Cancer chemotherapy costs money

EDITOR—I strongly endorse Sikora's claim that poor rates of survival from cancer in the United Kingdom reflect a lack of NHS resources.1 Increasing the number of specialist oncologists will not, however, make up for the massive shortfall in funds required to provide these oncologists with the essential tools of their trade.

Recent review of the budgetary allocation to Addenbrooke's Oncology Centre identified that, on average, £1700 a year is available to spend on drugs for any individual patient with cancer. Since a single course of chemotherapy may cost between £50 and £1500, oncologists cannot be expected to deliver the quality of care the public expects to receive. There are no other untapped sources of funding. Our clinical practice is already heavily subsidised: about one in six of all new patients with cancer referred to Addenbrooke's receives his or her standard chemotherapy courtesy of funds raised from industry sponsored research.

The government cannot claim commitment to improving cancer care while patients are being denied effective treatments on the grounds of lack of affordability.

Diagnosis in primary care is important factor

EDITOR—Sikora paints a bleak picture of the quality of cancer care in Britain compared with France, Germany, and Sweden.1 I agree with most of his editorial but take issue with his dismissal of diagnostic delay in primary care as being an important factor. The fact that patients reach secondary care at similar stagings throughout Europe should not allow complacency. Primary care diagnostic oncology in Britain may simply be as bad as that in the rest of Europe.

The Medical Defence Union has reported that failure and delay in …