With the UK lagging behind many other rich countries in the early diagnosis of cancer, our new partnership with the NHS and family doctors offers a solution
A pilot study, involving Paul Strickland Scanner Centre and the NHS which seeks to diagnose or rule out cancer in patients who visit their GP with vague symptoms, has proven so successful that it is now being rolled out across Hertfordshire.
The Vague Symptoms Pathway (VSP) programme aims to find the quickest, most efficient way to reach a diagnosis in patients who visit their GP with “non-specific” symptoms, including anything from unexplained weight loss, tiredness, constantly feeling sick, bloated, or even just feeling generally unwell for a period of weeks.
Although the risk is very low, these non-specific symptoms may sometimes be caused by a serious illness, such as cancer. By making a referral under the VSP, a GP can give their patients rapid access to diagnostic tests, including a CT scan, that could help catch cancer earlier.
Cherith Desmeules, Service Manager and Strategy Lead at Paul Strickland Scanner Centre, is leading and overseeing the programme at the centre. She said: “Living with vague, undiagnosed symptoms can be traumatic and devastating to someone’s quality of life, affecting everything from mental health to personal finances.
“Getting clarity on whether or not someone has cancer early on cannot only improve survival chances but can also avoid a lot of unnecessary anxiety for patients and their loved ones.”
She said: “We carried out the pilot with Herts Valley Clinical Commissioning Group in order to determine whether there might be a need for this service on the NHS.
“We started in March 2021 and scanned 308 patients during 18 months. Of those patients, 49 (16%) had an unexpected finding on their scans. Not all of those findings were cancer but they were referred on for further investigation, which will have led to their conditions been treated if required and their lives improved as a result. Some of the non-cancer conditions picked up include pulmonary embolisms (a blocked blood vessel in your lungs which can be life threatening), kidney or liver problems, or other infections.
“We’ve now evaluated the pilot and it has been so successful that it is being commissioned as a service by West Herts Hospitals NHS Trust, the NHS organisation that looks after Watford General Hospital, Hemel Hempstead Hospital and St Albans City Hospital, and is being rolled out across Hertfordshire.”
Lower radiation than elsewhere
“The patients referred to us during the pilot study were mostly over 40— very often in their 60s and 70s— who are more likely to develop cancer than those in younger age groups.”
GPs do have guidelines to support them in making a decision when it comes to whether someone should be referred through the pathway.
The CT scan isn’t the only test that is done – patients will usually have had blood, urine and other tests to rule out other conditions. Paul Strickland Scanner Centre’s dual energy CT scanner allows for lower doses of radiation than similar scans at many other centres and hospitals. “We initially only agreed to support the pilot, but have now committed to being part of the programme long-term, with one of our lead radiologists attending the West Hertfordshire Hospitals multidisciplinary team meetings in order to provide specialist cancer imaging advice.
“The commissioners have specifically commented on the exceptional care our team provide to patients on the pathway and the fantastic service referrers received. We’re very pleased that the pilot has been so successful that it is now being rolled out on the NHS.”
Cherith’s vision for the service
“It will be interesting to see what happens on a bigger scale. Until now we’ve run a small pilot which has proven to be very successful, with more patients coming through. Ultimately, if rolled out nationally, we hope to diagnose cancer much earlier through the Vague Symptoms Pathway than would otherwise have been the case. It’s taking a more preventative approach to cancer, as well as other diseases. This can not only improve quality of life and clinical outcomes but also prevent the condition from becoming an emergency and resulting in a diagnosis following a visit to accident and emergency.”