The new stage four cancer treatments and what they mean for patients
'Stage four means the cancer has spread to another part of the body further away from where it started,' explains Dr Ben O'Leary, a clinical oncologist at the Royal Marsden and a researcher at The Institute of Cancer Research (ICR). 'Most stage-four cancers still can't be cured, but our deeper understanding of how cancers evolve and grow means many people are living longer. In some cases, we now see responses, and yes, even cures, that weren't thought possible 10 years ago.'
What's driving this optimism? Five types of cancer offer a snapshot of progress.
Skip to:
Prostate cancer
Blood cancers
Breast cancer
Bladder cancer
Lung cancer
Prostate cancer
By the age of 80, half of men harbour cancer in their prostate, though it proves fatal in only a small minority. Even so, around 12,000 men die of metastatic prostate cancer each year in the UK.
Dr Anna Wilkins of the ICR and Royal Marsden says metastatic prostate cancer most often spreads to the bones. 'On scans, you can see up to 50 spots all over the skeleton. But there has been big progress in new drugs.'
Total testosterone blockade
Standard treatment reduces testosterone, the hormone that fuels tumour growth. Abiraterone, developed at the ICR, goes further by blocking its precursor hormones, extending survival significantly.
Liquid radiotherapy
This exciting development involves injecting patients with a radioactive liquid. Cancer cells 'drink' more of the liquid than healthy cells and the resulting burst of radiation destroys bone metastases. Liquid radiotherapy drug Radium-223 is already available on the NHS, while the even more potent Lutetium-177 PSMA is available privately and awaiting National Institute of Health and Care Excellence (Nice) appraisal.
Multimodal first strikes
'We now combine hormone drugs – and sometimes chemotherapy – immediately after diagnosis,' says Dr Wilkins. Even resistant cancers respond to this approach. Treating the original tumour with radiotherapy, even in metastatic cases, also boosts survival: 'It's as if you're silencing a mothership that coordinates the metastases,' she says.
While there is no cure yet, Dr Wilkins says, these approaches are turning stage-four prostate cancer into a condition many men will live with, not die from.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
The Independent
24 minutes ago
- The Independent
Junior doctors' strike to go ahead after government talks fail
Resident doctors' strikes are set to proceed for five days from Friday at 7am after last-ditch talks between the British Medical Association (BMA) and Health Secretary Wes Streeting failed. The BMA confirmed the industrial action, stating that Mr Streeting's offers "did not go far enough to warrant calling off strikes," with the dispute primarily centred on pay restoration. Health Secretary Wes Streeting criticised the BMA's decision as "reckless" and "unjustified," asserting that the government cannot offer further pay increases following a 28.9 per cent rise over the last three years. The BMA resident doctors committee co-chairs highlighted that while non-pay issues were discussed, the core issue remains pay, which they say has eroded by over a fifth since 2008. NHS leaders expressed concern over the "crushing blow" to patients and the NHS, urging resident doctors to minimise harm by notifying trusts of their strike plans.
Daily Mail
24 minutes ago
- Daily Mail
Wes Streeting accuses British Medical Association of showing 'complete disdain for patients' as union abandons peace talks and vows to plough on with five day doctors strike
Resident doctors have vowed to plough on with their five-day strike after abandoning peace talks with Wes Streeting. The health secretary last night accused the British Medical Association of showing 'complete disdain for patients' and described their walkout as 'unjustified '. Health leaders were also quick to round on the union, warning their 'crushing' and 'misjudged' action would cause widespread disruption and harm. Rory Deighton, acute director at the NHS Confederation, which represents health organisations, said: 'The BMA will clearly bear the responsibility for the distress being caused to patients. 