

However, it warned that British lifestyles – including a high incidence of obesity, too much drinking and a lack of exercise – were contributing to high rates of breast cancer at home.

Research has shown that around four out of 10 cases in British women could be prevented if women kept to a healthy weight, drank less alcohol and were more active.

Women in Eastern Africa drink much less alcohol than British women and obesity is far less common. They are also much more likely to breastfeed – which lowers the rates of breast cancer even further.

According to the statistics, the highest rates of breast cancer in the world are in Belgium, which had 109.4 cases per 100,000 women in 2008.

Breast cancer is now the most common cancer in the UK, with around 46,000 new cases each year. The disease kills about 12,000 British women annually.

Dr Rachel Thompson, deputy head of science for the WCRF, said: “The fact that breast cancer rates in Eastern Africa are so much lower than in the UK is a stark reminder that, every year in this country, thousands of women are diagnosed with a case of cancer that could have been prevented.

“That such a large difference in breast cancer rates exists between these two areas is a real concern. Also, it is not just Eastern Africa that has significantly lower breast cancer rates.

“The rate here is double that of South America, for example, and more than three times that of Eastern Asia.

“The fact that rates of breast cancer are much lower in other parts of the world highlights the fact that breast cancer is not inevitable.

“This means we need to do more to get across the message that just by making relatively simple changes to our lifestyle such as drinking less alcohol and maintaining a healthy weight, women can reduce their risk of breast cancer.”

Dr Caitlin Palframan, policy manager at Breakthrough Breast Cancer, said: “It is difficult to directly compare these two populations side by side as it is likely that many breast cancer cases in Eastern Africa are not diagnosed or recorded.

“Breast cancer is thought to be due to a combination of lifestyle, genetic and environmental factors and many of these may differ between the UK and other populations.

“Although some risk factors cannot be changed women can reduce their risk by drinking less alcohol, maintaining a healthy weight and exercising regularly.”

From: http://www.independent.co.uk/uk-breast-cancer-rate-higher-than-east-africa

Having wasted a few reports recently on extending the nanny state by battering voters into not eating fat food the killer quango NICE has now decided to prematurely kill cancer patients.
Kidney cancer patients will not be allowed a new drug that could extend their lives by up to three months because it is too expensive, the NHS drug rationing body has said.

The National Institute for Curbing Expenditure has turned down the drug called everolimus, also known as Afinitor, saying it does not offer enough benefit to patients to justify the cost.

Each pack of the drug costs £2,822 and the manufacturer, Novartis, had offered the first pack free to the NHS and a five per cent discount on following ones.

But even with this, and taking into account new guidance on end of life drugs which allows Nice to approve more expensive drugs that extend life for patients with rare diseases, the treatment was still too expensive, the panel decided.

An estimated eight week cycle of treatment would cost £5,264 per patient.

The cost per quality adjusted life year gained, a complex calculation taking into account improvement in quality of life as well as extra length of life versus the cost of the new drug over and above existing treatments, is almost double what Nice would normally allow.

Around 4,000 people a year in England and Wales are diagnosed with advanced kidney cancer and those who would be eligible for treatment because they had already tried the other drug, called Sutent, and were still fit enough to attempt another drug, would be much fewer, Nice said in a statement.

Patient groups hit out at the draft guidance saying people with rare cancers were being penalised.

Last year patients with advanced kidney cancer campaigned after four drugs including Sutent were turned down. Nice partially reversed the decision and Sutent is now available.

Mike Hobday, Head of Policy at Macmillan Cancer Support, said: “We are disappointed by Nice’s decision not to make everolimus available on the NHS for people living with advanced kidney cancer, who already have limited treatment options following the rejection of three clinically effective drugs last year.”

“It’s unfair that patients suffering from rarer cancers are repeatedly denied treatments that could extend their lives. Drugs like everolimus can dramatically improve people’s quality of life. They can mean the difference between patients being given a few weeks to live and a few months – valuable time that can be spent with family and friends, which means a lot to cancer patients.”

Nick Turkentine, Chief Operating Officer for the James Whale Fund for Kidney Cancer said: “Once again Nice has disappointed the thousands of kidney cancer sufferers in the UK by not approving everolimus, a drug which gives terminal kidney cancer patients and their families some hope.”

From: http://www.telegraph.co.uk/Kidney-cancer-patients-denied-drug-that-can-extend-their-lives

Hundreds of cancer patients may have been left to die without access to life prolonging medication, despite the drugs being approved by the labour government.

