Professor Rawlins, the chairman of NICE said the economic pressure on trusts meant that “completely illegal” decisions were being made to limit the use of expensive drugs.

He told the Financial Times: “I just wish a patient organisation would take a Trust to court for failing to comply.”

Nice has been criticised for ruling against the prescription of expensive new drugs on the grounds that they are not cost-effective.

But Sir Michael told the paper that most of Nice’s recommendations were in favour of prescription and that it was other bodies that blocked the drugs’ use.

Sir Michael criticised the local lists of approved medicines drawn up across the NHS which “second-guess” and sometimes ignore Nice recommendations.

While patient groups for particular diseases – often helped by pharmaceutical companies – have attacked Nice for advising against the use of some expensive new medicines, Sir Michael said they should be directing more criticism instead to the drug companies for charging high prices.

The government’s own innovation review recognised the problem by pledging a Nice “compliance regime” to reduce regional variation – the so-called “postcode lottery” – and to improve adherence to the agency’s guidelines.

It cautioned that local decisions should not act as a barrier to the medicines that Nice had approved.

In the most wide reaching study yet conducted into the issue, it was found that 14 different lifestyle factors ranging from smoking, to lack of exercise, eating too much salt, not having babies, drinking too much and being overweight contributed to four in every ten cancers diagnosed in the UK.

The findings expose the myth that developing cancer is ‘bad luck’ or down to your genes, the researchers said.

Previous studies had suggested around 80,000 cancers a year could be prevented but they did not take into account occupational exposures to things like asbestos, infections that can cause cancer and sunburn as the latest research has.

In a complex set of research studies, scientists calculated how many cancers and of what type could be attributed to each of the 14 lifestyle factors.

The findings of the research The Fraction of Cancer Attributable to Lifestyle and Environmental Factors in the UK were published in the British Journal of Cancer.

Smoking was the biggest factor, causing nearly one in five of all cancers.

But Harpal Kumar, chief executive of Cancer Research UK, said most people would not know that a quarter of all breast cancer cases could be prevented along with half of colorectal cancers.

He added: “Leading a healthy lifestyle doesn’t guarantee that someone will not get cancer but doing so will significantly stack the odds in your favour.”

Dr Kumar said tackling unhealthy lifestyle factors linked to cancer would also reduce the risk of a host of other killer diseases such as heart disease, respiratory problems, kidney disease and others.

The study found that alcohol was responsible for 6.4 per cent of breast cancers and almost one in ten liver cancers.

Three quarters of stomach cancers could be avoided, mostly by not smoking, eating too much salt and consuming more fruit and vegetables.

Red meat consumption led to 2.7 per cent of cancers, almost 8,500 cases. Obesity was linked to more than five per cent of cancers or almost 18000 cases, including a third of womb cancers.

Lack of breastfeeding was linked to 3.1 per cent of breast cancers and 17 per cent of ovarian cancers.

The study did not examine how many cancer deaths would be prevented with a healthier lifestyle.

Sara Hiom, director of information at Cancer Research UK, said: “We know, especially during the Christmas party season, that it is hard to watch what you eat and limit alcohol and we don’t want people to feel guilty about having a drink or indulging a bit more than usual. But it’s very important for people to understand that long term changes to their lifestyles can really reduce their cancer risk.”

The World Cancer Research Fund did a similar exercise in 2007 coming up with recommendations to individuals on how to reduce their cancer risk by eating less red meat, taking more exercise and staying slim.

Dr Rachel Thompson, Deputy Head of Science for World Cancer Research Fund, said: “This adds to the now overwhelmingly strong evidence that our cancer risk is affected by our lifestyles.

“We hope this new study helps to raise awareness of the fact that cancer is not simply a question of fate and that people can make changes today that can reduce their risk of developing cancer in the future.”

Survival rates for breast cancer, prostate cancer and cervical cancer were below the average for the 34 developed countries in the study.

Mr Lansley lays the blame for the poor performance on the previous government’s failure to make sure that extra investment in the NHS reached the front line. He claims patient care was ignored in favour of increased salaries and botched computer systems.

Writing in The Daily Telegraph, Mr Lansley says: “Unfortunately this report shows how much work there is to do to deal with Labour’s legacy of neglect and mismanagement of our NHS.

“They hugely increased spending on the Health Service, but wasted much of it on managers, failed IT projects and unsustainable PFI projects.

“They failed to focus on what really matters – patients – which is why we still have some of the worst cancer outcomes amongst comparable countries.”

Under Labour, spending on the NHS trebled, reaching almost £100 billion in 2009, but money for treating cancer still lags behind much of the rest of the world.

A report by the Policy Exchange think tank last year found that England spent around 5.6 per cent of its health care budget on cancer care, compared with 7.7 per cent in France, 9.6 per cent in Germany and 9.2 per cent in America.

In September it emerged that private finance initiatives, introduced by Labour to fund capital projects, have left 60 NHS hospitals on the “brink of financial collapse”. Meanwhile, the pay of NHS chief executives has risen, with typical earnings now more than £150,000.

The OECD figures reveal that the best breast cancer survival rates were in the US, where 89.3 per cent of women were alive five years after being diagnosed. The average across all OECD countries was 83.5 per cent, while in the UK it was 81.3 per cent.

Survival rates for cervical cancer were worse. Norway topped the table with 78.2 per cent still alive after five years, compared with 58 per cent of women in the UK. There were also more hospital admissions for asthma and other lung conditions than the average and infant mortality was higher.

The report also showed that consultations by doctors have fallen, and were below he OECD average in 2009.

Katherine Murphy, the chief executive of the Patients Association, said: “The NHS provides some excellent care but it does fall down on many counts. We know from patients phoning our helpline that the quality of care that they have experienced can be very poor and sometimes it is downright neglectful.

“Rather than trying to tackle the issue of poor care, the Department of Health is demanding that the NHS makes £20 billion of efficiency savings while spending a million pounds a day on a reform plan that doctors, nurses, patients and NHS managers all say risks irrevocably damaging the NHS.”

From:  http://www.telegraph.co.uk/Cancer-cash-wasted-on-NHS-salaries

Other experts said the findings added to a growing body of proof that aspirin could be used in the fight with cancer.

The study was conducted on 861 patients with Lynch syndrome, which affects one in every 1,000 people.

They struggle to detect and repair damaged DNA which means they are more likely to develop a range of cancers including those of the bowel, womb and stomach.

When looking at all patients in the trial, those in the group given 600 milligrams of aspirin every day developed 19 tumours compared to 34 tumours in the other “control” group, a reduction of 44%.

When the researchers looked at just those patients who took the medication for at least two years the reduction was 63%.

There was also an effect on other cancers linked to Lynch syndrome, which fell by half in the treatment group.

Prof Sir John Burn, from Newcastle University, said there were 30,000 adults in the UK with Lynch syndrome.

If all were given the treatment he said it would prevent 10,000 cancers over 30 years and he speculated that this could possibly prevent 1,000 deaths from the disease.

However, there would also be side effects.

“If we can prevent 10,000 cancers in return for 1,000 ulcers and 100 strokes, in most people’s minds that’s a good deal,” he said.

“People who’ve got a clear family history of, particularly, bowel cancer should seriously consider adding low dose aspirin to their routine and particularly those people who’ve got a genetic predisposition.”

Other studies over the past two decades have suggested the pain killer reduced cancer risk, but this was the first randomised control trial, specifically for aspirin in cancer, to prove it.

In 2010, a study suggested patients given aspirin had a 25% lower risk of death during that trial.

Prof Peter Rothwell, from Oxford University, who conducted that study said the latest research “certainly helps to build a consistent picture, all pointing in the same direction that there is a link with cancer”.

Cancer Research UK’s Prof Chris Paraskeva said: “This adds to the growing body of evidence showing the importance of aspirin, and aspirin-like drugs, in the fight against cancer.”

One of the questions asked by the research into aspirin was whether healthy people with no family risks should take the drug.

The lower the risk of heart attack or cancer, the lower the benefit of taking aspirin, yet there are still potentially deadly side effects.

Sir John said that it was a “finely balanced argument” and that he decided the risks were worth it for him.

“I think where we’re headed for is people that are in their 50s and 60s would look very seriously at adding a low dose aspirin to their daily routine because it’s giving protection against cancer, heart attack and stroke.

“But if they do that they’ve got to have their eyes wide open. They will increase their risk of ulcers and gastrointestinal bleeds and very rarely they will have a stroke caused by the aspirin.”

From: http://www.thelancet.com/search/aspirin+cancer

The drug, called ipilimumab, works by teaching the immune system how to tackle melanomas and was widely seen as an important advance on “old-fashioned” chemotherapy.

But in draft guidance NICE- the National Institute for Curbing Expenditure has recommended that NHS trusts do not prescribe the treatment, because it costs about £80,000 per patient and because it had doubts over the research data.

