Community pharmacy teams could play a pivotal role in early diagnosis of cancer, according to Royal Pharmaceutical Society.
In a report entitled ‘Utilising community pharmacists to support people with cancer’, the Society set out a plan to increase the role of pharmacies in the fight against cancer, especially during early diagnosis.
Launched at the Royal Society in London last week, the report described community pharmacies as “a convenient and accessible place for people to present with symptoms that they may have to be concerned about.”
It pointed out the possibility of pharmacists referring people with cancer symptoms to GPs or directly into secondary care for further clinical assessment and diagnosis.
“Community pharmacists and their teams could provide screening services to enable early cancer diagnosis. Enabling community pharmacy to be an active part of the referral pathway would benefit patients through reduced waiting times for diagnosis, which in turn leads to early treatment and improved health outcomes,” the report read.
The RPS report emphasised that a growing interest in pharmacists acting as clinicians and direct care providers meant an overlap between pharmacy roles and those of doctors and nurses.
While community pharmacists added value by supporting anticancer medicine users and helping them to navigate the wider health and social care system, specialised oncology pharmacists were in hospitals, responsible for the storage and make-up of anticancer medicines, it said.
Commenting on the report, Pancreatic Cancer Action (PCA) told Pharmacy Business on Tuesday that the charity fully supports and is excited about the increased role of pharmacists in the diagnosis of cancer.
“With the future role of community pharmacies in the wider NHS being shaped by the new pharmacy contract, this is definitely the right time to take bold steps that will place them alongside GP and secondary care colleagues, fighting cancers like Pancreatic Cancer,” said Ade Williams, PCA Pharmacy Ambassador and Lead Pharmacist at Bedminster Pharmacy.
However, PCA reminded that pharmacy workforce needed to be supported through changes to roles and responsibilities, as they were being increasingly relied upon to carry out health interventions previously left to doctors and other primary care professionals.
“Unleashing the expertise of community pharmacies will definitely advance the cancer survival goals, thereby saving many lives,” Williams added.
COMMUNITY PHARMACIES AS ‘EARLY DIAGNOSIS HUBS’
Another report led by the University College London School of Pharmacy’s Professor David Taylor was released during a press event at the Royal Society which stressed that community pharmacies could become “early diagnosis hubs”.
The UCL’s ‘Cancer Policy Update: Agenda for the 2020s’ also stated that the 15 per cent five-year survival rate for lung cancer in the UK was way behind nearly 25 per cent in “the best of the world,” i.e. Canada, Australia and the US.
However, policy experts said the UK could reach 35 per cent within the current decade by catching the disease earlier and reducing the “postcode lottery” of opportunities for treatment.
The authors of the report called for a proactive national cancer strategy, supporting UK-wide investment in both early diagnosis and treatment and world-class care for people with advanced cancers.
Commenting on the report, Professor Taylor pointed out that “earlier diagnosis coupled with rapid and well-coordinated treatment provision” could provide the answer.
“But as more effective ways of controlling advanced cancers become available the health service should ensure that there is flexible and timely access for patients of all ages and social classes in all parts of the country to the full range of diagnostic, surgical, radio-therapeutic and drug interventions needed for achieving individual clinical care excellence. This is a desirable and affordable goal for our publicly funded health care system,” he added.
LUNG CANCER: PHARMACY’S ‘POTENTIAL IS HUGE’
Lung cancer kills around 35,000 people each year in the UK. The disease is not identified until at a relatively advanced stage. But there is now evidence that low dose CT based screening for smokers and ex-smokers can detect lung cancers when curative surgery is possible.
Additionally, recent advances in immunotherapy and other targeted forms of cancer treatment have been shown to extend the lives of some people with advanced lung cancers for several years.
Professor David Baldwin from Nottingham University Hospitals Trust, who’s also a member of NHS England’s clinical expert group for lung cancer, said: “In areas like lung cancer care, the NHS’s problems have centred more on delayed diagnoses, poor co-ordination of care pathways after the initial identification of disease and undue variation of standards of care between different parts of the country.”
He outlined that it was possible to double five-year lung cancer survival rates during the 2020s.
“To do this we must focus more on ensuring nationwide NHS care consistency across the whole spectrum of intervention, from screening and accurate diagnosis to definitive treatment, and when needs be palliative and end of life care,” he added.
Dr Alison Cook, Director of External Affairs at British Lung Foundation, said “the UK has the fourth highest mortality rate in lung disease in Europe, adding: “the burden of lung disease doesn’t fall equally.”
People living in some of the most deprived societies were two and half times more likely to have COPD and nearly twice as likely to develop lung cancer than their counterparts in affluent areas.
She argued that community pharmacy was a “hugely valuable resource we need to tap into. “The potential is huge,” she said, as “there are more community pharmacies at the end of the streets in deprived areas… This is where people go to when they have persistent cough or breathlessness.”
Dr Cook said: “It’s estimated, for instance, that 70 per cent of homes are within one kilometre or a short walk from a community pharmacy.”
She added that 99.8 per cent people in highly deprived areas lived within a 20-minute walk from a community pharmacy.
PROF MARK EMBERTON’S NEW YEAR LECTURE
In his 2020 Royal Pharmaceutical Society/UCL School of Pharmacy New Year lecture on ‘Controlling Cancer in the 2020s’, Professor Mark Emberton, Dean, UCL Faculty of Medical Sciences, sounded optimistic.
He said: “During the 2020s we’ll be able to do more to detect the disease early and differentiate between those cancers that are life threatening and those that do not require intervention.”
Stating that although around 12,000 men in the UK out of about 50,000 who developed prostate cancer ultimately died, he said medicines had become “increasingly effective” as had surgery and radiotherapy.
In the 2020s, he continued: “we will be able to do more to detect the disease early and differentiate between those cancers that are life threatening and those that do not require intervention.”.
“The future of cancer therapy will, in the coming ten to twenty years, be defined by a quest for greater treatment selectivity on the one hand and increasing our abilities to counter treatment resistance on the other,” Professor Emberton added.