A major new cancer treatment and research centre would be built at the Western General under plans being drawn up by NHS Lothian to cope with soaring rates of the disease.
The specialist centre – which would be comparable to the renowned £105 million Beatson facility in Glasgow – would replace the Western’s Edinburgh Cancer Centre. Experts are predicting the number of cases will increase by more than a fifth in a decadee due largely to the region’s ageing population.
Every year more than 1000 people die from cancer in the Lothians, but the growing number of diagnoses, and the fact more people than ever are surviving the disease, is putting services under growing pressure, at a cost of nearly £44 million a year.
The rise is forcing health bosses to reassess how best to tackle the epidemic – incidents of some cancers are predicted to increase by more than 50 per cent in just ten years.
Plans are being drawn up for the centre, which will treat patients from Dumfries and Galloway and Fife as well as the Lothians, before funding bids are submitted to the Scottish Government. If successful, construction could begin as early as 2017, when the department of clinical neurosciences moves from the Western to its new home next to Edinburgh Royal Infirmary.
Experts will meet to decide what treatments will be increasingly needed – such as more radiotherapy and surgery – and design a model for the centre. They will study recently opened centres in Newcastle and Leeds and the services on offer at these purpose-built sites.
Professor Alex McMahon, director of strategic planning for NHS Lothian, who is chairing the taskforce, said cancer strategy was a vital part of the health board’s long-term vision. He added that while services were currently coping, it was essential that new measures, such as the centre and more community-based care, were put in place.
“We are doing well in terms of meeting current demand and cancer targets, but we know that in the future there will be real pressure on the cancer system,” Prof McMahon, pictured left, said. “Our population is ageing and that means there’s a higher incidence of cancer, and we also know there are different types of cancer we are seeing more of, so we need to think of how we deal with those scenarios. Part of that is what things need to happen in a hospital, but a big part is also what could we do in the community.”
Health chiefs considered building the new hub elsewhere, but want to replace the current building to keep it close to existing screening services – the Maggie’s Centre and the Edinburgh Cancer Research Centre. Moving existing radiotherapy equipment could also prove costly because of strict regulations about their proximity to other buildings.
The centre would also include preventative measures and outreach work to encourage healthier lifestyles – with poor diet, lack of exercise and alcohol intake increasingly blamed for many cancers.
Prof McMahon said: “The big message is health promotion, with kids and adults, that physical exercise and diet are proven to stave off incidences of cancer.
“There needs to be the right balance of investment in prevention as well as treatment and that is the big challenge.”
The news has been welcomed by cancer charities, politicians and union chiefs, but all urged caution over how the centre is funded. Unison’s Davie Forbes said: “The people in Lothian deserve the best and if there’s a requirement for more than one centre in Scotland, we want it to be in Edinburgh. We fully back that. One of the benefits of the Western is there are no requirements to go through the mad rigmarole we have had to do for the Royal for the new Sick Kids because it is publicly owned and it is important it stays like that.”
Projected figures for 2022 show all cancers, barring cervical, will go up compared with a decade earlier – with prostate cancer set to increase by 51.4 per cent, skin by 36.6 per cent and non-Hodgkins by 28.5 per cent. Breast cancer will rise by 19.4 per cent. The most common cancers in the region are prostate, lung, colorectal and breast cancers and it is hoped the new centre would expand screening programmes for these.
Alison Johnstone, Green MSP for Lothian, said investment in cancer treatment facilities was essential but expressed worries about how the new centre will be staffed.
She said: “I am concerned at reports many senior clinicians are due to retire in the next few years. We need assurances that as the need for cancer services increases that need will be met.
“I’d meantime welcome details of how the NHS plans to recruit extra staff, whether it feels the Scottish Government is doing enough to support it, and how it will train more people to work in crucial areas such as radiotherapy.”
