Cancer has again made national headlines in recent weeks with the news that King Charles III is receiving treatment for cancer, although the exact diagnosis has not been disclosed. Another royal by marriage, his former sister-in-law Sarah Ferguson, was reported in January to have been treated for malignant melanoma. The sharing of their diagnoses and experiences of cancer by high-profile individuals helps normalise cancer and challenges taboos. Dame Deborah James did not start out as a celebrity, but she gained fame through her efforts to raise awareness of bowel cancer and telling everyone to ‘check their poo’.
Cancer will affect 1 in 2 people in the UK during their lifetime (Ahmad et al, 2015) – and any disease that affects half the population should rightly be given high priority. The majority of people are treated within the NHS, but budgetary restrictions mean that it can only provide access to limited resources.
Beyond awareness, there are other reasons why individuals may have difficulty securing a timely diagnosis or treatment. For example, where someone lives can affect the outcome of a cancer diagnosis (Rashid et al, 2024). Other variables that will have adverse effects include a person's socioeconomic status, their health literacy, comorbidities, ethnicity, education level, culture, fluency in English, caring responsibilities and available support structures.
As specialist cancer nurses, although we strive to provide excellent care for all patients, we also recognise the obstacles posed by these challenges. We are all too aware that every person's experience of a cancer diagnosis and treatment will be individual and difficult in its own way. Clearly, the diagnosis itself will have a significant impact on the individual, but it is important to understand that the pathway to receiving a diagnosis of cancer is not an equitable experience.
The recent economic crisis has exacerbated health and social inequalities. Many of us will know cancer patients who have needed to access food banks for themselves and their families, or struggled with the cost of attending appointments. And we will know patients who make every effort to continue working to provide for their families. Other patients may have caring responsibilities and will always selflessly try to put others first, so every effort must be made to ensure that they can arrange appointments to fit around these.
In other cases, we may encounter some patients who may be at risk of abuse. As cancer nurses, we are critical in identifying such risks to patients and their families and helping to mitigate them. The holistic care we provide can help safeguard vulnerable individuals at risk of abuse, and we also understand the restrictions patients face due to financial difficulties, physical symptoms and the psychological effects following a cancer diagnosis.
External factors withstanding, cancer presents its own risks. Ideally, were there no limit on resources, patients would not have to wait for their appointments and results – waiting times that cause anxiety during or after a cancer diagnosis. This is where the compassion and expert communication skills of cancer nurses are needed to help patients navigate these events, communicate risks in a supportive manner, and minimise distress where possible.
In the UK, the healthcare system has limited resources, so we are now providing support to a rising number of patients with increasingly complex diagnoses and treatment regimens. This requires us, as specialist nurses, to innovate to meet the needs of the local populations we care for to try to mitigate inequitable access to care.
The UKONS annual conference always receives a significant number of abstract submissions detailing innovations that members have introduced to improve care for cancer patients. The submission process for this year's conference, which will be held on 15–16 November in Manchester, is now open (see UKONS conference page, http://tinyurl.com/ukons-2024), when we again welcome the opportunity to showcase the best of these.