Recent studies have started to involve community pharmacy in cancer prevention, treatment and support. Deborah Evans explores how this can be done.
There are around 363,000 new cancer cases in the UK every year (2014-2016)1 with breast, prostate, lung and bowel cancers together accounting for over half (53%) of all new cancer cases in the UK. With 1.6 million people visiting a pharmacy every day in England2 , pharmacists and their teams play a significant role in cancer – from prevention through to end of life care. One in every two people in this country will be told they have cancer at some point in their lives and whilst survival rates are improving, more lives can be saved with earlier diagnosis and referral.
The NHS Long Term Plan (LTP)3 aims to save thousands more lives each year by dramatically improving how we diagnose and treat cancer – the ambition is that by 2028, an extra 55,000 people each year will survive for five years or more following their cancer diagnosis. To do this, the LTP outlines a number of actions from screening improvements, creating new Rapid Diagnostic Centres, having a new fast diagnosis standard, personalising care and improving access to effective tests and treatments. To achieve this ambition, everyone will need to play their part.
Community pharmacy and cancer
Community pharmacy can support improved cancer outcomes through:
- By raising awareness of lifestyle choices that can increase the risk of cancer including running health promotion campaigns on healthy eating, obesity, alcohol, smoking and sun exposure and raising awareness of signs and symptoms of cancer. Smoking cessation, weight management services and alcohol advice and intervention offered in pharmacies can help to lower risk.
- Early referral. By raising the importance of national screening programmes such as for cervical and bowel cancers and signposting for further investigation in the case of red flag symptoms e.g. blood when coughing, in urine or faeces, unexpected weight loss, dysphagia (difficulty in swallowing), lumps and changing moles. For example, community pharmacists in Wales will soon be able to refer patients for a chest X-ray as part of a study to help increase the number of people identified with early lung cancer.4
- Following cancer diagnosis. Pharmacists continue to help individuals with any lifestyle changes required to support their recovery and help manage any side effects or issues with their treatment. For example, a recent study5 explored the impact community pharmacists can have when providing health and wellbeing services to men with prostate cancer to improve their cardiovascular health. Working as part of a multidisciplinary team, pharmacists can also support improved outcomes for patients, particularly in medicines optimisation.
- Helping people at the end of their life and during palliative care. This is an important role for pharmacists, particularly in urgent supply of medicines and advising on pain relief titration. Many areas have a locally commissioned or enhanced palliative care service commissioned by NHS England or the local clinical commissioning group to support access to a wide range of specialist medicines for end of life.6
To accelerate improvements in cancer survival, the NHS must look to include community pharmacies in their plans, leveraging our contact with people by formally including us in cancer pathway development.
Deborah Evans FRPharmS FFRPS FRSPH is Managing Director of Pharmacy Complete, a training and consultancy company working with pharmacy and the industry. Go to www.pharmacycomplete.org
1 Cancer Research UK https://www.cancerresearchuk.org/health-professional/cancer-statistics-for-the-uk#heading-Zero
2 https://psnc.org.uk/psncs-work/about-community- pharmacy/
3 https://www.longtermplan.nhs.uk/areas-of-work/ cancer/
5 https://www.surrey.ac.uk/news/community-pharmacies-make-lifestyle-impact-patients-prostate- cancer
6 https://psnc.org.uk/services-commissioning/services- database/