Scottish Tory health spokesman Jackson Carlaw said: “It’s good news that NHS Lothian is planning this much-needed upgrade. “What’s essential is it receives the necessary support from the Scottish Government to make it a reality. Patients in the Lothians have been left disappointed in recent years when it comes to grand announcements that haven’t yet come to fruition, not least with the new Sick Kids and brain unit.”
Labour Lothian MSP Sarah Boyack said: “With the predicted big increase in the Lothians population and the fact that people are living longer, we need increased capacity in our cancer services. “The question is where the funding will come from given that NHS Lothian announced it will have to make savings of £400m.”
A Scottish Government spokesperson said: “Investment in health is a top priority for the Scottish Government and we have committed to spending over £2 billion on improving NHS infrastructure over four years.
“We look forward to seeing more detail of NHS Lothian’s plans to improve the Edinburgh Cancer Centre and any business plan will be fully considered through our normal assessment process.”
Centres of excellence to inspire Edinburgh
THE Beatson West of Scotland Cancer Centre in Glasgow, which was officially opened in February 2008, is the main base for non-surgical cancer care for people in Lanarkshire, Greater Glasgow and Clyde, Forth Valley and Ayrshire and Arran.
It treats more than 8000 new patients every year and provides all the radiotherapy, and much of the chemotherapy, for patients with cancer in the west of Scotland.
The Leeds Cancer Centre is a £220 million development, specialising in radiotherapy, treating patients from Yorkshire and beyond. Tailor-made computerised treatment plans are produced for every patient.
The Northern Centre for Cancer Care opened at the Freeman Hospital in Newcastle in 2009, costing £100m, and is the largest centre of its kind in northern England, carrying out 100,000 treatments a year. It has the full range of the latest equipment.
By James Jopling, Director for Scotland, Breakthrough Breast Cancer
A round 4500 women are diagnosed with breast cancer every year in Scotland, an increase of 70 per cent since 1986. So while we have made big advances in reducing the rate at which women die from breast cancer, we have not yet successfully dealt with the challenges of an increased level of incidence.
Due to factors such as women living longer, there is a greater potential for cancers to develop. We also know that about 40 per cent of breast cancers can be explained by lifestyle issues such as levels of alcohol intake, physical activity, the importance around weight gain – in particular around the menopause. Earlier diagnoses are important.
We are picking up more breast cancers and we are treating them because cancer is more widely talked about – people are more aware of signs and symptoms and getting treated.
Since 1996 we have had a breast cancer screening programme and because of this more cancers are picked up in women between 50 and 70, and we know our lifestyles are contributing to an increased rate of diagnoses. Our lives generally are leading us to develop some cancers more than in the past, but there is no one thing causing the increase.
We need to better understand how women can take action themselves to stack the odds in their favour, and also how we can tailor more treatments to individuals, which is one of the biggest challenges within all cancer treatments. I think a lot of people like to imagine there might be a single cure to cancer, but we now know that there won’t be single cures, even for individual cancer types – breast cancer itself has as many as 20 variants.
It is great that we understand that, but what we need to understand is how better to treat each variation of the disease and that requires a lot more effort and investment.
It feels as if we are at a really important point here as we understand a lot more about cancer than we ever have so, while not knowing exactly what is proposed with the new hub, any efforts to increase our levels of understanding, and the speed at which we can develop new treatments, would be really welcome.
One of the most important areas for growth for us in terms of Breakthrough Breast Cancer is around prevention, understanding better how to stop women who may be at higher risk of developing breast cancer.
We think we might get better at understanding women who might be at risk. You may be familiar with the story of Angelina Jolie, inset – knowing she carries a faulty gene which means she is at a much higher risk of developing breast cancer than other women, the actor chose to have a preventive double mastectomy.
There will be other things we can find in the future which will indicate whether a woman is likely to be at a degree of higher risk, and it may be that for those women there are better ways we can monitor them throughout their life to spot cancer at the earliest time and ensure they have the most successful treatment.
Edinburgh has a strong tradition of excellence in cancer research and medical understanding and bringing together specialists and the best minds under one roof, to share their insights, can only be valuable.