James Whale’s wife reflects on his battle with cancer
A postcode lottery for cancer care is feared to be putting up to 100,000 lives at risk as patients turn down crucial tests or treatment after being asked to travel too far. Macmillan Cancer Support is sounding the alarm that sufferers are missing out on the best treatment because of where they live — potentially impacting their survival chances.
The charity’s lead medical adviser, Dr Anthony Cunliffe, said: “The reality is that for too many people with cancer it has begun to feel like a game of chance — a ‘flip of a coin’ and a need to be ‘in the right place, at the right time’ — when it comes to getting the treatment and care they need.” Macmillan’s survey of 2,000 adults with cancer found 3% had turned down a test or treatment because of the travel time and 4% had considered doing so.
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Some 3.4 million people are living with cancer in the UK, meaning in the worst case scenario an estimated 100,000 may have missed out on care due to travel concerns across the country.
Almost one in three people had been asked to travel for more than an hour to have a test or scan, and 29% for treatment.
Top concerns about travelling included the cost of transport or accommodation, additional worry, stress or anxiety, loss of income while taking time off work, and caring responsibilities.
Meanwhile, one in 20 people had chosen to travel to a hospital more than an hour away because it had a shorter waiting time, and 8% had done so for better treatment options.
The survey also highlighted inequalities in access to both well-established and cutting-edge treatments. Some 4% of those surveyed said they had found out from family or friends about other tests or treatments that were only offered in another part of the UK. And 3% had repeatedly requested a test or treatment that was not available locally.
One in six (16%) of those polled said they had experienced additional worry, stress and anxiety as a result of local variation in treatment, and one in eight (12%) had experienced exhaustion or worsened fatigue.
In total, Macmillan estimated that up to 1.4 million people with cancer — or four in ten — have been affected by this postcode lottery and a lack of care close to home.
Dr Cunliffe added: “As a GP, the fact that where you live can have such a huge impact on your cancer experience really does worry me.
“We need to see urgent action taken to make cancer care fair. Everyone with cancer should get the best possible care the UK has to offer. Everyone should get the treatment that is right for them. No-one should get left behind simply because of where they live.
“At Macmillan, we are trying to bring UK decision-makers, people with cancer and local communities together to make sure that well-established cancer treatments and tests are made equally available to everyone.”
The charity also estimated that if cancer waiting times everywhere matched the standards in the best-performing areas of the country, around 60,000 people would get more timely treatment every year.
NHS figures show that 76.8% of people with an urgent referral for suspected cancer received a diagnosis or had it ruled out within 28 days in June 2025, against a target of 75%. Performance on that metric has improved over the last two years.
However, only 91.7% of patients started treatment within 31 days of a decision to treat, against a target of 96%. And just 67.1% of those with an urgent referral for suspected breast cancer or after screening started treatment within 62 days, against a target of 85%.
The call for easier access to care close to home was echoed by other cancer organisations. Cancer Research UK chief executive Michelle Mitchell said: “It’s unacceptable that so many people are struggling to access cancer treatment or care because of where they live.
“That’s why we’re urging the UK Government to take bold action in its upcoming National Cancer Plan for England.
“NHS services must be backed by long-term investment and meaningful reform, so that every person seeking help receives the best care they deserve regardless of where they are in the country.
“Detecting and treating cancer earlier will help people live longer, better lives, free from the fear of cancer.”
Dame Laura Lee, chief executive of cancer support charity Maggie’s, said: “A cancer diagnosis is already devastating for people without also having to face barriers in accessing the best possible treatments simply because of where they live.
“The upcoming national cancer plan is a golden opportunity for the government to transform cancer care and at Maggie’s, we want to ensure that people are receiving enough practical and emotional support to deal with the additional challenges that often come with cancer and to navigate the complex pathways of cancer treatment.”
The Express has campaigned for greater funding for new radiotherapy machines and more centres to reduce the distance patients are forced to travel.
Professor Pat Price, chair of Radiotherapy UK and co-founder of the Catch Up With Cancer campaign, said: “There is a truly deadly cancer postcode lottery in this country when it comes to accessing cancer treatment.
“This is especially true for radiotherapy, where too many patients are either missing out or having to travel long distances across cancer care deserts.
“We know that around half of cancer patients will need radiotherapy treatments, yet in the UK only about 35% actually receive it. The Daily Express campaign for investment in radiotherapy is right to push for a change to this dangerous situation.
“Cancer patients must be able to get the treatment they need, when they need it. I’m very grateful to the Express and its readers for standing up and pushing for better access to radiotherapy.”
Charity Young Lives vs Cancer has campaigned for a dedicated travel fund for children and young people with cancer who need to travel for specialist treatment.
Chief executive Rachel Kirby-Rider said: “When a child or young person is diagnosed with cancer they often have to travel hundreds of miles to get to their nearest specialist cancer centre.
“At a time when they should be focused on getting the treatment they need, they are struggling with the cost of getting there.
“Our research found families are travelling an average 80 miles to and from hospital but in some areas this is over 100 miles and this costs on average £250 per month. Some families are having to make unimaginable decisions such as whether to put food on the table or fuel in the car.