It means that unless the manufacturer cuts the price, the only way that the growing number of advanced melanoma sufferers can access the drug is by applying to the Government’s Cancer Drugs Fund.

The decision comes after a provocative academic report claimed that some expensive cancer drugs are “futile” as they cost a lot and cause toxic side-effects yet only give dying patients a few more weeks to live.

In a joint statement, the support group Factor 50 and charity SKCIN said: “The breakthrough that patients and clinicians throughout the UK have been waiting for has arrived in the form of this drug.”

“Standard treatments that have been available since the 1970s are ineffective and to deny this drug to patients, many of whom are young and with very young families, has undoubtedly handed them down a death sentence.”

“To have come so close to a breakthrough and to be told no at this stage is truly devastating.”

Dr Pippa Corrie, Consultant Medical Oncologist at Cambridge University Hospitals NHS Foundation Trust, added: “Licensing of this drug for use in the UK marked a step change in melanoma patient care, and whilst the Nice decision is predictable, it is disappointing.

“It is essential that we all work to avoid any negative impact on facilitating patient access to this drug. Our patients have waited too long already.”

Rates of skin cancer are rising faster than any other type of the disease in Britain and it affects teenagers and young adults more than any other group.

Almost 12,000 people now develop the most serious kind, malignant melanoma, every year and about 2,000 will die after it spreads across the body.

For the past 30 years the only treatment has been a type of chemotherapy called dacarbazine which is not seen as particularly effective and leaves patients tired and at greater risk of infection.

The new treatment, marketed by Bristol-Myers Squibb as Yervoy, is taken in just four injections, one every three weeks and is said to have fewer side-effects.

In a trial on patients who had undergone prior therapy for skin cancer, 46 per cent who took the new drug were still alive after a year compared with 25 per cent who had not taken it.

In addition, 24 per cent were still alive at two years compared with 14 per cent of those who did not take the drug, and the median survival was 10.1 months compared with 6.4 months among those who did not take it.

But Nice, which assesses whether or not new treatments should be widely available on the NHS in England and Wales, has recommended against its use.

Sir Andrew Dillon, its chief executive, said: “We need to be sure that new treatments provide sufficient benefits to patients to justify the significant cost the NHS is being asked to pay.”

He said the evidence showed that ipilimumab was only effective for a “small percentage” of patients, it was not clear how long its effects last, and that it was linked to “a number of adverse reactions”.

“The Committee considered all these factors and concluded that, on the basis of the evidence provided so far, ipilimumab could not be considered a cost-effective use of NHS resources.”

But he added that the decision is open to public consultation while the manufacturer can offer to cut the cost.

Amadou Diarra, European Vice President and General Manager at Bristol-Myers Squibb UK, said: “We are fully committed to demonstrating that Yervoy represents real value for money to the NHS, and we will be submitting further evidence the hope that Nice will reconsider this decision so that all patients with metastatic melanoma can access this potentially life-extending treatment.”

From: http://www.telegraph.co.uk/Death-sentence-as-NHS-watchdog-rejects-skin-cancer-drug

Fair skinned people who are prone to sunburn may need to take health supplements to ensure they get enough vitamin D, say experts.

The Cancer Research UK charity say that even with a lot of sun exposure, those with fair skin may not be able to make enough vitamin D.

And too much sun causes skin cancer.

Clearly, for this reason, increasing sun exposure is not the way to achieve higher vitamin D levels in the fair-skinned population, say the researchers. But taking supplements could be.

Their work examined 1,200 people.

Of these, 730 were found to have “lower than optimal” vitamin D levels – and many of these were people with very pale, freckled skin.

Supplements are already recommended for groups at higher risk of deficiency. This includes people with dark skin, such as people of African-Caribbean and South Asian origin, and people who wear full-body coverings, as well as the elderly, young children, pregnant and breastfeeding women and people who avoid the sun.

Based on the latest findings, it appears that pale-skinned people should be added to this list.

Vitamin D is important for healthy bones and teeth.

A level less than 25nmol/L in the blood is a deficiency, but experts increasingly believe that lower than 60nmol/L are suboptimal and can also be damaging to health.

Most people get enough vitamin D with short exposures to the sun (10 to 15 minutes a day). A small amount also comes from the diet in foods like oily fish and dairy products.

But people with fair skin do not seem to be able to get enough, according to Prof Julia Newton-Bishop and her team at the University of Leeds.

Part of the reason might be that people who burn easily are more likely to cover up and avoid the sun.

But some fair-skinned individuals also appear to be less able to make and process vitamin D in the body, regardless of how long they sit in the sun for.

Hazel Nunn, of Cancer Research UK, explains how to increase vitamin D levels if you’re pale

Prof Newton-Bishop said: “It’s very difficult to give easy advice that everyone can follow. There’s no one-size-fits-all.  However, fair-skinned individuals who burn easily are not able to make enough vitamin D from sunlight and so may need to take vitamin D supplements.”

Hazel Nunn, of Cancer Research UK, said: “It is about striking a balance between the benefits and harms of sun exposure.

“People with fair skin are at higher risk of developing skin cancer and should take care to avoid over-exposure to the sun’s rays.  If people are concerned about their vitamin D levels, they should see their doctor who may recommend a vitamin D test.”

From:  http://www.bbc.co.uk/news/health-15151930

A drug that can give advanced prostate cancer sufferers an extra two months to live has been rejected by the NHS’s rationing body.

It said that although the drug did extend survival for patients with advanced prostate cancer, it was “concerned” about the side-effects experienced in clinical trials and that at an average cost of £22,000 per patient it was too expensive.

The move comes after an important study commissioned by The Lancet Oncology warned that the cost of cancer care is becoming unsustainable in developed countries, and that it makes no sense to keep giving “toxic” and costly drugs to patients with just a few weeks to live.

Sir Andrew Dillon, the chief executive of Nice, said: “The committee concluded that cabazitaxel would not be a cost effective use of limited NHS resources.”

But Owen Sharp, chief executive of the Prostate Cancer Charity, said: “Cabazitaxel is an important treatment, only recently licensed for use here in the UK, which can help to extend the lives of men in the final stages of prostate cancer for whom existing treatments have stopped working.

“These men currently have very few treatment options open to them when their cancer reaches this advanced stage. Increasing the number of treatments that may extend the lives of these men and allow them to spend precious time with their families is essential.”

Prostate cancer is the most common form of the disease among British men, with 37,000 cases diagnosed every year.

Some men live for years with slow-growing tumours, but in other cases it develops aggressively and kills after spreading to other organs.

Treatments often attempt to reduce the production of testosterone, a hormone that fuels the growth of the tumours, but patients can develop resistance to this type of therapy.

In clinical trials, men with advanced prostate cancer who were given cabazitaxel in combination with prednisone, a drug that suppresses the immune system, lived for an extra 10 weeks.

But Nice said there was “uncertainty” about the new drug’s effect on patients’ hearts and livers, and it did not meet its criteria for being considered as an end-of-life drug worthy of additional funding.

It means that anyone who hopes to obtain the new type of chemotherapy on the NHS must make an individual application through the Cancer Drugs Fund.

Nice is still assessing the value of a daily pill that can treat advanced prostate cancer, called abiraterone acetate, which is believed to have kept the Lockerbie bomber alive longer than expected.

From: http://www.telegraph.co.uk/NHS-rationing-body-rejects-prostate-cancer-drug

Patients who were given the drug found that it eased pain and caused only minor side effects.

The new drug accurately targets tumours using alpha radiation, which doctors conducting the study said is the most effective form of radiation to eliminate cancer because it limits damage to surrounding tissue.

Dr Chris Parker, lead researcher on the project at the Royal Marsden Hospital, said: “It’s more damaging. It takes one, two, three hits to kill a cancer cell compared with thousands of hits for beta particles.”

The drug, Radium-223 Chloride – known as Alpharadin TM – will also do less damage to surrounding tissue because it accurately targets calls, the doctors said.

Speaking at an international gathering of cancer experts, Dr Parker, a consultant clinical oncologist, said: “They have such a tiny range, a few millionths of a metre. So we can be sure that the damage is being done where it should be.”

Patients taking the drug has a 30 per cent lower rate of death compared top patients taking a placebo pill.

“It would have been unethical not to offer the active treatment to those taking placebo,” Dr. Parker said.

Radium-223 has “a completely different safety profile” to chemotherapy, he added.

The trial’s results were presented this week at the 2011 European Multidisciplinary Cancer Congress in Stockholm.

The researchers, who have pointed out the urgent need for an effective treatment for prostate cancer, will now submit their findings for approval by regulators.

Prof Gillies McKenna, Cancer Research UK’s radiotherapy expert said: “This appears to be an important study using a highly targeted form of radiation to treat prostate cancer that has spread to the bones.”

“This research looks very promising and could be an important addition to approaches available to treat secondary tumours – and should be investigated further.”

