Alan Maynard's article ('Looking Askance', 19 November), on the cost-effectiveness of cancer services, was disappointing in its narrowness of approach.
His attack on cancer trials is not only unfounded and contrary to the facts, but will be deeply distressing to all those dedicated people involved in the difficult, but vital, business of testing a new treatment in a clinical trial. By considering only the economic aspects, Alan Maynard neglects many other valid considerations.
The Cancer Research Campaign has been seeking and finding cures for cancer for 75 years. Tens of thousands of cancer patients have participated in our clinical trials, and we strongly refute the accusation of poor design.
We recognise and fully endorse the importance of quality of life, and have been targeting research funds to address it since 1973. Some of our trials measure quality of life but in many trials this would be quite inappropriate.
In the early stages of clinical evaluation of a new treatment, volunteer patients are obliged to undergo intensive hospital monitoring, which may well diminish, rather than enhance, their quality of life.
Yet we know from talking to many such patients - and there is no shortage of informed volunteers - that they derive a satisfaction in doing something for the patients of the future, and that the hope of some benefit from the unknown treatment, however remote, helps them cope with their disease.
We also know from randomised clinical trials that their chances of survival are enhanced by participation in the trial, irrespective of any benefit from the trial treatment. These are all factors which are difficult to quantify in economic terms, and which Alan Maynard fails to take into account.
What are the facts? Thanks to the quality of basic cancer research in the UK, a strong national network, supervised by the Cancer Research Campaign, for early clinical trials of new cancer treatments, and a uniquely favourable regulatory environment, this country has an enviable reputation for cancer clinical trials.
Britain has been hailed as the European leader in anti-cancer drug development by the president of the European Organisation for Research and Treatment of Cancer. Without the results gained from British clinical trials, many of the cancer medicines in use today would not be available. When one takes into account that the organisation of much of this activity is funded by charities, working in partnership with the NHS which provides much of the infrastructure, we can all be justifiably proud of this country's record.
Health secretary Frank Dobson is more in touch with popular opinion than Alan Maynard. When he said recently that a new discovery that could lead to an improvement in cervical cancer testing 'would be introduced into the NHS, whatever its cost', he was displaying an understanding of a valid democratic wish (and a confidence that this charity, which owns the invention, would not price it out of the market), not an ignorance of health economics.
This country has a reputation for failing to develop its inventions and deprecating its successes. While the field of anti-cancer drug development proves the exception to the former rule, Alan Maynard sadly epitomises the latter.
Dr David Secher
Director of drug development
Cancer Research Campaign
London NW1
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