The Royal Marsden

Rapid response: initiatives for early detection

Earlier and faster cancer diagnosis is often key to successful treatment. We highlight a raft of initiatives that ensure no-one gets left behind

When a patient's cancer is diagnosed at an early stage, there is a much greater chance of being able to treat the disease successfully, often with less invasive procedures and fewer long-term side effects. But too many people are being diagnosed with cancer at later stages.

At The Royal Marsden, we are committed to improving the early detection of cancer across the whole pathway: raising public awareness, encouraging people to see their doctor, and supporting GPs and other services so that all patients have timely access to tests, specialist advice and treatment.

In addition to offering patients the latest treatment and care, we are playing an important national role in the Cancer Vanguard, which has been tasked with delivering the National Cancer Strategy. One of the strategy’s priorities is the drive for earlier, faster diagnosis.

Alongside our national role, we have formed an alliance of local RM Partners that includes 10 acute NHS trusts, two sustainability and transformation partnerships and 14 clinical commissioning groups, plus specialised commissioning groups, community services, hospices, and third-sector and voluntary organisations across London.

With RM Partners, we are testing and introducing new ways of detecting cancer early. For example, we have set up three RM Partners multidisciplinary diagnostic clinics (MDCs).

Similar to The Royal Marsden’s Rapid Diagnostic and Assessment Centre, which provides the best diagnostic tests for suspected cancer patients, MDCs will assess patients with vague symptoms such as bloating, tiredness and weight loss, which could be associated with some of the more difficult-to-diagnose cancers.

Professor Stan Kaye, Director of Research, RM Partners, said: “The direction of travel for the next five to 10 years is to identify people with an increased risk of developing certain cancers, or relapsing after treatment for primary cancer, and do non-invasive screening. In particular, there is potential to improve early detection of lung and colorectal cancers.

“We’re due to pilot a lung cancer screening programme, which will invite smokers and ex-smokers over a certain age to attend a health check and possibly a CT scan so that any cancers are picked up as early as possible. With Imperial College London, we’re also working to develop a blood test that can detect increased risk of lung cancer.

“With TRACC, a study sponsored by The Royal Marsden, we’re investigating whether the persistence or reappearance of tumour DNA in the bloodstream following surgery can predict colorectal cancer relapse earlier and more accurately than standard methods of CT scanning, and early enough for a cure to still be possible.

"This may translate into early diagnosis for the general population, where a simple blood test or liquid biopsy can detect cancers up to eight months before they become symptomatic.”

Timely testing

Breath tests

With Imperial College Healthcare NHS Trust, we are exploring how breath tests could be used to diagnose certain cancers, such as those that affect the stomach and oesophagus. This method focuses on chemical changes in the breath, caused by bacteria in the gut and linked to the presence of cancer in the body. If our research has positive results, we could diagnose some cancer types early through this quick and non-invasive method.

Genetic testing

A trial offering a BRCA gene test – a blood test that uses DNA analysis – to men with a family history of prostate or breast cancer is under way. This could lead to thousands of men being diagnosed earlier, giving them the option to have preventative surgery.

Genetic sequencing

As part of the 100,000 Genomes Project, we are comparing DNA in healthy cells with mutated DNA in cancer cells to identify the precise changes that are important in the development of cancer. This will help inform which precision treatments are likely to be effective and identify those with an increased risk of developing certain cancers according to their genetic make-up.

GP Education Series

Over 600 GPs have attended events at The Royal Marsden, and thousands more have accessed our online learning resources as part of our GP Education Series. This helps GPs to spot the signs of cancer.