From:  http://www.telegraph.co.uk/Early-success-in-cancer-drug-trial-gives-patients-promising-future

Tests on laboratory mice have shown that the drug is highly effective at attacking tumours from a range of human diseases such as sarcomas and cancers of the breast, colon, lung and prostate.

The drug is also designed to target solid tumours directly, leaving healthy tissue unaffected, according to Professor Laurance Patterson, director of Bradford University’s Institute for Cancer Therapeutics.

“What we’ve designed is, effectively, a ‘smart bomb’ that can be targeted directly at any solid tumour to kill it without appearing to harm healthy tissue,” Professor Patterson said.

“What is also new about our approach is that we are effectively targeting the blood supply of the tumour,” he said. “If you can starve the tumour of that blood supply, then you can shut off its ability to grow and, indeed, you also shut off its ability to move around the body.”

The drug is well known as having anti-cancer properties, but is normally toxic to healthy cells and so has had limited potential in medicine.

The trick used by the Bradford scientists is to attach colchicine to another molecule that renders the drug inactive until it comes into contact with a one of a class of enzymes called matrix metalloproteinases (MMPs), which are used uniquely by tumours to burrow into the body’s healthy tissue, said Kevin Adams of the Bradford institute.

“The drug is inactive until triggered by the activity of an enzyme that is always found in the tumour environment but not elsewhere. Triggering releases a potent, anti-cancer agent which destroys the tumour’s blood vessels, effectively starving the tumours to death, a process known as haemorrhagic necrosis,” Dr Adams said. Tests on specially bred mice that have human cancerous tumours have shown that the drug and its delivery system can have a “cure rate” of greater than 70 per cent after a single dose, he said. Four different cancers have been treated and the animals suffered no adverse effects.

The next stage is a phase 1 clinical trial to test its initial safety, which is hoped to be conducted within 18 months at St James’s University Hospital in Leeds.

From: http://www.independent.co.uk/crocus-offers-scientists-hope-in-the-battle-against-cancer

An engineered virus which is injected into the blood, can selectively target cancer cells throughout the body in what researchers have labelled a medical first.

Researchers said the findings could one day “truly transform” therapies. Cancer specialists said using viruses showed “real promise”.

Using viruses to attack cancers is not a new concept, but they have needed to be injected directly into tumours in order to evade the immune system.

Scientists modified the vaccinia virus, which is more famous for being used to develop a smallpox vaccine.

The virus, named JX-594, is dependent upon a chemical pathway which is common in some cancers in order to replicate.

It was injected at different doses into the blood of 23 patients with cancers which had spread to multiple organs in the body.

In the eight patients receiving the highest dose, seven had the virus replicating in their tumours, but not in healthy tissue.

Prof John Bell, lead researcher and from the University of Ottawa, said: “We are very excited because this is the first time in medical history that a viral therapy has been shown to consistently and selectively replicate in cancer tissue after intravenous infusion in humans.

“Intravenous delivery is crucial for cancer treatment because it allows us to target tumours throughout the body as opposed to just those that we can directly inject.”

Infection prevented further tumour growth in six patients for a time. However, the virus did not cure cancer. Patients were given only one dose of the virus as the trial was designed to test the safety of the virus.

It is thought that the virus could be used to deliver treatments directly to cancerous cells in high concentrations.

Prof Bell acknowledges that the research is still in the very early stages, but he said: “I believe that some day, viruses and other biological therapies could truly transform our approach for treating cancer.”

Cancer Research UK’s Prof Nick Lemoine, also director of Barts Cancer Institute, said: “Viruses that multiply in just tumour cells – avoiding healthy cells – are showing real promise as a new biological approach to target hard-to-treat cancers.”

“This new study is important because it shows that a virus previously used safely to vaccinate against smallpox in millions of people can now be modified to reach cancers through the bloodstream – even after cancer has spread widely through the patient’s body.

“It is particularly encouraging that responses were seen even in tumours like mesothelioma, a cancer which can be particularly hard to treat.”

From:  http://www.bbc.co.uk/news/health-14730608

They found in experiments that mice were slower to develop skin cancer if they were genetically engineered to suppress a particular enzyme, as caffeine does.

Writing in the Proceedings of the National Academy of Sciences, the academics say their findings suggest that the protective effects of sunscreen could be enhanced by adding caffeine.

“Combined with the extensive epidemiologic data linking caffeine intake with decreased skin cancer development, these findings suggest the possibility that topical caffeine application could be useful in preventing UV-induced skin cancers.

“An additional appealing aspect of topical application of caffeine is that it directly absorbs UV and thus also acts as a sunscreen, potentiating the efficacy of topical UV protection.”

Commenting on the research, Prof Dot Bennett, Professor of Cell Biology at St George’s, University of London, said the team had made “interesting progress” but went on: “The authors suggest adding caffeine or related molecules to sunscreens. First one might want to check there is no adverse effect of caffeine on the incidence of other cancers, especially melanoma (pigmented skin cancer), which kills over four times as many people as squamous cell carcinoma. But caffeine lotion might promote tanning a little, since this family of molecules stimulates pigment cells to make more pigment.”

Previous research has suggested that drinking coffee could reduce risk of developing skin cancer, as caffeine appears to kill off cells that have been damaged by ultraviolet radiation from the sun before they become cancerous.

In the new experiment, researchers at Rutgers University in the US genetically engineered mice to have a reduced function of ATR, an enzyme that “rescues” damaged cells. Caffeine is known to suppress ATR, causing the damaged cells to die rather than turn cancerous, so the mice were mimicking its effect.

When the mice were exposed to UV light, the modified ones developed tumours three weeks later than unmodified ones.  After 19 weeks, the subject mice had 69 per cent fewer tumours than the unmodified ones.

From: http://www.telegraph.co.uk/Caffeine-in-sunscreen-could-protect-against-skin-cancer

Writing in Cancer Cell, they say the cells contract like muscle to force their way out and around the body.

Cancer Research UK said the study provided fresh understanding of ways to stop cancer spreading.

When cancers spread, a process known as metastasis, they become more difficult to treat, as secondary tumours tend to be more aggressive. It is thought that 90% of cancer-related deaths occur after metastasis.

Scientists at the Institute of Cancer Research, who investigated the chemicals involved in cell migration in melanoma – skin cancer – say cancerous cells can move in two ways.

They can “elbow” their way out of a tumour or the tumour itself can form corridors down which the cells can escape.

Lead researcher Professor Chris Marshall said both processes were being controlled by the same chemical.

“There is a common theme of using force, force generated by the same mechanism – the same molecule, called JAK,” he said.

JAK is not a new culprit in cancer. It has been linked to leukaemia, so some drugs are already being developed which target the protein.

“Our new study suggests that such drugs may also stop the spread of cancer,” Professor Marshall said.

“The test will be when we start to see whether any of these agents will stop the spread. We’re thinking of clinical trials in the next few years.”

Dr Lesley Walker, Cancer Research UK’s director of cancer information, said: “A huge challenge in successfully treating cancer is stopping it from spreading around the body, and keeping cancer that has already spread at bay.

“Discovering how cancer cells can funnel grooves though tissues, to squeeze away from primary tumours and spread to new sites, gives scientists fresh understanding of ways to stop cancer spread – literally in its tracks.”

From: http://www.bbc.co.uk/news/health-14530143

However, for those with a faulty RAD15D gene, the risk is raised to one in 11.

The discovery was made by scientists at the Institute of Cancer Research, which is connected to The Royal Marsden hospital in London.

Professor Nazneen Rahman, head of genetics and epidemiology, said: “At this level of risk, women may wish to consider having their ovaries removed after having children, to prevent ovarian cancer occurring.”

At the moment the discovery, published in the journal Nature Genetics, is limited to the knowledge that faulty copies of this gene raise ovarian cancer risk.

But Prof Rahman said: “There is also real hope on the horizon that drugs specifically targeted to the gene will be available.”

The study was based on comparing the DNA of women from 911 families with ovarian and breast cancer, to that from 1,060 people in the general population.

Cancer Research UK, which helped fund the study, described it as “the most significant ovarian cancer gene discovery for more than a decade”.

Prof Nic Jones, the charity’s chief scientist, said: “It’s incredibly exciting to discover this high risk gene for ovarian cancer.

“It’s further evidence that a range of different high risk genes are causing the development of breast and ovarian cancer and we hope there are more waiting to be discovered in different cancers.

“We believe the results of this research will help inform personalised treatment approaches and give doctors better information about risks of cancer to tell patients.”

About 10 per cent of the 6,500 new cases of ovarian cancer every year are estimated to be in those with “a strong family history” of the disease, said Annwen Jones, chief executive of the charity Target Ovarian Cancer.

She said: “This new information, in the future, could help more women with a family history understand their personal risk of developing this disease.”

Survival rates for ovarian cancer remain poor compared to other types. While 92 per cent of breast cancer patients now survive for at least five year from diagnosis, for ovarian cancer only about four in 10 do.

