Nigel Hawkes
2 for 1 at Pizza Express

Children with cancer are less likely to survive in Britain than in other European countries, two specialists have claimed.
The reason could be slower detection of the cancers or less aggressive treatment once they are diagnosed, according to Alan Craft, of the Institute of Child Health at Newcastle University, and Kathy Pritchard-Jones, of the Institute of Cancer Research in Sutton, southwest London.
Writing in The Lancet Oncology, Professor Craft and Professor Pritchard-Jones say that, despite a National Service Framework for Children that sets standards for care, there are no targets and children “continue to be a low priority for the NHS”.
They highlight trials carried out on Wilms’s tumour – a childhood condition – in Germany, which showed that, between 1994 and 2001, 27.4 per cent of patients had a cancer that was first identified during a visit to a health professional for an unrelated problem, or by routine surveillance.
By comparison, in Britain, only 11 per cent of patients treated at the Royal Marsden Hospital, London, and 4 per cent of those referred to Newcastle General Hospital or the Royal Victoria Infirmary, Newcastle upon Tyne, were identified in this way.
This suggests that GPs, and possibly some specialists, are slow to detect the cancers, thereby delaying treatment. In Germany, early diagnosis by routine or incidental examination is linked to increased survival, they say.
Routine health surveillance systems and opportunities for diagnosis for children may also be worse in Britain. In Germany most children have a primary-care paediatrician who provides regular check-ups, whereas in Britain the guidelines are not as thorough, the authors say.
They conclude: “Sub-optimum survival for childhood cancer is just one example of the worse state of children’s healthcare in the UK compared with many other countries.
“The perinatal mortality rate puts the UK in fifteenth position in Europe and there is clear evidence that children with diabetes are [also] not receiving optimum care.”
However, Professor Alex Markham, a former chief executive of Cancer Research UK and now its senior medical adviser, said that overall survival rates from childhood cancer in Britain had reached 77 per cent, and for some types of the disease survival was more than 90 per cent. “The data discussed in this comment in Lancet Oncology were collected between 1977 and 1997. Some of these apparent survival differences might be down to variations in the way data are collected in different countries,” he said.
Roisin Trehy, senior nurse with Cancerbackup, said: “Any evidence to suggest that children are not a health priority is hugely concerning. However, this research does not seem to take account of the fact that, until the end of the trial period in 1997, the UK did not have a multidisciplinary team approach to cancer care.”

Like many 4 year-old boys, Toby Barrett is full of energy and enjoys playing in the park and is due to start school in September. His parents admit it is something they thought would never happen. In 2003, they were told that Toby had infantile neuroblastoma, an advanced form of cancer.
Toby’s condition was only identified when his mother, Claire, asked a chance question during a routine hospital check-up.
“What looked like a tiny lump on his back turned out to be an internal spinal tumour the size of a fist,” she said yesterday. “We could have easily missed it, I don’t like to think about what may have happened if we had not,” said Mrs Barrett, from Daventry, Northamptonshire. Toby has taken recovery in his stride, with the help of a mini-Zimmer frame.
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