For the first time in more than five years, cancer services in Kent and Medway have hit the national target for the 62-day performance standard.
Cancer teams from the four hospital trusts in Kent and Medway made sure 85.6 per cent of their patients seen in December did not wait more than two months for cancer treatment, following an urgent referral from their GP.
This means the Kent and Medway Cancer Alliance is the second highest performing alliance in the country. This improvement comes just 18 months after cancer services in the county were consistently performing bottom in the country.
Ian Vousden, Programme Director for the Kent and Medway Cancer Alliance, said: “We are absolutely delighted at the news, because it means more people are receiving the essential care they need as quickly as possible.
“This result is due to the continual hard work and collaboration between all of our cancer services and comes hot on the heels of our October performance where Kent and Medway performed top in the country, seeing 84.8 per cent of patients. To now exceed that and meet the national standard is a testament to how we are working hard to improve cancer care.”
The improvements have been a result of several changes, particularly in how men with prostate cancer are being treated. Waiting times have been cut for prostate cancer patients by up to six weeks by introducing MRI scans before a biopsy so clinicians can specifically target the area that needs to be tested. This streamlined process is far more effective for both patients needing treatment and clinicians delivering care.
Dr Henry Taylor, Clinical Lead for the Kent and Medway Cancer Alliance, said: “Nationally, there has been a significant increase in referral numbers over the past 18 months and we were committed to meeting that challenge. More than 89 per cent of prostate patients are now treated within the 62 day target.
“Our next challenge is making sure we can sustain this performance every month. To do this we are now rolling out similar improvements that have elevated prostate care across other cancer pathways so all patients receive timely and appropriate care.”
Professor Sanjeev Madaan, Consultant Urological Surgeon and Lead Cancer Clinician at Darent Valley Hospital said: “It has been a real partnership effort. Working closely with hospital colleagues, GPs, cancer clinicians and our commissioners, we were able to buy new equipment and introduce new roles to help patients move smoothly through the stages of identifying, diagnosing and treating cancer.”
Case studies:
Ralph Clarkson
Looking at him today, it’s hard to imagine just a few months ago Ralph Clarkson was having major surgery to remove his prostate.
The 53-year-old civil servant from Swanley had been told in October 2019 he had ‘scattered’ cancer in his prostate and due to his age, his best option was to have his prostate removed.
Just two weeks later, Ralph underwent a keyhole prostatectomy.
He said: “I first went to my GP because I thought I had a urine infection.”
After tests showed Ralph had a high PSA score of 7.9, he was referred to the Urology Department at Darent Valley Hospital. The PSA test is a blood test which can be done at a GP surgery and measures the level of prostate-specific antigen (PSA) in your blood – a protein which when raised above 4.0 can indicate cancer.
Ralph was seen quickly and the consultant decided to send him for a MRI scan to identify where on his prostate they should be taking biopsy samples.
This new process is just one of the reasons men in Kent and Medway are receiving quicker and more effective cancer treatment. Previously, a high PSA would indicate a patient needed to have their prostate biopsied, but without a MRI, samples could be taken from anywhere on the prostate.
Now a detailed scan shows the surgical team exactly where the areas of concern are, making sure biopsies are targeted to the problem areas.
For Ralph, his initial biopsy led the team to offer him medication and a chance to monitor his prostate over the next few months. A few months later, consultant Mr Sanjeev Madaan called Ralph back for a second biopsy procedure and the results confirmed it was definitely not an infection, but his prostate was ‘scattered’ with cancer.
Ralph said: “I remember feeling a bit shocked after the diagnosis. The team was very supportive and I was seen straight away by Alan, the cancer nurse specialist, who gave me a lot of information and told me what would happen next and what to expect. To be honest, it’s such big news that it’s hard to take all the information in at first.”
Before his surgery, Ralph was invited to join a pre-operative workshop which he found really useful and helped answer questions he had about his future surgery. “They did a brilliant job,” said Ralph. “I was particularly well-supported by cancer nurses Alan and Nicky.”
For Ralph, this meant just two weeks after receiving news of his second biopsy test, he was having surgery. He was in Medway Maritime Hospital for just one night, then discharged home to begin his recovery.