From: http://www.telegraph.co.uk/Ovarian-cancer-gene-raises-risk-six-fold

Rising cancer rates mean four in 10 people in the UK get the disease at some point in their lives, a health charity says.

The charity says the rise poses a “massive challenge” for the NHS.

Ministers in England say they are working to improve cancer survival rates and the quality of life after diagnosis and treatment.

Macmillan Cancer Support says a decade ago about a third of people, or 33%, developed cancer at some point in their lives. The charity says that figure has risen to more than 40%.

The estimates are drawn from projections published two years ago in the British Journal of Cancer, which concluded that at the end of 2008 there were two million cancer survivors in the UK and that the figure was rising every year.

Macmillan also looked at recent cancer incidence and mortality statistics for the UK, indicating that 310,000 people were diagnosed with cancer in 2008.

About 157,000 people died from the disease, and 89,000 who had been diagnosed with cancer died from other causes, making a total of 246,000 who died “with” cancer.

The charity says this accounted for 42% of total deaths in the UK – which stood at 580,000.

Macmillan says the increase is partly down to an ageing population – older people are more likely to develop cancer. It says lifestyle factors, such as diet and exercise, and improved diagnosis have also contributed to the rise.

The chief executive of Macmillan Cancer Support, Ciaran Devane, said the calculations had important implications for the health service.

“It is really alarming that the number of people who will get cancer is now well past one in three and that there are so many more people with cancer today than even 10 years ago,” he said.

“There are currently two million people living with cancer in the UK and that number is doubling to four million over the next 20 years. Yet no-one thinks the country can afford to double its spending on cancer. We’ve therefore got to become twice as effective in how we spend that money.”

The charity says there is growing evidence of the long-term health problems many cancer patients are experiencing long after initial diagnosis and treatment. It says there is a need for more services to help people stay well at home, rather than waiting until they require emergency hospital treatment.

The Care Services Minister for England, Paul Burstow, said it was absolutely right for Macmillan to raise this as a major issue.

“We agree with Macmillan. That’s why we are working to deliver more personalised care and more help to keep people well in their own homes. We are investing more than £750m over four years to improve cancer outcomes,” he said.

The chair of the Royal College of GPs, Dr Clare Gerada, said the figures highlighted the increasing impact of cancer on many people’s lives.

“What is clear from this study is that cancer survival is not the whole picture. All healthcare professionals have a duty to see that patients receive the best possible care, and aftercare, following a diagnosis of cancer, and to ensure their patients are not just living, but living well,” she said.

From: http://www.bbc.co.uk/news/health-14140424

The study shows that 2,880 applications were made to the interim Cancer Drugs Fund during October 2010-March 31, 2011 (773 applications in March alone) and that, overall, 2,506 cancer patients gained access to treatment as a result of the Fund, although applications for 187 patients were denied.

It also reveals a dramatic postcode lottery with a northsouth divide in approvals, as SHAs in the south of England approved a lower number of applications than those in the north.

For example, NHS South Central approved around 75% of applications during the period whereas NHS North East approved every application it received, and while NHS South West used less than a quarter of its allocated funds, NHS Yorkshire and the Humber spent slightly more than its allocated budget.

Most SHAs have taken steps to expedite the application process for the Fund, with one – NHS East of England – removing the requirement for clinicians to submit exceptional-case applications before they can access the Fund.

Also, six out of 10 SHA operate lists of drugs which will be routinely reimbursed through the Fund. “This approach reduces bureaucracy, enables rapid decision-making and provides greater certainty to clinicians and patients,” says the RCF.

However, NHS North West’s operation of a negative list of drugs which will only be funded in exceptional circumstances breaches the spirit of the Cancer Drugs Fund policy, says the RCF, adding that, despite guidance instructing SHAs to cease using negative lists, NHS North West’s list was still operational on June 3, 2011.

The Fund could potentially benefit more than 30,000 patients, enabling them to access 34 treatments which would not have been routinely available on the NHS, and patients with bowel, kidney and blood cancers have been among the greatest beneficiaries, the report finds.

The most-requested drug – by far – has been Roche’s Avastin (bevacizumab), followed by Merck & Co’s Erbitux (cetuximab), Novartis’ Afinitor (everolimus), GlaxoSmithKline’s Tyverb (lapatinib) and Roche’s MabThera (rituximab).

Commenting on these findings, RCF chief executive Andrew Wilson said that while it was “great news” that thousands of patients have benefited from the Fund, it was concerning that 187 patients had been denied life-extending treatment “despite money going unspent and the emergence of significant regional variations in approval rates.”

The report also looks at progress with Primary Care Trust (PCT) exceptional-case processes. It estimates that 7,743 applications were submitted between April 2007 and December 2010, and suggests that the substantial increase in application rates during October-December last year reflects the fact that many SHAs required clinicians to submit exceptional-case applications to PCTs before a treatment could be considered for reimbursement from the Cancer Drugs Fund.

October-December 2010 (the period in which the interim Fund was introduced) also saw a dramatic drop in the exceptional-case approval rate.

This is likely due to more clinicians being encouraged to apply for treatments which would have stood little chance of being approved before the Fund was introduced, the Foundation suggests, although it adds that this requires further investigation.

Some 15,000 people over 75 in Britain die prematurely from cancer each year compared with better performing countries, according to estimates.

The report said there was “substantial evidence” that older patients were under treated on the NHS and that their chances of survival were “poorer as a result”.

It found the elderly were less likely to receive proper tests or surgery and more likely to be seen when their cancers were advanced and so beyond treatment.

The study identified “age bias” in the NHS as a factor behind this.

Catherine Foot, Senior Fellow at the King’s Fund, said: “England still has a way to go to reach cancer survival rates that are ranked with the best international performers. The evidence points to early diagnosis as being key to improving outcomes.

“We hope urgent priority is given to closing the gap in survival rates between different groups in society. We found that older people are particularly burdened by this, being more likely to have cancer, to be diagnosed later, to be under-treated and to experience worse outcomes.”

Ministers have repeatedly cited England’s relatively poor performance in cancer survival as justification for their unprecedented reform of the NHS, repeatedly claiming that 5,000 lives could be saved a year if standards were raised although some health experts have queried this figure.

The new report by the King’s Fund think-tank acknowledges that overall cancer survival rates are improving, but agrees with the Government that England’s performance is still worse than that of several other developed countries.

One important factor behind the generally lower survival rates in England is late diagnosis, the study found.

For example, the difference between England and the Nordic countries for all cancers is 10.8 per cent.

But, if patients who have been diagnosed late and have died after a year are excluded, this falls to 3.6 per cent. This suggests that late diagnosis causes a large chunk of the difference.

Chances of surviving colorectal, breast, lung and ovarian cancer are “persistently lower” in parts of Britain and Denmark than areas of Australia, Canada, Sweden and Norway, with the gap having “widened slightly” for lung cancer, according to the report.

It said there was “strong evidence” that delays in diagnosis by GP and in accessing care partly explained the difference.

In addition, some studies have suggested that patients in some parts of Britain are far less likely to likely to have surgery on tumours than others, while more people should receive radiotherapy.

Ciaran Devane, Chief Executive at Macmillan Cancer Support, said: “There is strong evidence to show that age, not their health, is the main consideration when choosing the most appropriate cancer treatment for older people. It is absolutely vital that we look at new assessment methods in order to improve survival rates and the experience of older people with cancer.”

From: http://www.telegraph.co.uk/Older-people-receive-worse-NHS-cancer-care

While almost three times as many die from breast cancer, those diagnosed with ovarian cancer are far more likely to die earlier.

Figures published in The Lancet show that about 82 per cent of British women with breast cancer survive to at least five years after diagnosis. For ovarian cancer the figure is just 36 per cent. The key reason for the difference is late diagnosis.

Consequently, the National Institute for Curbing Expenditure (Nice) is publishing its first guidelines to help doctors identify and manage the disease.

These include checking the level of a blood protein called CA125, if a women tells her GP she has been persistently experiencing symptoms which could be ovarian cancer.

The test, which costs around £20, is already available on the NHS but offering it sooner could give women a greater chance of survival by speeding up diagnosis and treatment.

Dr Fergus Macbeth, director of Nice’s Centre for Clinical Practice, said older women were often misdiagnosed with irritable bowel syndrome (IBS) when they actually had early stage ovarian cancer. Other possible symptoms include feeling full quickly and the need to urinate urgently or quickly.

He said: “While the symptoms are nonspecific, their persistence can be an important indicator of the disease.”

Women who experienced them 12 or more times a month should see a doctor, the guidelines say.

Although the CA125 test is a useful indicator, they cautioned that it only picked up around 50 per cent of early stage ovarian cancers. Sometimes women with tumours had no raised level of the protein, while others with raised levels sometimes did not have ovarian cancer.

Frances Reid, of the charity Target Ovarian Cancer, said: “This guidance tackles for the first time critical issues facing women who develop ovarian cancer, and could save hundreds of lives. British women must no longer die from delayed diagnosis”, she said.

