Watch ITV Cymru Wales' video report by Ellie Pitt
Thousands of people expected to come forward for a cancer diagnosis since the coronavirus pandemic began are 'missing' from treatment services, ITV Wales can exclusively reveal.
Since the start of the pandemic, there are an estimated 4,200 diagnoses outstanding that medics would have expected to give to patients.
Figures from Macmillan also show that there were 1,430 missed first treatments for cancer in Wales between March 2020 and March 2021, compared to what the charity would have expected, based on activity in 2019.
Part of the reason the numbers are lower is because patients are not coming forward with suspected cancer.
Macmillan Cancer Support’s Head of Partnerships Richard Pugh said: “Macmillan’s research estimates there are now around 4,200 missing cancer diagnoses in Wales since the start of the pandemic, so it is vital that anyone with a new or worrying symptom contacts their GP.
“While we welcome the investment the Welsh Government has made towards tackling the cancer backlog, we need urgent action to ensure cancer services can offer people the timely diagnosis and personalised care they need."
'I didn't want to burden the NHS'
Lisa Harvey, from Cardiff, put off visiting the doctor last year when she noticed a change in her breast.
"I put off calling the GP for a couple of weeks," she said.
"I didn't want to burden the NHS - we were going through a pandemic. I was quite conscious of wasting their time if it wasn't anything, but at the same time was conscious that it could be something.”
Lisa's instincts were correct, and in April this year she had a double-mastectomy operation to remove her breast tissue and to try to stop the cancer from returning.
She said: “Although I didn't want to waste their time, I did sort of say to myself, well what would I do if this was a friend or my sister - and I would have given them a kick up the bum and told them to go and get it checked out, definitely.”
'If we don't take symptoms seriously, we're storing up serious problems'
Health professionals also believe that fears over the virus made some people not want to go to GP surgeries or hospitals.
Doctors now anticipate that people will seek help when their cancer is more advanced and harder to treat.
Dr Calum Forrester-Paton is a GP in Penarth and told ITV News if serious symptoms are not taken seriously, "we're storing up serious problems for later on."
He said: "Early on in the pandemic, you know the message was really strong, protect the NHS, don't overwhelm it, only come if you really need to. And I think we're not in that phase of the pandemic, and I think also if we don't take seriously persistent symptoms that might be cancer we're really storing up serious problems for later on".
He said GPs could be seeing more patients face to face and urged anyone with suspected cancer symptoms to make an appointment with their doctor.
“I think we’re aware we need to do it a little bit more. We’re thinking in my own surgery, for instance, of having more bookable face-to-face appointments if the patient feels it’s necessary," he added.
'There's a definite increase in demand'
Cancer services across Wales are now working through the backlog of patients waiting for diagnosis appointments and screening.
The National Screening Programme in Wales covers tests to detect bowel, cervical and breast cancer early. But when the pandemic hit, kits and invites for smears and mammograms stopped. Services were paused for at least three months - and some, longer.
Sharon Hillier, the director of screening for Public Health Wales, told ITV News there "wasn’t a different decision to make at that point" because people had stopped attending their appointments at the start of the pandemic too.
Now, staff at the screening laboratory in Pontyclun are processing more than a thousand samples every day. Dr Hillier said they hope to have cleared the backlog by the end of the year.
At a breast clinic in the Rhondda, extra clinics are being run to see as many patients as possible.
“There's a definite increase in demand," consultant radiologist Dr Sally Bolt said.
"Because of requirements of social distancing and infection control, it means the number of patients we see has reduced because we can't have waiting rooms full of patients like we had in the old days so as well as maximising what we can do in the normal working week, we have to have additional sessions to try to increase our capacity.”
Health minister Eluned Morgan MS recently announced a £25m investment shared between Welsh hospitals for new diagnostic equipment like scanning machines, in order to reduce the diagnostics bottleneck and pressure on services.
A Welsh Government spokesperson said: “Since the start of the pandemic, we have worked with NHS Wales to ensure as much cancer care as possible continued.
“We have published Health and Social Care in Wales COVID 19: Looking Forward backed by an initial £100m investment. This sets out our ambitious but realistic approach to building back our health and care system and includes a focus on cancer services. We also recently announced £25m in funding for new diagnostic equipment.
“We will work closely with the NHS in the coming months to take forward the specific actions relating to cancer services. We continue to urge anyone with symptoms to contact their GP and for people to attend their diagnostic and treatment appointments.”
What does the future hold?
The pandemic and the impact it has had on the wider health service is encouraging top clinicians to consider how Wales’ health system operates.
A main focus for health bosses is to prevent further disruption in the face of any future national health emergencies.
“I think this is a moment we really need to grasp the nettle and to consider doing things differently,” explains Professor Tom Crosby, the national cancer clinical director for Wales.
Professor Crosby says Wales needs to start working towards the idea that cancer services are in designated buildings and facilities that are away from main hospitals treating emergency patients and acutely unwell patients. In this way, they can be protected from future disruptions and services can continue to operate.
But plans to overhaul the design of services in Wales will take a long time, he adds. The future of cancer treatment might not be a reality for another five years. Until then, already exhausted NHS staff must continue to see as many patients, and potential patients, as possible.
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