Inverness mum speaks out as Cancer Research UK launches a landmark new report highlighting the “unacceptable” health inequalities facing cancer patients in Scotland
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An Inverness mum has spoken out after Cancer Research UK found that around 4,900 extra cancer cases a year are linked to deprivation in Scotland, which equates to around 13 avoidable cases a day.
It comes as research shows that cancer death rates are 74 per cent higher in the most deprived communities than the least deprived in Scotland.
The report – unveiled at the Scottish Cancer Conference today (Monday November 28) by the charity’s CEO Michelle Mitchell – reveals those living in the poorest areas of the country are more at risk of developing cancer and are more likely to be diagnosed at a later stage when cancer can be harder to treat successfully.
Inverness mum Melanie Finlay knows living with cancer costs a lot.
Everything from travelling to hospital appointments, to paying the energy bills needed to keep the rented property she shares with her husband Tom and son Joseph (8) warm this winter hits their household budget.
And that’s before they take in to account the physical and emotional impact that a diagnosis of secondary breast cancer has on all the family.
Melanie receives a disability benefit - Personal Independence Payment - but with Tom on reduced hours and working from home as his wife’s full-time carer, finances are tight.
Now as the Scottish Government develops a new cancer strategy to improve cancer outcomes over the next decade, Melanie believes it is vital that ministers start by listening to cancer patients to learn what could be done better.
Melanie (48) said: “Cancer affects all of us, it doesn’t discriminate.
“It is unfair if people living in one area or community in Scotland have less chance of surviving cancer because of who they are, where they live or barriers they face while trying to get treatment. Beating cancer should be beating cancer for all.
“I am living with cancer and living with the knowledge that this could be my last Christmas. I’m working on creating a memory box for my son to help capture all the special moments we share.
“I know early diagnosis of cancer gives people the best chance of a good outcome. If my experience can help others coming through the system then I’ll tell my story.”
Melanie was an admin officer for Police Scotland when first diagnosed with breast cancer in May 2018. After surgery, chemotherapy and radiotherapy, she hoped to put the disease behind her. But when she started to get joint pains, it was thought to be side effects from treatment.
In December 2020, after the hip and knee pain got worse, Melanie tried to get a GP appointment. It was the height of the Covid-19 pandemic and she faced a two month wait before finally being seen.
Melanie said: “When I called my GP surgery, the receptionists were triaging the calls.
“I explained that I couldn’t put any pressure on my knee and asked if I could come and see the doctor. I was told there was, 'no space today' and asked to call back tomorrow at 8.30am. The next day when I phoned at 8.30am, I got the same answer, ‘no, there was no space.’
“In January, I got a referral by phone to a physiotherapist. I explained that my knee was swollen and I couldn’t put any weight on it. She advised me to put an ice pack on my knee every 20 minutes. She said she was going on annual leave and would contact me in a fortnight. Finally I saw my GP in late February 2021 after sending photos of my swollen knee to the physiotherapist.”
In March 2021, Melanie was diagnosed with secondary breast cancer that had spread to her bones and was stage four.
She is currently receiving a chemotherapy treatment known as Kadcyla at Raigmore Hospital in Inverness. But at an earlier stage in her treatment Melanie also faced several 200-mile round trips from Inverness to Aberdeen Royal Infirmary for appointments.
Melanie said: “It was a long journey travelling to Aberdeen to be seen by a doctor and we had to arrange for someone to pick Joseph up after school while we were away.
“I’ve also met people who live in the countryside and have faced long, difficult journeys to access treatment.
“There was anger and sadness when I learnt the cancer was back. My first thought was for my son, that my son needs his Mum. But my son also has a wonderful dad. We got married in April this year. It was a very small wedding but the best day with a proper ceilidh. I know we’re fortunate to have support from great family and friends.
“We’ve still got a roof over our head and food on the table although we do have to be very careful with money.
“It’s not like that for everyone going through cancer. Some people are living alone, unable to work, struggling with cancer and unable to pay their bills.
“It’s hard enough being a cancer patient, it’s tough going through the physical and mental ordeal of treatment and scans every few months. But add in to this a crisis in the NHS, a cost-of-living crisis and the everyday financial worries many people with cancer have and it’s a perfect storm.
“It’s a lot to tackle but there are simple things the Scottish Government could do which could help.
"More NHS staff could help so people face a shorter wait for diagnosis and treatment. I also think it would help if terminally ill people could have early access to their state pension. It’s something they’ll have paid towards all their working life through National Insurance contributions.”