He said: “It’s not an easy operation to recover from. They send you home with a catheter in place and I had to give myself anti-clotting injections for a month afterwards, so you have to take things slowly and rest.”
But now, just a few months later, Ralph is back to work and feels better than he did before his operation. His advice? “If you notice anything different or unusual about your health, don’t wait. Make that GP appointment and find out what is going. If it is cancer, they can help. The earlier, the better.”
Tristan Swain
It was an increased need to go to the toilet, and needing to do so urgently, that led to 53 year-old Tristan Swain’s cancer diagnosis and keyhole prostatectomy to have his prostate removed in September 2018.
The father-of-three, who has been married to wife Denise for 25 years and works as a member of civilian staff for the Met Police, thought his increased visits to the toilet were due to his blood pressure medication. He had no idea it could be because of prostate cancer.
A visit to the GP, tests and a PSA of 6.1 meant he was quickly referred to the urology service at Darent Valley Hospital. At first his condition was treated with medication, but an MRI-led biopsy suggested he had a moderately aggressive form of cancer on the edges of his prostate and because of his age a prostatectomy was the recommended option.
Receiving the news he had cancer was the last thing Tristan and Denise expected. He said: “It was a major shock and completely unexpected. The nurses were amazing and really supportive, not just for me but also my wife who was really upset by the news. It felt as if they worked on my case very quickly and it wasn’t long before I was having surgery.”
As with most major diagnoses and operations, the surgery was just the start of Tristan’s recovery. “It was life-changing,” he said. “I took each day at a time, but the after effects of having this operation took some getting used to. What helped was knowing I had the support of the team and I just tried to get on with life as normally as possible.”
A keen runner, Tristan was in good shape before his surgery, but the long recovery process did affect his ability to keep fit. “I used to do a lot of running, but that had to go on hold for a while. I have started back on the treadmill now though and am keen to get back in the gym. Life goes on.”
Michael Utchanah
For property and financial business owner Michael Utchanah, it was a family scare that finally prompted him to have his prostate function checked in 2013.
Michael, 60, from Meopham, was visiting family in Mauritius nearly 10 years ago when his two uncles told him they had their prostates removed due to cancer.
An avid helicopter pilot, Michael had been having yearly medical exams from the age of 50 to keep his helicopter licence. The doctor assessing him had recommended a couple of times that he speak to his GP to have his PSA level tested, but it wasn’t until his trip back to his birth country that he was convinced it was time.
He said: “I didn’t have any symptoms, so when I spoke to my GP, he thought I was being over cautious, but there is a family link with prostate cancer so when I said my uncles had been diagnosed a blood test revealed I had a PSA of 4.9.”
He was referred into Darent Valley Hospital’s urology service and a biopsy of his prostate showed a Gleason score of 7. He was given different choices for treatment, but due to his young age, Michael agreed with the consultant that surgery to remove his prostate was his best option.
“I felt well supported to make the decision and wasn’t too worried about the surgery,” said Michael. “I was more nervous about coming home with a catheter and the known side effects of having such a major operation, such as incontinence. I would say it took about 18 months to be physically back to normal.”
During his recovery, Michael’s treasured helicopter pilot’s licence was suspended for 12 months until the surgeon contacted the Civil Aviation Authority to say he was fit to fly again. Since then, he hasn’t looked back and he even gives his time up once a month to volunteer as part of Darent Valley Hospital’s Prospect Group.
He said: “When I was first diagnosed, my cancer nurse suggested I join the hospital’s support network, the Prospect Group, so I could talk to other men with a prostate cancer diagnosis and men who’d had the surgery. Speaking about it really helped me as it was the mental impact of having cancer rather than the physical recovery from the surgery that I found hardest. I enjoy giving my time back to support the team that supported me.”
Transforming health and social care in Kent and Medway is a partnership of all the NHS organisations in Kent and Medway, Kent County Council and Medway Council. We are working together to develop and deliver the Sustainability and Transformation Plan (STP) for our area. Find out more at www.kentandmedway.nhs.uk