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A national health concierge service

As a busy GP, I am fully aware and exposed to the everyday pressures faced by our National Health Service, sadly witnessing the NHS stretching to breaking point.

A huge spectrum of demands placed on services, realistically this sometimes results in patients being unable to access the most effective treatment they require.

Cancer Care is heavily affected by NHS budgets, and expensive drugs are a large proportion of the concerns. As the NHS battles to provide an excellent service, it is frustrating that even the most expensive cancer therapies vary in their effectiveness.  In most instances, standard treatment regimens are unsuccessful in a majority of patients, it has been estimated that overall objective response rates to cancer therapies are only 25 per cent.

We know research is constantly striving to find ways to improve drug efficacy, hopefully therefore ultimately reducing costs. Just very recently we learnt of the exciting advances in pancreatic cancer from researchers in Boston. They have developed a polymer which is inserted literally onto the pancreas, via minimally invasive surgery. The polymer can be saturated with chemotherapy medication, therefore acting locally, improving efficacy, and the scientists also report the device reduces local spread.

In contrast with my NHS work, I also work with the private medical management company, Alivia. Our cancer patients are indulged with exposure to all treatment options, worldwide opinions, clinical trials and Personalised Medicine – a logical intelligent method of improving survival, but expensive.

I am becoming increasingly concerned about the widening gap between options available to our NHS patients, and to our Private patients.

Personalised cancer care has been shown to improve prognosis, because molecular genetics and tumour grafting (growing a piece of a patient’s tumour in mice so combinations of various chemotherapy drugs can be tested specifically), provides patients with the optimum treatment according to their individual specific malignancy.

A recent case study, Antonio, presented with abdominal pain and jaundice. A CT scan revealed a tumour located in the bile duct and the liver.  A stent was inserted into the occluded bile duct.  Antonio was told he most probably had inoperable bile duct cancer, and that the prognosis was poor.

A biopsy confirmed a diagnosis of a cholangiocarcinoma and the biopsy also provided opportunity for molecular profiling and tumour grafting. Metastatic spread meant Antonia was not suitable for surgery, all hope therefore resting with the medical team. After just 10 days the molecular profiling results indicated that the chemotherapy suggested would indeed be effective on this individual tumour.

Antonio is still undergoing his personalised chemotherapy schedule, which is responding extremely well to his personalised treatment plan. Current images were this week reported as showing no further tumours. Via ALIVIA, Antonio has been fortunate to access personalised oncology solutions which have given him an improved chance in his fight with cancer.






Dr Ruth Kagan
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