A small thing on Cancer Awareness but I think it might be important

All these fulminations on Cancer Awareness are leading me with ever increasing certainly to the conclusion that it is a concept not fit for purpose, the 'purpose', in my view, being the old fashioned ambition to reduce risk, relieve suffering and extend, or better still, save lives. 

Here's a list

1. Pancreas
2. Lung
3. Oesophagus
4. Brain
5. Stomach

And here's what it's a list of.

It's the bottom five cancers - worst first - by chances of survival to five years after diagnosis.

Usually the public counting of cancers is based on how many people get it. 'Breast cancer is the most commonly diagnised cancer in women', 'prostate cancer is the most commonly diagnosed cancer in men' etc. But if a cancer diagnosis is really bad news, and it is, surely cancers with the shortest times between diagnosis and death, are the worst news? 

Now tell me what you know about those 1-5 cancers above or the last time you saw any coverage of them?

These cancers conform to stereotype - the nightmare cancer story of old, when no-one spoke about cancer, the outlook was grim for men and women who got them, except....except..... they're still here. The old cancer story remains very much the same for some cancers.

Only 2% of men and women diagnosed with pancreatic cancer are alive 5 years later, 7% of people with lung cancer, 18% of women, 15% of men, after a stomach cancer diagnosis.

Appalling.

But it reflects research spend and that, to some extent, is driven by public interest. Or lack of it. Notice none of them are gender specific, all of the cancers listed afflict giblets and can't be made 'attractive'. None have screening tests (though that does increase survival in strange ways, unrelated to the effectiveness of treatment. Look up 'lead time bias' if you want to know how....) and if there was research spend to find effective treatments these survival rates could be as good as the 80% alive at five years that women with breast cancer can achieve.

Or 98% of men with testicular cancer.

A quick look at our National Cancer Research Institute website for the most recent research spend and I can see that three times as much (£54m v £18m) money was spent researching the top five cancers with the longest 5 year survival rates as was spent on the bottom five cancers with the shortest survival. Hmmm. I can see 'spend' has improved things in the past and this would explain some of the difference now but I'm still inclined to wonder if the statistics to also indicate fundamental inequality. And 4 out of the 5 on my list above have the lowest relative site specific research spend across the NCRI partners.  Hmmm again.

So that's the next conumdrum. How should research spend be driven? By numbers of people who could be affected? In which case don't get a rare cancer, even though 52% of people diagnosed with cancer in the UK each year do exactly that ....

Or maybe look at the potential for research to increase survival up to, for a first target, the current median survival possible across all cancers. Discuss.