Belfast Telegraph

New breast cancer strategy needed for Northern Ireland, warns charity


By Victoria Leonard

A leading charity is calling for a new cancer strategy to be implemented in Northern Ireland within a year, after a major report warned that breast cancer care here "is stalling".

Breast Cancer Now has called for urgent action after its landmark 'Good Enough? Breast cancer in the UK' report noted a "worrying plateau in progress".

The report reveals that the urgent referral waiting time target to see a breast cancer specialist here has been missed for the third year in a row.

Meanwhile, the uptake for breast screening declined by 2.6% between 2010/11 and 2012/13, falling to 73.9%.

Local patients are also experiencing delays in routinely accessing some of the best new cancer drugs which are available on the NHS in other parts of the UK.

Breast cancer rates in Northern Ireland continue to rise, with 1,456 women diagnosed in 2015 - almost twice that of 2006.

Although the five-year survival rate is increasing, over 280 women here are still losing their lives to the disease every year.

The 'ministerial expectation' in Northern Ireland is that 100% of patients will be seen by a specialist within two weeks of an urgent referral for suspected breast cancer. But between January 2016 and March 2017, performance swung from a low of 63.9% in June to a high of 99.4% in October.

Moreover, while the target for patients beginning treatment within 31 days of a decision to treat is 98%, this was met in only one month in the past year.

Breast Cancer Now says there is a need for a clear plan to routinely meet the two-week target for women to be seen by a specialist following an urgent referral.

The group also wants a review of how guidance issued by the National Institute for Health and Care Excellence (Nice) is implemented, to ensure that treatments recommended for NHS use elsewhere in the UK are made routinely available more quickly here.

Drugs such as Kadcyla, which can give women living with incurable secondary breast cancer an extra six months with their loved ones, are already routinely available in England, Scotland and Wales.

Northern Ireland's Health and Social Care Board can make Kadcyla available in individual cases here via Individual Funding Requests. While 98% of applications are approved, campaigners say that process delays access to the drugs for patients.

Bangor mum-of-two Melanie Kennedy (40) was diagnosed with incurable secondary breast cancer in 2014. Her first request for Kadcyla was rejected, but, following the approval of the drug for routine use in the NHS in England, she was able to access it for free for the first time.

Melanie, who initially had to resort to crowdfunding to fund her Kadcyla, described Northern Ireland's cancer care system as "broken".

She was first diagnosed with HER2+ primary breast cancer in January 2013, when she was 35 years old and pregnant.

"A year later, I was told my breast cancer had spread to my liver. By the time the fourth chemotherapy drug I'd taken had stopped working, I felt like I was running out of options," she said.

"My oncologist put in an Individual Funding Request for Kadcyla. It was rejected because I wasn't considered 'exceptional' enough. With nowhere left to turn, I began campaigning for system change. However, continued political instability meant each time I took a step forward, I took three steps back.

"I was left with no choice but to crowdfund for Kadcyla - and amazingly I managed to raise my target in two days.

"Those with the power to fix it should remember that every time a drug stops working and a patient is denied their next best option, they feel like they're being diagnosed all over again."

Breast Cancer Now chief, Baroness Delyth Morgan, added: "Our vision is that, by 2050, everyone who develops breast cancer will live and live well. But if we are to make this a reality in NI, we need a new and ambitious strategy, supported by adequate funding, that can ensure research progress reaches patients as quickly as possible."

The number of women in Northern Ireland who were diagnosed with breast cancer in 2015

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