We can all be heartened by the picture portrayed in Macmillan Cancer’s ‘Cancer: Then and Now’ report published yesterday.

The report is a fascinating look at how the life chances of people with cancer have changed over the last 25 years.  People on average are now twice as likely to survive at least 10 years after being diagnosed with cancer than they were at the start of the 1970s.

The reason? Earlier diagnosis – by way of screening programmes and advances in diagnostic tools – and improved treatments.  All of which is a testament to the efforts of researchers, clinicians, patients and carers in developing ever better treatments over the years.

However the societal challenge we now face as a consequence are significant.  As the charity says: ‘those who survive many years after a cancer diagnosis do not necessarily have a good quality of life.  Macmillan estimates that there could be around 42,500 ³ people living with cancer who were diagnosed  in the 1970s and 1980s who may still be dealing with problems linked to their cancer, such as long-term side effects.’

Jane Maher, the Join Chief Medical Officer at Macmillan is quoted in the report as saying: ‘some of the effects doctors consider ‘small’, such as fatigue and poor bowel control, can have a profound impact on someone’s quality of life. Sadly, there is no cancer treatment available at the moment that does not carry a risk of side effects.’

Once again it raises the issue of whether we have got the balance right between the amount we spend on research into new treatments and interventions and the amount we spend on quality of life issues.

Also the degree to which funders and researchers are promoting work that really reflects patient priorities.  See this that went round twitter last week which looks at the different perspectives between patients and clinicians on trial outcomes that matter for patients.

Whether we can expect research funders to make this shift and re-focus their work in remains to be seen. But given historical precedent and the presiding culture across the health research system we can be forgiven for having low expectations that they will.  If so, our concern must be that while ever better treatments represent good news in many respects, we are also storing up other problems for patients which it would be unethical to address at the same time.

Perhaps we should charge a levy on research into new medicines. Or have a hypothecated tax on medicines sales with the funds raised dedicated to research into the social consequences of treatment and how best to support people.