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NHS patients have cancer scans cancelled after supplier problems

The Guardian logo The Guardian 07/04/2019 Haroon Siddique
a person standing in front of a television: A surgeon performs a robot-assisted prostate tumorectomy. © AFP/Getty Images A surgeon performs a robot-assisted prostate tumorectomy.

Concerns have been raised that problems related to the supply of a substance used to screen for cancerous cells is causing delays for NHS patients in England, with many exposed to repeated cancellation of scans at short notice.

Choline is a radiotracer injected into patients an hour before PET-CT scans, predominately when patients are feared to have a recurrence of prostate cancer. Without it the scans cannot go ahead.

The worries surrounding its availability come as waiting times for cancer patients in England are at a record high, with almost one in four patients not starting treatment within the two-month target period.

Karen Stalbow, the head of policy, knowledge and impact at Prostate Cancer UK, said: “Some men are facing lengthy delays in confirming their prognosis, as scans are repeatedly cancelled at short notice due to the shortage.

“This causes major stress and anxiety for these men, leaving some with little choice but to pay around £1,500 for a scan which uses PSMA tracers as an alternative to choline. These scans are currently only available privately, with some men even travelling abroad to get access.

“NHS providers must take immediate action to ensure that PET-CT scans are available to all men with suspected prostate cancer recurrence, starting first with restoring the supply of choline and then progressing the commissioning of a more effective tracer.”

NHS England told the Guardian that problems with the supply of choline had been resolved.

But Richard Taylor, from west London, who is going through a cancer diagnosis for the third time in two years, initially had a scan at University College London Hospital (UCLH) scheduled for the end of April, more than three weeks after his appointment with his oncologist – which should precede it – because of unavailability of choline.

Related: Prostate cancer: radiotherapy could extend thousands of lives, study finds

Taylor said: “Someone in the NHS should be ashamed of the unnecessary stress they’re causing patients through a lack of reasonable forward planning to ensure essential tracers are reliable, easily available, and – if a batch fails – an alternative is quickly available.

“When you hear there are likely to be lengthy delays in getting a scan, you feel like not coming out from under the duvet in the morning, as your worst fears may be realised in the near future by the cancer spreading in the time it takes the NHS to put measures in place that your treatment may reasonably progress.”

UCLH had offered him a PMSA scan as an alternative, privately for £2,200, but after the Guardian contacted the hospital it offered him the same scan the next day on the NHS.

A UCLH spokeswoman said: “It is well-known that choline is a fragile tracer and its production can be relatively unreliable, leading to unpredictable short-term cancellations. We have been working constructively with NHS England to address the choline production issues and they recently agreed to fund PSMA scans for a limited period.”

Prostate cancer is the most common cancer in men. About one in eight men will be diagnosed with the disease at some point in their lives, according to Prostate Cancer UK.

Dr Wai Lup Wong, the chair of the NHS England cancer diagnostics clinical reference group, said: “There is not a shortage of choline … however, some patient scans were delayed last year when a supplier experienced difficulties whilst refurbishing one of its production sites.

“It is important that all patients with suspected cancer have scans as promptly as possible and any delays, for whatever reason, are kept to an absolute minimum during what is a difficult time in patients’ lives.”

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