A postcode lottery means hundreds of people are missing out on life-prolonging care

Now figures obtained under the Freedom of Information Act show that a cancer patient’s chances of overruling health authorities who deny them access to drugs depends on where they live.

Some NHS trusts, such as Torbay in Devon and Salford in Manchester, granted all appeals while in others, such as Kingston in southwest London, only 7% were granted. In about one-third of trusts, fewer than half of the requests for drugs that can cost thousands of pounds a month were approved.

Access to cancer drugs has become an election issue, with the Conservatives saying they will ensure the National Health Service directs £200m more into supplying new drugs. The money will come from what the health service would otherwise have had to pay to meet Labour’s hike in National Insurance, which the Tories have said they would partially reverse.

The drugs concerned have all been approved by the labour government’s National Institute for Curbing Expenditure (Nice). However, each of 152 primary care trusts (PCTs) in England is allowed to use its own interpretation of Nice’s regulations.

In some cases patients who have already had two courses of chemotherapy are not allowed the drugs; in other cases they must have tried cheaper alternatives before being eligible. Those who do not meet the conditions must appeal to an “exceptional case” panel.

Widespread variation in attitudes between health trusts emerged in research to be published in Health Insurance magazine. It asked how many “exceptional-case funding requests” for cancer were received by trusts in 2009.

It named five drugs, including Rituxan for leukaemia; Tarceva for lung cancer treatment and Revamid for blood cancer.

All such appeals were granted by 17 healthcare trusts, with the areas benefiting ranging from Walsall and Manchester, to Torbay and Suffolk. However, Kingston and Northamptonshire refused most of the appeals made to them.

Forty one of 122 primary care trusts that responded granted fewer than half requests. The figures present an incomplete picture because some trusts may prescribe medicines without the need for patients to appeal. Critics, however, say they still show unacceptably wide variations in practice.

Specialists also complain that the NHS trust officials who decide whether or not to grant the appeals are rarely experts in the disease, so they help to create the wide discrepancies.

Karol Sikora, a cancer specialist at Hammersmith hospital, west London, said his department has a wallchart that marks both sympathetic and unhelpful PCTs. “You find yourself talking to office temps and all sorts of unlikely people who are apparently making these life-or-death decisions,” said Sikora.

A woman has been denied an operation on the NHS after paying for a private consultation to deal with her severe back pain after cancer.

Jenny Whitehead, a breast cancer survivor, paid £250 for an appointment with the orthopaedic surgeon after being told she would have to wait five months to see him on the NHS. He told her he would add her to his NHS waiting list for surgery.

She was barred from the list, however, and sent back to her GP. She must now find at least £10,000 for private surgery, or wait until the autumn for the NHS operation to remove a cyst on her spine.

“When I paid £250 to see the specialist privately I had no idea I would be sacrificing my right to surgery on the NHS. I feel victimised,” she said.

The case will reopen the debate over NHS policy towards patients who pay for some of their care privately. Following a Sunday Times campaign in 2008, the government ordered the NHS to stop withdrawing care from patients who received additional private treatment or drugs.

Cancer sufferers were being barred from further NHS treatment after buying potentially life saving medicines not offered by the health service.

Whitehead’s case, which has shocked her local Labour MP, reveals that patients who go private in despair at long waiting lists still risk jeopardising their NHS treatment. Department of Health officials admit it remains official policy.

Whitehead, 64, a former museum assistant from Yorkshire who works as a volunteer at a hospice, went to her GP in December for back pain. Because of her breast cancer history, she was immediately offered an MRI scan to check the disease had not returned. It revealed a cyst on her spine, pressing against her sciatic nerve. Her GP referred her to a consultant at Airedale NHS hospital.

She was told the next available NHS appointment was in May, so she accepted the offer of a private slot to see him the following week.

“My husband and I are retired and don’t have a lot of money, but I am in intense pain and couldn’t face the thought of waiting months just for an initial consultation,” she said.

The specialist promised to add her to his NHS waiting list for surgery. After two months, however, hospital managers told her she had been barred from the waiting list because she had seen the surgeon privately.

Now her only alternative to paying £10,000 privately is to go back to her GP, seek another referral to the same specialist, this time on the NHS, and face another 18-week wait.

