How new NHS tumor analysis labs fail to keep up with demand


How new NHS tumor analysis labs fail to keep up with demand

Cancer patients are missing out on life-saving drugs as ‘overburdened’ NHS tumor testing labs take months to deliver crucial results, The Mail on Sunday has found.

Pioneering new cancer therapies can target tumor DNA to slow or even eradicate the spread of the disease — but before patients can receive treatment, a sample of their tumor must be tested to discover which one is most likely to work.

In a bid to ensure patients have access to these innovative medicines, NHS England will open seven ‘genetic hubs’ in 2021, where samples will be sent for research.

These tests determine treatment for thousands of people every month. But the MoS has found that the labs can’t keep up with demand — meaning that by the time some patients get their results, their disease has progressed too far and become incurable.

John Gosney, Professor of Thoracic Pathology at the Royal Liverpool University Hospital, says: ‘Every oncologist has horror stories where patients progressed in the time it took to get the result and their disease is now irreversible.

The mother of three, Rebecca Condie, 40, from Hampshire, was diagnosed with advanced stage BRAF bowel cancer in 2022. After chemo failed, it took Rebecca’s hospital four weeks to offer her a DNA test that could find out what cancer drug she was on. was eligible, and then another six weeks before the genetic hub returned the results

In a bid to ensure patients have access to these innovative medicines, NHS England will open seven 'genetic hubs' in 2021, where samples will be sent for research.

In a bid to ensure patients have access to these innovative medicines, NHS England will open seven ‘genetic hubs’ in 2021, sending samples for research

Did delays affect Rebecca’s chances?

Colon cancer patient Rebecca Condie had to wait ten excruciating weeks before she found out if she could take a life-prolonging drug.

The mother of three, 40, from Hampshire, was diagnosed with advanced stage three BRAF colon cancer in 2022. After chemo failed and she progressed to incurable stage four, she was told she urgently needed another treatment.

However, it took Rebecca’s hospital four weeks to offer her a DNA test that could find out which cancer drug she was eligible for, and then another six weeks for the genetic hub to return the results.

Rebecca’s sister Anna, 50, says she believes the delays have caused her sister’s cancer to progress further, reducing the effectiveness of the new drugs. “The delays in the DNA test definitely hurt her chances,” says Anna. “Her cancer is incurable, but patients like her who get the right drugs in time can live another three or even four years without showing any signs of the disease. But these drugs need to be given as soon as possible, and that didn’t happen with Rebecca.’

Rebecca is due for a scan in two weeks to see if the latest treatment has slowed the spread of the disease.

‘Patients with advanced cancer don’t have the luxury of time. The speed with which these tests are returned must improve.’

A cancer consultant at a leading London hospital says he no longer sends tumor samples to the genetic centers because they are so unreliable. “Instead, I send samples from all my patients to a laboratory in the US, because I know I get the results back faster,” says the oncologist, who wishes to remain anonymous.

“The genetic hubs were a positive, ambitious project, but the system is now overloaded and using them has become slow and painful.”

Most patients are told to expect their test results within 10 days, says Prof. Gosney. But a report published by the Office Of Health Economics found that patients waited an average of three weeks. The think tank also reported that many tissue samples were unfit for testing by the time they arrived at the hubs, adding to the delays.

Campaign group Breaking BRAF – a patient group for patients with BRAF colon cancer, the aggressive genetic type that killed Dame Deborah James – says many of its members waited as long as two months to find out if they were eligible for the targeted treatments .

“We regularly hear from patients who have waited anywhere from a month to two months for their genetic test results,” says spokeswoman Helen Canning. “Patients with BRAF colorectal cancer often have a life expectancy of less than a year, so even a delay of just three or four weeks in treatment can have a devastating effect.”

Genetic testing has revolutionized cancer treatment. Previously, the majority of patients received chemotherapy, radiotherapy or surgery. But scientists can now look for clues in the DNA of tumors — tiny mutations in the cells that provide crucial information about what causes the disease in each patient. These mutations can then be linked to a new generation of precision drugs that target specific genetic idiosyncrasies.

Experts say the new technology has provided a lifeline for countless cancer patients.

Prof Gosney adds: ‘We are curing more patients than ever. It has been a complete revolution, but it depends entirely on a system that can test quickly and accurately for genetic mutations.’

The hubs are officially called Genomic Laboratory Hubs. Two are in London, the others in Birmingham, Cambridge, Manchester, Bristol and Newcastle.

Tumor samples for the lab are taken during a biopsy, when the diagnosis is made in the patient. In some forms of the disease, such as lung cancer, it is immediately sent for analysis. But in other cases, such as bowel cancer, NHS guidelines state that patients cannot undergo genetic testing until they reach stage four – when the disease has spread.

Professor Gosney, who was involved in setting up the hubs, says the main problem is that the service is understaffed. “The centers were set up in the middle of the pandemic and none of them were ready, but the NHS insisted that the launch go ahead,” he says. “Two years later they still haven’t hired enough staff.”

A senior doctor claimed that the laboratories had overestimated how many tests they could feasibly process. “They have exaggerated their skills to win the contracts, but now they can’t keep up with the demand,” the doctor said.

The problem has become so serious that experts say many hospitals are considering setting up their own laboratories.

‘You can’t rely on the hubs to deliver results on time,’ says Prof. Gosney. “Targeted drugs are being discovered all the time and the need for genetic testing is only going to increase, so this needs to be fixed.”

An NHS spokesperson said: ‘Genomic testing has a range of turnaround time requirements, so it’s a complex picture and depends on whether a sample has been classified as urgent by a doctor based on the patient’s needs.’