From: http://www.telegraph.co.uk/GPs-should-offer-20-ovarian-cancer-blood-test

The case, known as Operation Singapore, centred on the importation of more than two million doses of counterfeit life saving medicines into the country.

More than half of these were captured by the Medicines and Healthcare products Regulatory Agency, but a huge amount – almost 900,000 doses – initially reached pharmacies and patients.

Despite an immediate recall of Eli Lilly’s antipsychotic Zyprexa (olanzapine), Bristol-Myers Squibb’s bloodthinner Plavix (clopidogrel) and AstraZeneca’s prostate cancer drug Casodex (bicalutamide), 700,000 doses were left unaccounted for, putting the health of many Britons in jeopardy.

Mick Deats, the MHRA’s head of enforcement, also revealed that plans to bring in three other counterfeit drugs – Pfizer/Eisai’s Alzheimer’s drug Aricept (donepezil), UCB’s antiepileptic Keppra (levetiracetam) and Johnson & Johnson’s antipsychotic Risperdal (risperidone) – had been foiled.

“They didn’t get to bring them in but they were definitely well on the way to being prepared to receive them,” he told the media, according to Reuters.

“This is serious criminal activity and puts people’s lives at risk,” Deats said, and stressed that the Agency would not hesitate “to take all appropriate action to eliminate the risks posed by counterfeit medicines and take action against those engaged in their supply”.

However, he also noted current evidence suggests that medicines supplied through the UK legitimate supply chain are genuine and safe to take.

Since 2004 there have been just 15 known instances of counterfeit medicines in the UK regulated supply chain, and given that 850 million prescriptions are dispensed every year in the UK, the likelihood of receiving a counterfeit medicine remains extremely rare, the MHRA said.

From: http://www.pharmatimes.com/Man_jailed_for_worst_ever_breach_of_medicines_supply_chain

The extensive review also other widespread variations in the quality of care and performance throughout primary care.

For example, one-third of patients with stomach or oesophageal cancer who needed an urgent referral to hospital were actually given a non-urgent referral by GPs.

In fact, overall, an eight-fold variation at which practices urgently refer patients with suspected symptoms of cancer on to specialists in secondary care was found.

Continuity of care continues to be an issue, as only just over a quarter of patients are able to see the doctor of their choice in the lowest performing practices.

Crucially, there were also wide variations in admission rates for patients that could actually be treated outside hospital, which is particularly important as the effective management of patients within the community could also save the NHS hundreds of millions of pounds a year, The King’s Fund said.

On a more general note, the inquiry’s report strongly backs the position of GPs as generalists rather than specialists, but also notes that the profession must embrace the radical changes laid out in the government’s reform of the health system – particularly new commissioning powers -  in order to “maintain its international reputation for excellence”.

In addition, in order to help meet the growing challenges in healthcare, such as the ageing population and increasing demand on service, by building on the changes already taking place within the system.

It calls on GPs to accelerate the trend for multi-professional teams that work closely alongside specialists outside the practice, move away from being ‘gatekeepers’ to ‘navigators’ who essentially co-ordinate care for people with complex needs, and place a greater emphasis on prevention of ill health.

There must also be a much stronger focus on improving the quality of care, the report notes, and also calls on GPs to take responsibility for driving forward progress through a stronger commitment to transparency, particularly on performance data, peer review and benchmarking, and better data capture and use of information.

“Although general practice in this country remains the envy of the world, there is no room for complacency,” warned The King’s Fund’s chief executive Chris Ham.

“While many practices have been at the vanguard of innovation and quality improvement, too many GPs remain unaware of significant variations in performance and do not give priority to improving quality,” he noted.

NHS Confederation acting chief executive Nigel Edwards said improving primary care and GP services is one of the biggest challenges facing the NHS, and that the report “highlights the need to address the major variations in the standards of care patients are receiving”.

He calls for the introduction of a national process to compare general practice standards which, he claims, would not only empower patients to compare the standard of care, but would also help “drive down variation in diagnosis, referrals and prescriptions, all of which are central to saving lives”.

According to the British Medical Association a “culture of self-scrutiny has existed for many years but now more than ever, given the increased intensity and complexity of general practice work nowadays, GPs need time off the treadmill so they can look critically at what they do and make improvements”.

“A reduction in bureaucracy would help them to do this, as would stopping the constant reorganisations within the NHS”, it stressed.

From: http://www.pharmatimes.com/NHS_could_save_millions_of_pounds_with_better_prescribing

Ovarian cancer is the fifth most common cancer in women in the UK, with more than 6,500 patients diagnosed every year.

In around 80% of cases the cancer will return following first-line treatment, and it is estimated that just over two fifths of these could be eligible for treatment with Yondelis, a marine-based anticancer drug derived from the sea-squirt that attacks cancer cell DNA to prevent cell growth and spread.

But the Institute’s Appraisal Committee said it has serious concerns over how Yondelis’ effectiveness compares to that of other treatments available on the NHS. Crucially, PharmaMar did not submit any evidence comparing its drug to platinum-based chemotherapy regimens in treating relapsed disease, despite the latter being the gold standard therapy in such cases.

“This means that we cannot be sure that [Yondelis] extends patients’ lives for longer than the most routinely used treatments,” explained NICE chief executive Andrew Dillon.

Evidence ‘not robust’

New evidence considered did suggest that Yondelis might be most effective in women with ‘partially platinum-sensitive’ ovarian cancer, i.e. when the disease comes back between six and 12 months after initial platinum chemotherapy.

However, the Committee said it was not sure that the effectiveness of the drug in this subset of patients was “genuinely different from that seen in the wider group of patients for which the drug is licensed”, and so concluded that the data were not robust enough.

Taking all the uncertainties into account, the Committee calculated that the incremental cost-effectiveness ratio (ICER) for Yondelis could be higher than £95,000 per QALY gained for the entire eligible population, and £68,000 for the partially platinum-sensitive subgroup, despite a proposed patient access scheme under which PharmaMar offered to pick up the tag for treatment with its drug following the fifth cycle of treatment.

“Even when taking into consideration the Patient Access Scheme, through which the manufacturer limited the total cost of the drug, the committee concluded that the cost of trabectedin was too high relative to the uncertain benefits it may provide patients,” Dillon said.

Meanwhile, the Institute has announced that Sir Professor Sir Michael Rawlins has been reappointed as its chair for another year’s term, until March 31, 2012.

Professor Rawlins has held the position since NICE was created by the then Labour government in 1999 to curb the NHS’s expenditure on drugs.

From: http://www.pharmatimes.com/Another_NICE_no_for_PharmaMar_s_Yondelis

The trial hit its primary goal of demonstrating that Sativex induced a significant improvement in the scores of spasticity, spasm frequency and sleep disturbance related to spasticity compared to a placebo.

Following a four-week, single-blind therapeutic trial period involving 572 patients, Sativex was shown to have reduced the mean score for spasticity, with 48% of patients achieving a clinically meaningful improvement of =20% in spasticity severity.

Of these responders, 241 took part in a 12-week, randomised, placebo-controlled trial phase, at the end of which the number of patients reporting an improvement in spasticity scores of =30% was significantly greater in the Sativex group (74%) than in the control arm (51%).

“We have been aware for a long time that cannabinoid medicines can significantly improve spasticity, which is a common, complex symptom of MS, and now the results from this study prove the positive impact they can have on patients’ symptoms, and ultimately their lives,” said Professor John Zajicek, Honorary Consultant in Neurology, Derriford Hospital and Chair of Clinical Neurosciences at PCMD, University of Plymouth, commenting on the findings.

MS affects around 100,000 people in the UK, and spasticity is a common symptom that is considered to be a major cause of disability, interfering with many every day activities such as walking, picking up objects, washing or dressing.

Sativex was approved by health regulators in the UK and Spain last year, but only in patients who have not responded to other medication and who show a clinically significant improvement in symptoms during a trial run of therapy.

Overall, GW Pharma is celebrating a stellar year with 27 sales hike GW Pharma s cannabis-based MS drug approved in Spain GW rolls out cannabis-based MS drug Sativex in UK Sativex deemed approvable by regulators in UK Spain. GW Pharma’s share has also received a boost on initial Sativex research on reducing cancer pain data.

From: http://www.pharmatimes.com/Study_backs_use_of_cannabis-based_Sativex_to_treat_MS

An investigation by The Sunday Telegraph has uncovered more than 80 cases in which desperately sick NHS patients have been refused the cancer drugs their doctor sought, in the four months since a £200 million fund was introduced to stop health authorities rationing treatments.

The fund was a key move by the Coalition so that those suffering from cancer would never again be refused drugs on grounds of cost.

Ministers were responding to years of anger over a system which meant patients were unable to secure life-extending drugs because central NHS rationers had decided the treatments were not “cost effective”.