'While we recognise the concerns that resident doctors have, we believe the strikes are a misjudged course of action given the large pay rise that resident doctors have already received.' Up to 50,000 resident doctors - formerly known as junior doctors - are set to strike from 7am on Friday in pursuit of a 29 per cent pay rise. They have already received above inflation pay rises for the past three years, worth an extra 28.9 per cent in total, following previous strikes. This includes an inflation-busting rise this year of 5.4 per cent, which is the most generous in the public sector. The BMA and Department of Health and Social Care held talks over the weekend with the aim of negotiating a settlement and averting industrial action. Mr Streeting had refused to budge on pay but offered a number of other financial concessions relating to the cost of exams, equipment and training. The BMA's delegates took the offer to the union's resident doctors committee but members voted to reject it this afternoon and immediately announced they would proceed with the walkout. It said Mr Streeting's offer 'did not go far enough to warrant calling off strikes' and lacked any 'substantive proposal on both pay and non-pay elements'. Dr Melissa Ryan and Dr Ross Nieuwoudt, co-chairs of the BMA's RDC, said: 'Disappointingly, what we saw would not have been significant enough to change the day-to-day financial situation for our members. 'The non-pay aspects of last year's pay deal have still not been delivered, which has shaken the confidence of our members that any further non-pay elements would be honoured.' Mr Streeting said: 'After a 28.9 per cent pay hike in the last three years and the highest pay rise in the public sector two years in a row, strike action is completely unjustified, completely unprecedented in the history of British trade unionism and shows a complete disdain for patients and the wider recovery of the NHS.' Rachel Power, chief executive of the Patients Association, said: 'This latest strike adds even more uncertainty for people who are waiting in pain, with anxiety, and without answers, and will leave more patients vulnerable and unsupported as their health and wellbeing deteriorates. 'It demonstrates a worrying disregard for the very real toll this further disruption will have on people's health and their confidence in the healthcare system.' The announcement came after health bosses warned striking doctors will cause patients 'undoubted harm' and a new poll revealed the majority of the public now oppose walkouts. The latest YouGov poll reveals more than half (52 per cent) of people in the UK either 'somewhat oppose' (20 per cent) or 'strongly oppose' (32 per cent) the idea of resident doctors going on strike over pay. Meanwhile, only a third (34 per cent) of the 4,954 adults surveyed either 'somewhat support' (23 per cent) or 'strongly support' (11 per cent) doctor strikes. YouGov said the proportion supporting the strike over pay has dropped five points since it last asked the question in May. Then, 48 per cent opposed resident doctors striking, while 39 per cent supported them taking action. Daniel Elkeles, chief executive of NHS Providers, said of the BMA's announcement: 'This decision is a crushing blow for patients and for the NHS. 'We urge resident doctors to help trusts minimise the harm by notifying them of their plans for strike days. 'For example we must ensure that there are enough staff for all the cancer, transplant and maternity care that cannot and must not be delayed. 'Another huge worry is the cost. 'It is vital that consultants providing cover take NHS rates of pay rather than insisting on inflated BMA rates that are simply unaffordable. 'We say to the BMA 'think again' and pull back from this hugely damaging decision.' The BMA is demanding NHS hospitals pay consultants £6,000 to provide on-call cover for striking junior colleagues this weekend. This would be even higher if they have to given advice over the phone or attend hospital in person. NHS England said it is 'vital' people do not put off seeking care during the strikes and managers are working hard to maintain 'as much routine care as possible'. Patients should continue to attend appointments as planned unless they are told otherwise by their local trust, it added. The BMA says the pay of resident doctors has been cut in real terms since 2008 and it wants to achieve full pay restoration.