“We will scratch together the money if we absolutely have to, but I feel it’s incredibly unfair,” said Whitehead. “I’ve paid full National Insurance contributions all my working life and feel I should get this operation on the NHS.”

Ann Cryer, who is standing down as Labour MP for Keighley, has written to the hospital urging it to reconsider. She told Whitehead that she had been “badly let down and ill advised”.

Bradford and Airedale NHS trust said it was looking into the case “as a matter of urgency” but added: “Anyone who chooses to pay for a private outpatient consultation cannot receive NHS treatment unless they are then referred on to an NHS pathway by their consultant.”

From:http://www.timesonline.co.uk/tol/life_and_style/health/article7100968.ece

Patients are being denied access to drugs for rarer cancers because the NHS treatment watchdog is acting contrary to the recommendations of a government inquiry, a report claims today.

Analysis by the Rarer Cancers Forum (RCF) suggests that the National Institute for Curbing Expenditure (NICE) is “failing to follow the spirit” of guidelines designed to improve access to end-of-life cancer treatments.

It claims that as many as 16,000 patients have been denied access to drugs because the watchdog had concluded unfairly that they did not meet the criteria for consideration, or they were deemed too expensive — without proper negotiation with pharmaceutical companies.

The report, Exceptional Progress?, looks at improvements to treatment access for people with rarer cancers following a review carried out by Sir Mike Richards, the Government’s national clinical director for cancer.

Sir Mike’s review was prompted by complaints from patients who were denied NHS care after having paid privately for treatment. The Government subsequently lifted the ban on so-called “top-up payments” and said that cancer drugs that were more expensive than NICE normally allowed, but which could offer patients a few more months of life, should be considered.

Andrew Wilson, chief executive of the RCF, said that although progress had been made in improving access to treatments since the publication of the review, there were still serious shortfalls which required urgent review.

“It is unacceptable that many thousands of patients are still missing out on the treatment they need, and which their doctors want to give them, because NICE has decided that their treatment does not meet some arbitrary criteria,” Mr Wilson said.

He added that NICE was failing to assess drugs quickly enough — taking 21 months to appraise new cancer drugs, rather than the six months promised by ministers by 2010.

Until the Richards review, NICE would not approve drugs that cost more than £30,000 to £40,000 for a year of good quality life. The ceiling has since been raised to £80,000.

Sir Andrew Dillon, NICE chief executive, said the watchdog had, in conjunction with the Department of Health, introduced “significant additional latitude in its appraisal of treatments, particularly where they are designed to extend life, at the end of life. NICE and the Department of Health are working together to assess ‘patient access schemes’ – proposals from companies for ways of managing the entry of expensive new treatments into the NHS by sharing some of the costs, and the Innovation Pass – a scheme to support a small number of promising new drugs with funding at a national level.”

From: http://www.timesonline.co.uk/tol/news/uk/health/article7061769.ece

Women who have taken the contraceptive pill are less likely to die of cancer and heart disease, a study has found.

The research, which studied 46,000 women over almost 40 years, was led by Prof Philip Hannaford of the University of Aberdeen.

He said that earlier data from the study had suggested there was an increased risk from using the pill but this disappeared in the longer term.

The professor said: “I think it is really reassuring for women.”

The results are from the Royal College of GPs Oral Contraception Study, one of the world’s largest investigations into the health effects of the pill.

The study was published online in the British Medical Journal (BMJ).

Prof Hannaford told BBC Scotland: “We have known for a while that whilst women use the pill they have a small excess risk of disease but that seems to wear off. What we have never known is, what are the really long-term effects?”

“This study, after following up a large group of women for 39 years, has shown there is no increased risk among women who have used the pill, in fact there is a small 12% drop.”

He said women who had taken the pill were less likely to die from cancer, heart disease or stroke.

The professor added: “There are some risks whilst you use it but you can minimise those risks by avoiding smoking, having your blood pressure checked, taking part in screening programmes.

“What we know now is once the pill is stopped those risks disappear and in the very long term there is no increased risk, in fact, if anything, a small benefit.”

He said the results of the survey related to the first generation of pills.

Prof Hannaford said pills had changed over the years and methods of assessing risk were now different.

He added: “It would be wrong for me to say these results directly apply to today’s pills, today’s women, but from the few studies that have been done on the newer pills we are finding similar effects as the older pills. So one would suppose that the overall benefit from the newer pills is equally as good.”

From:
http://news.bbc.co.uk/1/hi/scotland/north_east/8563606.stm