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CANCER OF UNKNOWN PRIMARY FOUNDATION

OnHealthy

Long Term Plan for Cancer

January 8, 2019

The NHS Long Term Plan has now been launched which sets out the way forward for cancer services. Cancer and the NHS Long Term Plan

In the consultation period, and in meetings with the team preparing the plan, we have pushed for genomic testing for CUP patients and it is pleasing to see in the attached ‘The offer of genomic testing to all people with cancer for whom there would be clinical benefit’. We need to wait and see how this is interpreted and actioned. We are pleased to see also the ‘Roll out [of] new Rapid Diagnostic Centres across the country so patients displaying symptoms of cancer can be assessed and diagnosed in as little as a day.’ This was piloted in 2018 and we saw this an excellent way of helping CUP patients who often present with vague symptoms to get a rapid referral.

Of particular note is: ‘The offer of genomic testing to all people with cancer for whom there would be clinical benefit, beginning with children and young people, will also increasingly enable more precise diagnosis, and better-targeted and safer treatments’. On the surface this would seem to encourage the use of molecular profiling as part of the diagnostic work-up in certain circumstances – which we were pressing for in the plan. Time will tell whether this is ‘theory in practice’ or empty rhetoric. How will this be interpreted by practitioners in relation to the NICE Guideline which only supports molecular profiling for use in trials (because there was insufficient evidence of its value when the guideline was being prepared in 2008-2010)? Will cost and human resource implications deter its use?



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