Announcing the fund last summer, Andrew Lansley, the Health Secretary, promised to end “the scandal” of cancer patients being refused the drugs that their doctors sought, because of restrictions by the National Institute for Health and Clinical Excellence (NICE).

A £50 million stopgap version of the fund was launched in October, before the annual £200 million investment starts in April.

But this newspaper’s investigation has raised serious concerns over its operation, including:
* At least 86 cases involving terminally-ill patients being turned down;
* Extreme variations in access to drugs, with one NHS region promising free access to more than three times as many cancer treatments as another;
* Local policies so restrictive that in many parts of the country, consultants are expected not to even bother asking for drugs which are not on the “priority lists”.

In its first four months, the fund has paid for approximately 1,300 patients’ drugs – even though research last March suggested up to 20,000 cancer patients’ lives were being shortened each year by drugs rationing.

The Government has allowed each NHS regional health authority to set its own rules about which drugs are put on priority lists, creating a postcode lottery across the country.

If treatments are not on the list, patients and their doctors have to fight harder to justify why they should get them.

Bureaucrats have created complex structures, leaving terminally-ill patients to spend their last months fighting for drugs which could increase their survival.

The policies say every possible funding route for drugs must be exhausted before the NHS will even consider dipping into the fund.

Cancer charities warned that some NHS authorities were attempting to “drive a coach and horses” through the Government pledge.

They fear the £50 million fund may actually end the financial year underspent because of the restrictions.

Andrew Wilson, chief executive of charity The Rarer Cancers Foundation, said: “We are deeply concerned that health authorities are creating really restrictive policies which go entirely against the spirit of the fund – which was that clinicians would be able to decide what treatment their patients need.

“Some organisations are effectively operating blacklists of drugs, while others are making every patient go through lengthy bureaucracy to apply as an exceptional case, when in fact they are a cancer patient requiring treatment should be sufficient. The way some of these organisations are operating drives a coach and horses through the principle of the scheme.”

In most parts of the country, if a patient requires a treatment such as Avastin for bowel cancer – which NICE says is too expensive – their doctors must first apply to see if their primary care trust will fund it as an “exceptional case”.

If that is refused, as would normally be the case, a separate application is then made to request authorisation from the cancer drugs fund – and if that too is refused, patients and doctors are left to attempt an appeal.

Patients refused include those seeking Avastin for advanced bowel, breast and brain cancer, Tyverb for breast cancer and drugs to treat tumours of the bladder and kidney.

NHS authorities said they had turned down requests because they did not think there was enough evidence patients would benefit from drugs their doctors sought. In other cases, they were refused help because their medical history did not match the precise criteria drawn up by trusts.

There is also concern over the “postcode lottery” in availability of drugs.

NHS North West has cited 22 drugs which should normally be funded – while NHS South Central, spanning five counties from Oxfordshire to the Isle of Wight, lists just six treatments which would automatically be allowed.

The policies are so restrictive that in Yorkshire and the Humber, just 82 patients have been given funding. Yet across the East of England, with a similar population, 201 cases were funded.

Even those areas which seemed to have the most generous policies have tightened their belts as end of financial year approaches.

In the North West, which had backed the use for Avastin for some advanced breast cancers, and Glivec for cancer of the stomach, says patients who have not been given funding will now have to wait until April before their cases are even considered.

Several have changed their rules even in during the four months since the fund was set up, so that several patients in London were denied drugs under one set of criteria, only to have their cases reconsidered all over again as their health declined.

Mike Hobday, head of policy at charity Macmillan Cancer Support, said he was “very worried” by the findings of the investigation.

He said: “Every cancer patient should get the drugs their doctor recommends, regardless of what type of cancer they have, or where they live.

“A few extra months towards the end of a patient’s life can mean the difference between seeing a child get married or graduate.”

Health Minister Anne Milton said: “Since October, more and more patients are being treated with life-extending drugs that they wouldn’t have got under the previous system. Demand for the fund will vary across the country; we set up the fund in order to balance out existing variation in access.”

From: http://www.telegraph.co.uk/Cancer-sufferers-refused-life-extending-drugs-despite-Government-pledge

In total there were 12.7 million new cases of cancer worldwide in 2008The latest global figures show that in 2008, there were 12.7 million cases of cancer diagnosed worldwide.

The highest rates of cancer were found in Australia/New Zealand and North America, and the lowest rate was in Africa.

The cancer rate in Australia and New Zealand was nearly three times that in Africa.

Of the total number of cases 48% are in Asia and 25% in Europe. Only 14% of cancers diagnosed worldwide are from regions with the highest rates i.e. Australia, New Zealand and North America. This apparent disparity is likely due to the large population size in Asia.

The most common cancer in men is prostate cancer except for Asia where it is lung cancer. In all regions the most common cancer in women is breast cancer.

Age standardised incidence rates for cancer (excluding non-melanoma skin cancer) in 2008

The tables show the countries with the top ten cancer rates – how many people in every 100,000 develop cancer every year – in four different categories.

Overall cancer rates
1. Denmark (rate: 326.1)
2. Ireland (317)
3. Australia (314.1)
4. New Zealand (309.2)
5. Belgium (306.8)
6. France (Metropolitan) (300.4)
7. USA (300.2)
8. Norway (299.1)
9. Canada (296.6)
10. Czech Republic (295)
[22. United Kingdom (266.9)]

Cancer in men
1. France (Metropolitan) (360.6)
2. Australia (360.5)
3. Ireland (355.9)
4. Uruguay (354.4)
5. Hungary (352.3)
6. Belgium (351.3)
7. Czech Republic (348.8)
8. Norway (338.4)
9. New Zealand (337.6)
10. USA (335)
[33. United Kingdom (280)]

Cancer in women
1. Denmark (325.3)
2. New Zealand (287.1)
3. Ireland (285.1)
4. Israel (280.4)
5. The Netherlands (276.5)
6. Belgium (275.7)
7. Canada (275)
8. Australia (274.4)
9. USA (274.4)
10. Norway (270.3)
[12. United Kingdom (260.5)]

Breast cancer (women)
1. Belgium (109.2)
2. Denmark (101.1)
3. France (Metropolitan) (99.7)
4. The Netherlands (98.5)
5. Israel (96.8)
6. Iceland (95.5)
7. Ireland (93.9)
8. Uruguay (90.7)
9. Switzerland (89.4)
10. New Zealand (89.4)
[11. United Kingdom (89.1)]

From: http://www.wcrf.org/cancer_facts/millions_new_cancer_worldwide.php and GLOBOCAN 2008 http://globocan.iarc.fr

In only 10 of the 50 countries assessed by the researchers do women have a higher chance of being diagnosed with breast cancer than those in the UK.

The experts said that many of the 46,000 breast cancer cases in the UK each year could be avoided if British women drank less, ate more healthily or took more exercise.

More than a quarter of women who develop the disease in Britain die from it, as survival rates have remained low despite record investment in the NHS under Labour.

Professor Martin Wiseman, medical and scientific adviser for the World Cancer Research Fund, which compiled the new study, said: “We know that people in high-income countries are more likely to be overweight, to drink a lot of alcohol and to be inactive.

“When you look at the list, it is clear that the countries that do worse for these factors tend to be nearer the top.

“The high incidence rates in the UK, Denmark and other high-income countries are not inevitable and lifestyle changes can make a real difference to people’s risk.”

Sarah Woolnough, Cancer Research UK’s director of policy, said: “We do know that up to half of all cancers could be prevented by changes to lifestyle such as giving up smoking, keeping a healthy weight and cutting down on alcohol. People can also reduce their risk by eating a healthy balanced diet that is high in fibre, fruit and vegetables and low in red and processed meat.

“All these things, along with taking regular exercise and avoiding sunburn, can reduce the risk of developing cancer.”

More and more British women have been developing breast cancer in recent decades as diets have worsened, excessive drinking has become more common and exercise rates fallen.

Detection rates have improved thanks to the development of advanced screening techniques and increased awareness, but 12,000 women still die from the disease each year as Britain spends less on treatment drugs than other European nations.

Earlier this month the Department of Health announced a new £750 million cancer strategy aimed at saving the lives of 5,000 people a year in England, by giving GPs greater access to advanced diagnosis and improving investment in radiotherapy.

The WHO, through a project called GLOBOCAN, collects figures on the incidence of and deaths from the most common types of cancer for countries across the world, standardised for age in order to aid comparisons.

Its most recent data, analysed by the WCRF for today’s report, show that Belgium had the highest rates of breast cancer in 2008, with 109.2 cases per 100,000 women.

Britain is 11th, with 89.1 cases per 100,000, not as bad as Denmark, the Netherlands, Israel, Ireland or New Zealand but worse than many other leading nations as well as less developed countries where lifestyles are less sedentary. Just 50 in every 100,000 women develop breast cancer in Estonia and Montenegro, for instance.

Britain is the 12th worst of the 50 countries in terms of rates of all cancers among women.

