Thousands with incurable breast cancer face repeated GP visits before diagnosis

By Jemma Crew, Health and Science Correspondent11th October 2019News EnglandCancer, News England, NHS, Palliative Care, Primary Care / GP's

Thousands of patients with incurable breast cancer are repeatedly visiting GPs before they are diagnosed amid concerns their symptoms are not being taken seriously or misinterpreted, a new report has suggested.

Almost a quarter (24%) of women surveyed by Breast Cancer Now reported having visited their GP at least three times before being told their cancer had returned and spread.

The survey found a fifth of those previously treated for breast cancer were treated for another condition by their GP when they presented with symptoms, before being told that the cancer had returned.

About four in ten (41%) respondents who had spoken to a healthcare professional before being diagnosed with secondary breast cancer said they felt that their symptoms had not been taken seriously.

Just 13% of more than 2,000 women questioned by the charity said they were given enough information about the signs of incurable secondary breast cancer when they completed their initial treatment.

Symptoms of secondary breast cancer are wide-ranging, including unexpected weight or appetite loss, discomfort or swelling under the ribs or across the upper abdomen, and persistent headaches.

The Royal College of GPs (RCGPs) said doctors were highly trained to spot signs of recurrence but that some symptoms “are very difficult to interpret”.

It is not known whether delays in diagnosis significantly shorten patients’ lives, but early access to treatment can dramatically improve quality of life by alleviating symptoms, the charity says.

If left untreated, secondary breast cancer continues to spread and symptoms can worsen.

The charity is launching a campaign, The Unsurvivors, to challenge the “worrying” perception that everyone with breast cancer survives.

Baroness Delyth Morgan (pictured), chief executive at Breast Cancer Now, the research and care charity, said avoidable delays were “completely unacceptable”.

Calling for a “radical shift” in thinking about breast cancer, she said: “We need health services to properly cater for the tens of thousands of people living with breast cancer where treatment is no longer curative.

“We need to guard against complacency in the face of recent advances and ensure that clear pathways are developed for secondary breast cancer patients, from diagnosis through to care. We cannot let those with secondary breast cancer be written off.

“For too long now, the worrying perception that everyone survives breast cancer has masked the heart-breaking reality for 11,500 families in the UK that lose someone they love each year.

“Early diagnosis is at the heart of NHS cancer policy, but we are not yet doing enough to ensure the same prompt diagnosis for secondary breast cancer patients.

“By providing better support for GPs and ensuring that all patients treated for primary breast cancer receive the support and information they need about what to look out for, we can help more people live well for as long as possible.”

Breast Cancer Now said its survey, of 2,102 women, is the largest to date of UK people with incurable breast cancer.

An estimated 35,000 UK people have incurable secondary breast cancer.

The charity is calling for better support for GPs, including online training and IT alerts that can spot “red-flag” symptoms to be rolled out to all practices’ software.

The charity is urging doctors to investigate non-specific but persistent symptoms in people who have previously had breast cancer.

Professor Helen Stokes-Lampard, RCGPs chairwoman, said: “We understand the importance of timely cancer diagnosis and are highly-trained to identify possible symptoms of cancer and its recurrence.

“But some symptoms are very difficult to interpret because they are vague in the initial stages or indicative of other, more common conditions – in other cases, there may be no symptoms at all.

“We are actually making positive progress on cancer diagnosis in primary care, but GPs must have better access to the right diagnostic tools in the community and the appropriate training to use them.”

An NHS spokeswoman said: “Breast cancer survival is at a record high and, thanks to huge advances in NHS care, the number of people dying from the disease is falling faster in this country than the rest of Europe.

“The NHS long-term plan is already taking action to catch more cancer earlier, including getting GPs to work together to spot potential problems quicker and giving breast cancer patients faster appointments, regular check-up scans and a named contact to raise any concerns with.”