Cancer expert attacks 'cowboy' doctors

A LUNG cancer expert yesterday accused non-specialist colleagues of being 'cowboys' for giving cancer patients powerful drugs with harsh side effects that they do not fully understand.

In a strong attack on the lack of specialist treatment for cancer, particularly lung cancer, Professor John Smyth, of Edinburgh University, said doctors were seduced by the drugs industry into giving new, expensive drugs - with the effect that precious resources may not go to patients who need them most.

'I am sick and tired of the arrogance of the medical profession in its reluctance to refer patients to the people who know better than they do. It is very frustrating that so much more could be achieved by relatively simple clinical research.'

He has joined a growing group of British cancer specialists prepared to break the silence over the difference in standards in cancer treatment around the country.

Professor Smyth, head of the Department of Clinical Oncology at the Western General Hospital in Edinburgh, said only 40 per cent of cancer patients were 'seen by people who take it seriously. There are too many clinicians with biased, ill- informed opinions of what constitutes optimal care'.

As a result, he said patients might not be offered the most useful treatment, might be given the wrong treatment or 'even worse be given state of the art treatment without any information or back-up'.

He said: 'Cowboys up and down the country are giving cytotoxic (cell killing) drugs and patients are having the most extraordinary experiences, which are costing money. We must find ways of stopping inappropriate treatment.'

Professor Smyth told a conference at St Thomas's Hospital, London, with the theme of patient's choice, organised by Marie Curie Cancer Care and the cancer information charity, Bacup, that too many doctors believed nothing could be done for lung cancer patients. It was difficult to make progress if patients were not referred to the centres where they would get the best help.

In his own department cancer patients survived for twice as long when optimal treatment was introduced. In the 1970s survival was about three months for small cell lung cancer but by the 1980s 10-15 per cent were living for two years and 'almost everyone' for a year. 'I think survival for even a year is a very valuable thing for the patients and for their families,' he said.

Even though it was known what caused lung cancer and what could be done to prevent it, he said the profession was making 'a complete cock-up of the whole thing'. Unless patients were referred to the specialist centres, research into the best treatments methods was impeded. Even oncologists needed to review their practices and consider entering lung cancer patients into trials instead of giving them standard treatment.

With lung cancer killing 40,000 people a year and accounting for 24 per cent of all cancer deaths 'even a small change in survival will affect a very large number of people'.