The picture is slightly better for men, where the UK ranks as the 33rd worst. Overall, across both sexes, Britain is ranked 22nd worst out of 50 countries with 267 out of every 100,000 people developing tumours.

International studies have shown that Britons now eat and drink more than their counterparts in many other countries.

Recent figures from the Office for National Statistics show that one in seven women over the age of 16 drinks more than double the recommended daily allowance of alcohol every week, while 24 per cent of women in England are classified obese.

Denmark was given the overall title of “cancer capital of the world”, and although it has a good record of diagnosing the disease, the WCRF said the country’s residents drank a lot and Danish women were heavy smokers.

Meg McArthur, Senior Policy and Information Officer, Breakthrough Breast Cancer, said: “Although these statistics show that we have further to go before we have a future free from the fear of breast cancer in the UK, it is important to remember that more women than ever are surviving due to better screening, improved treatment and greater awareness.

“Breast cancer is thought to be due to a combination of lifestyle, genetic and environmental factors and although some risk factors cannot be changed, women can reduce their risk by drinking less, maintaining a healthy weight and exercising regularly.”

The Government and leading cancer charities insist that Britain’s position near the top of the cancer incidence tables shows that the disease is being picked up by doctors, which aids early treatment, and point out that other countries may not record data so accurately.

Sarah Woolnough, from Cancer Research UK, added: “Comparing cancer incidence rates between different countries can be misleading due to differences in how the data is collected. In some countries, such as the UK, the whole population is accounted for in the data. But in others, coverage is much smaller, so the overall figures might not actually be representative of the whole country.

“Age is the biggest risk factor for cancer, so high-income countries where people live for longer will tend to have higher incidence rates.”

The National Cancer Director, Professor Sir Mike Richards, said: “There are many important factor to consider when looking at cancer incidence figures – for example smoking, alcohol, obesity, and other lifestyle choices.

“We want to vastly improve cancer outcomes – that’s why we will shortly be launching the first ever Government awareness campaign for cancer, to promote earlier diagnosis and to save more lives.”

From: http://www.telegraph.co.uk/Alcohol-and-poor-diet-linked-to-UK-breast-cancer-rates

In particular, individuals at higher risk from the country’s two biggest killers would be helped by taking the painkiller as a preventive medicine, they added.

The experts were speaking at the Royal Society of Medicine a month after research from Oxford University published in The Lancet showed that taking 75mg of aspirin daily for five years reduces the risk of getting bowel cancer by a quarter, and deaths from the disease by a third.

A 75mg dose is a quarter of the standard over the counter pill.

Earlier studies had already shown that a low daily dose could reduce the risk of developing heart disease.

Members of the panel said that the recent research was potentially of “enormous importance” to public health.

Bowel, or colorectal, cancer is the third most common form of the disease in Britain, with 39,000 diagnoses annually and 16,000 deaths.

The Lancet study suggests greater aspirin use could potentially save thousands of lives a year in relation to this one cancer alone.

But research is also looking into whether aspirin could have a preventive effect on other types of cancer as well.

Combined, all cancers claim more than 150,000 lives in Britain every year, while cardiovascular disease accounts for some 200,000 deaths.

Prof Peter Rothwell, the Oxford neurologist who led the bowel cancer study and was part of yesterday’s panel, has started taking a daily dose of aspirin himself. He said: “I suspect that in five to 10 years’ time we will be prescribing aspirin to middle-aged people, not only for the known vascular benefits.”

But members of the public might take matters into their own hands before then, he predicted.

“If it becomes clear that there are benefits for other cancers, then the balance of risk and benefit will become so clear that people may take the decision to take it for themselves,” he said. “It seems implausible that this effect on colorectal cancer is going to be a completely isolated phenomenon in relation to other cancers, given that we know that there are similarities between how cancers develop.”

Prof Rothwell said that he thought it would be “sensible” for people to start taking aspirin at about 45, when the chance of developing bowel and other cancers began to rise. “The risk of cancer goes up substantially between the age of 40 and 55,” he said.

As aspirin had a preventive effect, it was advisable to start taking it daily towards the beginning of that period, he explained. However, he said it was ultimately up to individuals to decide whether to take the drug, “rather than us making definitive statements”.

Prof Peter Elwood, of Cardiff University’s School of Medicine, who conducted the first trial into the effect of aspirin on heart disease in the 1970s, said: “I think we are on the brink of another breakthrough of enormous importance to the community in general.”

Prof Gordon McVie, a leading cancer specialist, from the European Institute of Oncology, said the discussion among the experts was whether this was metaphorically a “put-it-in-the-water moment”.

Opinion on the subject varies however. Experts are divided particularly over the question of to whom aspirin should be recommended as a daily preventive medicine.

The drug was formulated as a painkiller more than a century ago but researchers are finding that it can help in diseases ranging from heart disease to dementia.

Advocates believe that its active ingredient is akin to a vitamin that almost everybody should take, as our modern diet does not provide it. Others point out that taking the drug is known to double the incidence of intestinal bleeding, from about one in 1,000 people per year to about two.

The question is how much of the population – in terms of their age and their risk of developing serious diseases – should be recommended to take aspirin on a daily basis.

Prof McVie said: “I think there’s a frankly conservative feeling in this group, that for [colorectal] cancer, it should be targeted for people at higher risk.”

Prof Sir John Burn, a geneticist at Newcastle University, said: “The problem is, if we recommend something to the whole population, then we will see side effects.

“We know aspirin can cause gastrointestinal bleeding. That is to some extent holding back the situation.” Prof Dion Morton, a colorectal surgeon at University Hospital Birmingham, was another of those attending yesterday’s meeting, which was convened by the Aspirin Foundation.

He said that medicine was increasingly using a “stratified approach, where we target the right drugs at the right patients”.

He thought regulatory approval should be sought for doctors to prescribe aspirin as a preventive medicine for those at a higher risk of bowel cancer. “If they have not been told in writing they should be advocating it, they won’t advocate it,” Prof Morton said.

While intestinal bleeding was serious, research suggested that aspirin increased the risk only of less serious cases, said Prof Elwood. He said there was some evidence that the intestines adjusted to aspirin over the long term.

From: http://www.telegraph.co.uk/Daily-aspirin-dose-for-everyone-over-45-to-protect-from-cancer-heart-disease

The disease is one of the most common forms of cancer in men. About 35,000 men are diagnosed with prostate cancer in Britain every year and about 10,000 die from the disease.

Figures show that men diagnosed with the condition in south east Cambridgeshire are almost five times less likely to die from the disease than those in Tottenham, north London.

The statistics, collated by the Prostate Cancer Charter for Action, also show that 96 of England’s 529 parliamentary constituencies have a death rate 25 per cent higher than the England average.

The figures show that in Tottenham, 57 men per 100,000 died from the disease, 131 per cent higher than the national average.

In south east Cambridgeshire the figure was 12 per 100,000.

An earlier report found that areas of the country which had failed to implement NHS guidelines on improving care had a mortality rate 4 per cent higher than those areas were the guidance had been taken up.

Dr Frank Chinegwundoh, a consultant urologist, said: “It is not enough that prostate cancer services are improving as a whole, if patients face such a lottery in the care they receive.”

“We need better services for all patients across the country, not just a lucky few.”

David Smith, of the Prostate Cancer Support Federation, said: “All men with prostate cancer should benefit from better services, yet these figures suggest that the inequalities in prostate cancer are getting worse.

“There can be no excuse for services in some areas of the country to be performing so much worse than in others.

“This situation cannot be allowed to continue.”

Mark Simmonds, the Tory shadow health minister, said: “We have been warning for some time about the inequalities in access to treatment for cancer.

“We want an NHS focused around the needs or patients and the outcomes they want to see.

“And the way funding is allocated to local NHS organisations needs to reflect the burden of disease across the country better.”

Professor Mike Richards, the NHS’s national clinical director for cancer, said: “The Department of Health recognises the importance of implementing the Improving Outcomes Guidance published by NICE and we have asked Strategic Health Authorities to submit action plans to demonstrate how they will implement this.

“Raising the public awareness of prostate cancer is one of the key challenges for the future. We want men to know what their prostate is, what it does, and what can go wrong with it and we are tackling this through the National Awareness and Early Detection Initiative.

“Also for the first time, as a result of the work of the Prostate Cancer Advisory Group, we now have a definitive set of consistent key messages for the general public about the prostate, including prostate cancer. These clear messages provide men and their families with information about the prostate that they need to be aware of and are designed in such a way as not to cause unnecessary anxiety.”

From: http://www.telegraph.co.uk/health/healthnews/5531954/Postcode-lottery-in-protate-cancer-treatment.html

Macmillan Cancer Support said that showed too many patients were not being cared for properly after being given treatment like chemotherapy and radiotherapy.

According to the NAO’s report, which examines how well the NHS has managed to deliver the last government’s five year Cancer Reform Strategy so far, waiting times have fallen and the number of days cancer patients spend in hospital has dropped.