Smoking – the biggest cause of cancer in Scotland, with nearly one in five cases caused by smoking – continues to be far more common in deprived communities.*** People living in more deprived areas are more likely to be overweight or obese, which is the second biggest risk factor for cancer after smoking. Nearly 7 per cent of cancer cases each year in Scotland are caused by excess weight.
Early diagnosis also remains a significant problem. The report found people from deprived backgrounds are less likely to know the signs and symptoms of cancer and face greater barriers to contacting their GP if they have noticed any changes.
Calling for urgent action by the Scottish Government to improve cancer survival for all, chief executive of Cancer Research UK, Michelle Mitchell, said: “It is unacceptable that people in Scotland are 74 per cent more likely to die from cancer if they live in an area of higher deprivation.
“This landmark report offers the first comprehensive picture of deprivation and cancer in Scotland, setting out in detail the stark inequalities in health and cancer across the country.
“Right now, people from more deprived populations are more likely to develop cancer, are less likely to take up their invite for cancer screening and face greater barriers to seeking help for potential cancer symptoms.
“The Scottish Government’s forthcoming cancer strategy is a key opportunity to tackle cancer inequalities.
“People in Scotland need the strategy to be bold, ambitious and fully funded so no one with cancer is disadvantaged because of where they live or due to financial pressures. Now is the time to go further and faster to ensure that beating cancer means beating cancer for everyone.”
CRUK researchers found that screening uptake is far lower in more deprived communities. Bowel cancer screening is 38% lower and breast cancer screening is 32% lower in the most deprived populations compared to the least deprived.
A similar trend is seen for cervical screening, with 17% fewer people from more deprived populations attending screening.
And access to cancer treatment can vary greatly depending on where people live in Scotland. For example, receiving treatment can be more challenging for people living in rural areas. Some patients have reportedly chosen or been prescribed treatments that are less optimal to avoid having to travel.
In the report, Cancer Research UK lays out three key actions to tackle cancer inequalities:
Rolling out interventions that tackle known drivers of inequalities. This includes a focus on providing more support to tackle smoking and obesity which are cancer risk factors that disproportionately affect more deprived populations.
Diagnosing cancers earlier and ensuring everyone has access to the right treatments for them. Starting with removing barriers to seeking help and enabling people to get timely access to health services, including screening.
Strengthening data collection, infrastructure and access to build a stronger understanding of where inequalities exist in Scotland by routinely collecting data on patient characteristics across the entire pathway.
Director of the Poverty Alliance, Peter Kelly said: “There is perhaps no greater illustration of the injustices of poverty than these stark figures released by Cancer Research UK.
“We all expect and deserve to have access to the best health care and treatment. But for too many people living on low incomes in Scotland this is just not the case. Cancer death rates that are 74% higher in the poorest communities should be a wake-up call for us all.
“It is simply not right that such staggering inequalities exist. We strongly support efforts to improve early diagnosis, and urge the Scottish Government to put addressing these inequalities at the heart of the new cancer strategy. Ultimately, this is a reminder that we need to redouble our efforts to address the root causes of poverty in our society.”
A Scottish Government spokesperson said: “We know that the earlier cancer is diagnosed the easier it is to treat and even cure which is why we continue to invest in our Detect Cancer Early (DCE) Programme, initially launched in 2012.
“We recognise that the impact from the COVID-19 pandemic may have exacerbated inequalities within screening. A key Ministerial priority is reducing inequalities in access to and uptake of screening programmes. That is why we committed up to £2.45 million to the Screening Inequalities Fund over the next two years to build a programme of evidence-based, sustainable and scalable projects that tackle inequalities in a systemic way.
“Last month we announced that the next two Rapid Cancer Diagnostic Services (RCDS) will be established in NHS Lanarkshire and NHS Borders to add to RCDSs in NHS Ayrshire and Arran, NHS Dumfries and Galloway and NHS Fife.
“Addressing obesity remains a public health priority to ensure Scotland is a place where we eat well, have a healthy weight and are physically active. Our Diet and Healthy Weight Delivery Plan sets out ambitious and wide ranging action to address this challenge, including our aim to halve childhood obesity by 2030.
“Our goal is a tobacco-free generation of Scots by 2034 and a number of new strategies are currently being considered as part of our refreshed Tobacco Action Plan including improved support for people who want to quit.”