“One in ten young people and families say they missed or delayed their treatment because they couldn’t afford to get there. That isn’t right. This is why we are calling for a Young Cancer Patient Travel Fund to ensure children and young people get to the treatment they need, without struggling with the cost of getting there.”
The NHS National Cancer Patient Experience Survey of 64,000 people last year showed that the average rating given for overall care was 8.9 out of 10.
An NHS spokesperson said: “The NHS is seeing and treating more people with cancer than ever before, survival rates have never been higher, and we have delivered the first increase in early diagnosis of the disease in over a decade.
“But we know patients’ experience can vary, and we are working closely with government on the National Cancer Plan to ensure everyone gets the highest possible standard of care, no matter where they live.”
A Department of Health and Social Care spokesperson said: “This government is working to stamp out this country’s stark health inequalities – quality of care should never be determined by where you live.
“We are also prioritising cancer care as we turn around more than a decade of neglect of our NHS, and we’re already seeing progress, with 95,000 more people having cancer diagnosed or ruled out within 28 days between July 2024 and May 2025, compared to the same period the previous year.
“The National Cancer Plan will set out how we will help put the NHS back at the forefront of global cancer care.”
Alex and Simon have witnessed the differences in cancer care (Image: Macmillan Cancer Support )
‘We should all have the best care, regardless of where we live’
Alex, 62, from Perthshire was diagnosed with bowel cancer in 2023 and had to travel around 50 miles for treatment.
She said: “Living in rural Perthshire did mean that we had some distance to travel, but we were lucky — we had the transport and the means to do things ourselves.
“For others, you could be looking at buses that only run four times a day and have huge waits in between transfers just to get you where you want to go.
“I really couldn’t imagine having to go through treatment and its side-effects while having to navigate all that.”
Alex’s father and her husband Simon’s sister both died of cancer, along with four of the couple’s godparents.
During her treatment, Alex met others who had been affected by differences in cancer care — from waiting times to ease of diagnosis.
She said: “We’ve even had friends who have been told by consultants to avoid hospitals in certain areas as local care just wasn’t up to scratch.
“With my own sister-in-law, who was desperately ill, there were times when she would end up in the hospital at 11pm at night and not be seen till 5am in the morning, in pain and discomfort the entire time.
“Unfortunately, it does seem to come down to where you live, a bit of luck and often how bullish and confident you are to push for the care you need.”
Alex added: “It can’t be right that there are just so many differences in the type and quality of care people get. We should all have access to the best possible care, regardless of where you live and without having to push for it.”
Daisy travelled for up to six hours a day to have treatment (Image: Macmillan Cancer Support)
‘I was lucky mum helped me push for the best possible care’
Daisy, 17, was diagnosed with Hodgkin’s lymphoma in February and soon found herself travelling for up to six hours a day to access specialist care.
She said: “It was like a bomb dropped when I got my diagnosis – I was really active, studying for A-levels, really enjoying my life, and then suddenly everything just stopped.
“My treatment couldn’t be in North Wales due to my age, so I was referred to the specialist Teenage and Young Adults centre in Liverpool.
“Whilst the support I got in Liverpool was fantastic, things would have been so different if I didn’t have my Mum, who eventually had to stop work for a while to do everything and support me through my treatment.”
The pair sometimes had to make the journey from Anglesey to Liverpool as many as three times a week.
Daisy often felt sick in the car and worried that if she became unwell at home — perhaps with infections or reactions to the treatment — the only option would be a long wait at her local A&E.
Daisy, who rang the bell to signal the end of her treatment in August 2025, said: “While we knew my treatment was going to be a tough challenge, I also wanted to go to the best place I could.
“I would say to anyone with cancer that they should not be afraid to push for the best possible care. I was lucky because my Mum works in healthcare and could help me ask the right questions, but not everyone will have that.
“People shouldn’t be afraid to challenge to get the care they think is right for them, and everyone should be able to get the care they need.”
Cancer shouldn’t feel like a game of chance, says DR ANTHONY CUNLIFFE
As a GP, the fact that where you live can have such a huge impact on your experience of cancer care really does worry me.
But for too many people, the harsh reality is that cancer care is beginning to feel like a game of chance – a ‘flip of a coin’ or the need to be ‘in the right place, at the right time’ when it comes to getting the treatment and care they so desperately need.
While one person may be treated on time, another may face months of anxious delays. While one person can easily access the care they need, another may have to turn down vital cancer tests and treatment simply because they live too far away.
This is affecting people’s experience of cancer care and, in some cases, the outcomes that can be achieved for them. This is unacceptable, but it is fixable.
Only recently we teamed up with AstraZeneca to look at biomarker testing — a type of cancer testing that can make cancer treatment much more precise.
We found widespread variation across the UK in how quickly people got their results. That single inconsistency could spell the difference between one person getting highly effective cancer treatment, and another starting a form of treatment that may never even work for them.
We will now be continuing that work to help deliver solutions to help improve the situation across the UK.
At Macmillan, our aim is to bring UK decision-makers, people with cancer and local communities together to make sure that well-established cancer treatments and tests are made equally available to everyone.
We need to see urgent action to make cancer care fair. No-one should get left behind simply because of where they live. Everyone deserves the best the UK has to offer, and we are on a mission to make this a reality.
– Dr Anthony Cunliffe is Macmillan’s Lead Medical Adviser