The strategy, launched in 2007, was meant to make NHS cancer services “among the best in the world” by 2012.

But the NAO report said there was “limited assurance” as to whether the £6.3 billion spent on cancer care annually was money well spent, because such poor information linking spend and outcomes was available.

In particular it illuminated problems caring for cancer outpatients.

Ciaran Devane, chief executive of Macmillan Cancer Support, said: “English cancer services have improved but there is still an incredibly long way to go for the UK to be a world leader.”

She warned: “The NHS won’t be able to support the growing number of cancer patients unless it seriously ups its game.

“The whole NHS needs to realise that cancer is a long term condition for many. If the NHS does not provide appropriate services after patients leave hospital, they can expect to see a massive increase in costs as cancer patients are forced to use emergency services.

“Abandoning cancer patients after treatment is no longer acceptable, nor does it make any financial sense.”

The previous government had pledged to cut the total number of emergency cancer admissions – not just via A&E but also for example by doctors making emergency referrals – but instead the number has been rising steadily.

It has risen from 231,000 in 2000/01 to 300,000 in 2008/09. However, the rate of annual increase has almost halved. Four in five have an existing diagnosis.

Karen Taylor, from the NAO, said there was “poor understanding” of the issue while primary care trusts “don’t appear to be aware of it’s extent”.

Mike Hobday, head of policy at Macmillan, said the reason was clear.

“The traditional NHS approach at the end of cancer treatment has been to say, ‘Go away, you are cured.’ ”

But he explained: “While treatment is in most cases extremely good, people with cancer have ongoing problems. Chemotherapy is toxic – you can’t do it without impacting people’s health.

“Patients aren’t being given the support to manage themselves, so they turn up at A&E.”

A “small investment” in things like better information and dedicated helplines for cancer patients would reap large savings by lowering emergency admissions, he predicted.

With growing numbers of cancer survivors and stretched budgets “the NHS has to do this smarter”, he said.

Dr Jodie Moffatt of Cancer Research UK said the increase could partly be explained by the tripling of cancer patients receiving chemotherapy since 2000. The government was trying to tackle the problem, she argued.

Paul Burstow, the Health Minister responsible for care services, said: “This report is a damning indictment of Labour’s failure to deliver on their promises to improve the quality of cancer care.

“The shocking levels of emergency admissions are the legacy of Labour’s obsession with hitting targets instead of helping patients.

“Under Labour, NHS spending rose to European levels of funding, but they have failed to deliver European levels of quality cancer care. If the NHS was performing at the level of the best in Europe, an extra 10,000 lives could be saved each year.”

Jo Webber, deputy director of policy at the NHS Confederation, which represents health trusts, said: “It is difficult to attribute a rise in emergency re-admissions to any one factor.

“Commissioning appropriate after-care services and providing patients with access to specialist services and home support services all play their part in bringing numbers of re-admissions down.

“Providing patients with access to quality treatment in or close to home, as well as information on local support services, is just as important as the early detection and treatment of the disease when planning an effective cancer strategy.”

From: http://www.telegraph.co.uk/Cancer-patients-abandoned-after-treatment

The following day, Californians went to the polls to vote on a proposal to legalise cannabis. In a dramatic move, President Obama and his Attorney General, Eric Holder, threatened to intervene if the outcome was a “yes” (it wasn’t).

It is timely then that today the Wellcome Trust opens it’s doors on High Society, an exhibition exploring the history of mind-altering drugs.

In keeping with the Wellcome ethos, the exhibition blends a scientific and cultural approach, with curiosities such as a 20 metre opium pipe – an installation by the Chinese artist Huang Yong Ping – sitting alongside more scientific (if no less bizarre) exhibits, such as a Nasa experiment that studied the strange webs spiders spin after they are given different types of drugs.

Amid the debate about drugs, one thing is often ignored: their surprising potential in medicine.

Most people are familiar with the idea that cannabis can be used therapeutically, chiefly in relieving pain or the nausea caused by chemotherapy, but also to moderate autoimmune and neurological disorders.

But according to Amanda Feilding, Countess of Wemyss and director of the Beckley Foundation – a charity that promotes research into drugs and consciousness – we have not fully harnessed its potential.

“The prohibition of the past 50 years has dramatically slowed the advancement of knowledge in the area,” she says. “In combating the recreational use of cannabis, the baby has been thrown out with the bath water.”

More surprising is the fact that harder drugs may also have therapeutic potential. Class A substances such as LSD and ecstasy, Feilding claims, may have a wealth of health benefits.

“We need to wash these substances of their taboo by using the best science,” she says. “Opium and heroin are already widely used in hospitals. Hallucinogenic drugs, however, are victims of a prohibition that came into place in the Sixties.”

“The potential of Class A hallucinogens for clinical use is tantalising,” says Mike Jay, curator of the exhibition. “Psychedelic drugs have been subjected to the most stringent legislation. Yet when administered clinically, they are non-addictive, non-toxic and effective in the smallest quantities.”

LSD was discovered in 1943 by Albert Hofmann, a Swiss chemist. Hofmann, the story goes, was carrying out experiments and got a tiny amount of LSD on his fingers. As he was riding his bicycle that evening, the world “transformede_SLps dissolving into a flux of kaleidoscopic spirals and fountains”.

“In the 1950s, the advent of LSD sparked a furious interest in psychedelic psychotherapy,” says Dr Ben Sessa, a consultant psychiatrist involved in organising the conference. “Then the substances leaked to recreational users, the drug revolution started, and the government halted the supply, even for therapeutic use.”

These may sound like the views of a crank. But Dr Sessa points out that he is not “a fringe figure in a wacky tie”, but a “serious, grey-suited scientist” who has “no interest in decriminalisation”.

There is, he adds, particular excitement over research into MDMA, the active component of ecstasy. “MDMA is an incredibly clean substance when administered in a controlled setting. It’s very unlikely to cause a bad trip. There is no evidence that it is physically addictive. And it is extremely effective in psychotherapy, and to ease the anxiety experienced by cancer sufferers.”

This doesn’t mean that we should dispense MDMA over the counter at Boots. But the drug, which was developed in 1976, has proved its mettle in the treatment of post-traumatic stress disorder (PTSD). Dr Michael Mithoefer, a psychiatrist from South Carolina, has carried out extensive research in this area.

He found that for the 30 per cent of PTSD sufferers who were too traumatised to talk about their experiences, therapy was useless. The administering of a small amount of MDMA, however, enabled them to talk freely about their trauma, allowing them to “move on”.

The British Government maintains that its rules on drugs do not mean that legitimate research is being curtailed. “The Misuse of Drugs Act 1971 recognises the importance of research into drugs such as MDMA,” says a Home Office spokesman, “and allows it to take place under licence.”

Anecdotal evidence, however, points the other way. “It can be frustrating,” says Dr Celia Morgan, a psychopharmacologist at University College London who is engaged in research into cannabis. “Our work is funded by the Medical Research Council, but it was hard to come by. I’d like to see fewer restrictions and more scope for real research.”

The Government’s restrictive attitude, she says, is highlighted by a proposed amendment to the 1971 Act that will give ministers the power to ban “legal highs”, without any scientific evidence that they are harmful. “Prohibition should be based on proper evidence,” she says. “Science should not be circumvented or curtailed.”

Morgan and her co-researcher, Professor Val Cullen, have found that an element of marijuana called cannabinadol, or CBD, which has a beneficial effect on psychosis, anxiety, inflammation, nausea and cancer cell growth, is being bred out of commercially available cannabis. “Only 30 per cent of cannabis on the street contains any CBD at all,” says Prof Cullen. “That makes it far more dangerous.”

From the point of view of the Wellcome Trust, the societal forces that influence drugs policy must also be taken into account. According to Mike Jay, every drug has its own history.

“Traditionally, we tend to be suspicious of drugs associated with other cultures, while being tolerant of those identified with our own,” he says. “For example, we don’t take alcohol very seriously, despite its dangers. Cannabis, however, with its historical links to Caribbean immigrant communities, has been viewed as far more dangerous.”

This is illustrated in the High Society exhibition by two pre-war posters. One reads, “Guinness is good for you”. The second states that “marihuana” is a “weed with roots in hell” and leads to “weird orgies, wild parties and unleashed passions”.

“Another good example is kava, a narcotic drink that has a central role in cultures across the South Pacific,” says Jay. “It encourages cordial conversation and comfortable silence. Yet in 2001, the EU banned it, on the flimsiest of evidence.” The ban has now been lifted.

“Every society is a high society,” he says. “The question is, what are we going to do about it? If illegal drugs can be used as effective medical treatments, it would be wrong not to research that rigorously.”

The High Society exhibition runs from today- 11 November to 27 February 2011 and is being held at the
Wellcome Collection, 183 Euston Road, London NW1 2BE with FREE admission.