The Independent
34 minutes ago
- The Independent
Majority of UK people now oppose NHS doctor strike, poll suggests
Public support is falling for the upcoming doctors' strike, research suggests. It comes as the row between the British Medical Association (BMA) and health leaders over the strike is deepening. NHS Providers, which represents hospital trusts, hit back at BMA claims that health leaders were putting patients at risk, saying it was actually the 'costly' BMA strike that was risking patient care. Health Secretary Wes Streeting told the House of Commons he 'sincerely hopes the BMA will postpone' the 'unnecessary and irresponsible' strikes to continue talks with the Government, which he said had been 'constructive' in recent days. He said, however, the Government stands 'ready' and 'responsive' if the five-day strike by resident doctors, which is scheduled to start at 7am on Friday, does go ahead. Earlier, the BMA said NHS England plans for managing the strike could put patients at risk owing to the fact it has ordered hospitals to continue with as much pre-planned care as possible. Previous strikes by health workers have seen hundreds of thousands of operations and appointments cancelled, but NHS England is taking a different approach this time to managing the strike. In a letter to hospital trust leaders, it urges the health system to focus on maintaining emergency care, maintaining the flow of patients and 'maintaining elective care to the fullest extent possible' as well as 'priority treatments' such as cancer care. 'It will be important for systems and trusts to try and maintain normal levels of booked activity…' it said, adding: 'Reducing volumes of bookings and rescheduling of appointments and other activity should only happen in exceptional circumstances to safeguard patient safety.' On Tuesday morning, BMA deputy chairwoman Dr Emma Runswick told BBC Radio 4's Today programme this plan risked patient safety. She said: 'We've had proven systems over the last decade that have made sure that where we have to take strike action, senior doctors cover urgency and critical care. 'This time round, NHS England are pushing for the continuation of non-urgent and scheduled care in a way that we think at best is confusing and will create on-the-day cancellations – and at worst could be risky and lead to harm in emergency departments and on wards, because senior doctors cannot physically be in two places at once. 'We think that a notional guidance from NHS England which is saying that basically all scheduled work should continue to go ahead has potential to be seriously risky for patients… 'Senior doctors are needed to be freed up in order to provide urgency and critical care. 'We think the vast majority of planned and unscheduled care should be shifted.' NHS Providers hit back at the BMA's claims, saying it was the strike itself that posed a risk to patients. Its chief executive, Daniel Elkeles, said: 'The NHS, not the BMA, is putting patients' interests first. 'Given that some patients will be caused undoubted harm if the short-notice strike goes ahead, NHS trusts are doing the responsible thing by not cancelling people's care while talks to avert the strike are ongoing. 'Now is a time for cool heads in the BMA because it's not too late to avoid a damaging, costly strike. NHS trust leaders hope for a breakthrough from talks between Government and the union. 'If the strike goes ahead then NHS trusts will do everything they can to avoid any harm to patients and are planning for as many patients as possible to be cared for.' It comes as a new YouGov poll showed about half (52%) of people in the UK either 'somewhat oppose' (20%) or 'strongly oppose' (32%) the idea of resident doctors going on strike over pay. Meanwhile, a third (34%) of the 4,954 adults surveyed either 'somewhat support' (23%) or 'strongly support' (11%) doctor strikes. YouGov said the proportion supporting the strike over pay has dropped five points since it last asked the question in May. Then, 48% opposed resident doctors striking, while 39% supported them taking action. Speaking in the Commons on Tuesday, Mr Streeting said that before he came into office, 'strikes were crippling the NHS'. He added: 'Costs ran to £1.7 billion in just one year, and patients saw 1.5 million appointments rescheduled. 'Strikes this week are not inevitable, and I sincerely hope the BMA will postpone this action to continue the constructive talks my team and I have had with them in recent days. 'Regardless, our priority is to keep patients safe, and we will do everything we can to mitigate the impacts of strikes on patients and the disruption that will follow should these totally unnecessary and avoidable strikes go ahead.' Quizzed by MPs, he said the 'approach we're taking is different from that taken in previous periods of strike action'. He added: 'NHS leaders have been clear to me that previous rounds of strike action caused much wider levels of harm than previously realised, and there is no reason why planned care in issues like cancer, for example, cancer appointments, as well as other conditions should be treated as somehow less important or second fiddle to other NHS services. 'That is why the chief executive of NHS England has written to NHS leaders asking them to keep routine operations going to the fullest extent possible, as well as continuing priority treatments. 'It will be for local leaders to determine what's possible given staffing levels. 'That's why it's really important that resident doctors do engage with their employers about their determination or not to turn up at work this week, and why again, I just spell out the serious consequences for patients that means that these avoidable and unnecessary strikes should not go ahead.' Elsewhere, the BMA has also issued strike guidance for consultants regarding the extra pay they can seek for covering work that is not in their contracts. The BMA 'rate card' says consultants can ask for £188 per hour on weekdays from 7am-7pm and £250 an hour from 7pm to 11pm. At weekends, the pay claim can rise to £250 per hour from 7am to 11am and £313 per hour for overnight work from 11pm to 7am. Resident doctors, formerly known as junior doctors, were awarded an average 5.4% pay increase this financial year, following a 22% rise over the previous two years. However, the BMA says real-terms pay has still fallen by around 20% since 2008, and is pushing for full 'pay restoration'. Resident doctors are qualified doctors in clinical training. They have completed a medical degree and can have up to nine years of working experience as a hospital doctor, depending on their specialty, or up to five years of working and gaining experience to become a GP.
