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PLANETS Cancer Charity has criticised months of NHS inaction following the approval of a pioneering targeted radiotherapy treatment for patients with neuroendocrine tumours (NETs) in the liver.
In May last year, cancer specialists and patients welcomed the decision by the National Institute for Health and Care Excellence (NICE) to approve SIRT for use in the NHS, offering new hope for patients previously denied the option.
Until the decision, selective internal radiation therapy (SIRT) was only available to patients whose liver cancer had developed in the organ directly or spread to it from the bowel – despite it being one of the most common sites for NETs to spread to.
The treatment, which involves injecting millions of tiny radioactive beads called microspheres – smaller than the width of a human hair – into the blood supply in the liver.
The beads stick to the small blood vessels in cancer cells in the liver and release radiation which destroys them, causing minimal damage to surrounding healthy cells as the radiation only travels a few millimetres from where the beads settle.
In its review, NICE found SIRT, which can take one to two hours, may result in fewer side effects, faster recovery times and better quality of life for patients compared with surgery or chemotherapy.
However, despite NICE’s endorsement, NHS England has yet to provide funding, leaving medics and patients in a frustrating limbo.
NETs are rare types of cancer which are usually found in the pancreas, bowel or lungs but can also develop in other parts of the body.
They arise from cells found throughout the body which form a link between the nervous system and the endocrine system, a collection of glands which produce hormones.
Around 6,000 new cases are diagnosed every year in the UK, though it is thought that a larger number of people are affected but remain undiagnosed as the cancers are slow growing.
If detected early they can often be cured with surgery but, at present, most are diagnosed at a later stage when they have already spread to other parts of the body, commonly the liver.
Until now, treatment options for NETs in the liver have been limited to surgery, percutaneous ablation (heat delivered via a probe), embolisation (drug injected into the organ to stop the blood supply), radionuclide therapy (radioactive substance injected into bloodstream) and chemotherapy.
Dr Brian Stedman, a leading interventional oncologist and co-founder of PLANETS, has criticised the current system.
“We’re seeing a pattern where NICE approval is used as a mechanism to delay progress,” he said. “NHS England demands a NICE evaluation, but once a treatment is approved, they claim the service isn’t commissioned.
“This leaves both doctors and patients in an impossible position – NICE has recommended the treatment, but there’s no way to access it.”
When the NICE guidance on NETs was first released last year, then-health minister Andrew Stephenson welcomed the decision to expand its use on the NHS.
He said: “Internal radiation therapy could provide a better treatment option for thousands of liver cancer patients, so I welcome today’s decision to expand its use on the NHS.
“A treatment that offers faster recovery not only helps cancer patients to get back to living their lives, but helps free up NHS resources and cut waiting lists even quicker.”
Despite this, 10 months later, NHS England has yet to develop a service to deliver SIRT for NET patients.
Layla Stephen, a NET cancer patient and director of strategy and finance for PLANETS, said: “It is completely unacceptable that a treatment which has been deemed safe, effective, and cost-efficient is still not being made available to the very patients it was approved for. This is another example of how bureaucracy is failing cancer patients.
“People with NETs don’t have time to wait—they need access to the best treatments now, not in another year or two. NHS England must act immediately to fund this treatment and stop playing with people’s lives.”
Dr Sachin Modi, a consultant Interventional radiologist and member of the PLANETS clinical team, added: “Research shows that NETs, as a collective group, is the tenth most prevalent cancer in England and, with the increasing incidence of NETs diagnoses, it is critical that there are a variety of treatment options that enable clinicians to improve patient care.”
Dr Stedman and Ms Stephen met members of both the House of Lords and House of Commons in February to discuss the issue and call for NHS England to immediately commission and fund SIRT for NET patients nationwide.
Join the campaign – NHS funding for SIRT
Patients and clinicians are now calling for an immediate resolution, with members of the public asked to sign a petition launched by PLANETS Cancer Charity on change.org.
Without NHS funding, many patients are either denied access to a life-changing treatment or forced to seek private care, with the NHS falling behind when it comes to delivering the latest innovations in cancer care.
The charity is urging NHS England commission SIRT for NET patients without delay and ensure that life-saving treatments approved by NICE are not left stranded in bureaucratic limbo.
How to help:
- Sign the petition urging NHS England to fund SIRT for NET patients:
https://www.change.org/p/ensure-access-for-cancer-patients-to-life-changing-treatment-approved-by-nice - Write to MPs urging them to take action.
- Share the story and petition link on social media to raise awareness.
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