Heavy smokers are often reluctant to be screened for lung cancer, according to doctors who are pioneering new clinics dedicated to spotting the disease at its early stages in the hope of lifting the stigma.
“Some people feel guilty about their smoking. We’re trying to wash away a lot of the stigma associated with lung cancer and smoking,” said Dr Richard Lee, consultant respiratory physician at the Royal Marsden, an NHS hospital specialising in cancer treatment.
The hospital’s private clinic in central London is now screening patients for early stage lung cancer, years before the National Health Service completes its nationwide rollout of the same programme, known as Targeted Lung Health Checks.
Patients aged between 55 to 74 whose history of smoking puts them at high risk of lung cancer will be offered a low-dose computed tomography scan.
“One of the big challenges has been how do you get people to come to the programme. It's important to raise awareness about what lung cancer is and the opportunity for positive outcomes,” Dr Lee told The National.
But the scan could help doctors to catch the cancer early, saving lives and reducing the need for chemotherapy. “It seemed like an obvious thing for us to do,” Dr Lee said.
“Research has shown that low-dose CT scans of patients that are at high risk of lung cancer reduce the number of people who die from it,” he said.
“It’s quite a limited service at the moment on the NHS, so we wanted to be able to offer another route to access the service,” he added.
Lung cancer is the most common cause of cancer deaths in the UK, because the disease is often caught in the late stages. The survival rate for the disease is currently 10 per cent, and this has not improved in 50 years, according to the charity Cancer Research UK.
The NHS announced a national rollout of its lung cancer screening programme in June, which it expects to complete by March 2030.
More than 200,000 smokers and former smokers aged between 55 and 74 were scanned in the first pilot phase of the NHS programme, which began in 2019. Of these, lung cancer was detected in 2,000 people, with 76 per cent at an earlier stage compared to 29 per cent in 2019 outside of the programme.
Prime Minister Rishi Sunak hopes the programme will “provide a lifeline to thousands of families across the country.” Yet the NHS is plagued by a shortage of diagnostics technology, including CT scanners, a report by the King’s Fund think tank found in June.
Dr Lee was involved in developing the NHS model, and this experience helped him set up the clinic at the Royal Marsden in between 12 and 18 months. “We’re quite agile in what we’re able to offer in the Marsden. We have the capacity, we have the new facility at Cavendish Square, so it seemed like quite a straightforward thing for us to add to the services we offer,” he said.
The service will be extended to people under 55 and over 75 with potential symptoms of the disease, such as a persistent cough, shortness of breath and coughing up blood.
The screening will involve a 30-minute consultation with a specialist to assess whether the patient would benefit from a CT scan. “If you’ve not smoked enough we wouldn’t recommend a CT scan,” said Dr Lee, pointing to the imaging technology’s low radiation exposure.
The risks are assessed on a case-by-case basis which looks at the patient's smoking habits, their family history and existing respiratory problems. The consultations can, “in theory”, be booked for the next day, with a CT scan usually offered on the same day or within a few days. The results of the scan will be offered within two weeks.
Early diagnosis could improve the patient’s treatment options. “It’s much more likely that those patients will get lung surgery to remove the cancer, rather than more complicated chemotherapy regimens,” said Dr Lee.
“Some patients will still need chemotherapy or radiotherapy, but the treatment will be much more straightforward when you diagnose at an early stage,” he added.
More than one in 10 people in the UK (13.3 per cent) smoke but the habit is on the decline, according to 2021 census data from the Office of National Statistics.
Yet Dr Lee believed the effects of smoking would continue to be visible in the next decades. “It would take many years for the damage that’s been done to subside. If you think of the number of people who are smoking now, their risk is going to be high for decades,” he said.
“It's important to make sure there's awareness of what lung cancer is and the opportunity for positive outcomes,” he said.
The new clinic's launch comes as researchers are increasingly linking lung cancer to air pollution.
In April, a study by the Francis Crick Institute, University College London and Cancer Research UK found that air pollution “wakes up” dormant cancer cells which could “grow and form tumours”.
Lung cancer is the seventh most common cause of cancer death among people who have never smoked.
“We don’t fully understand the risks behind that. Pollution and indoor cooking smoke are probably factors,” said Dr Lee. “That will likely become more important as the population ages or as smoking becomes less prominent.”
Yet it is still too early to assess the risks air pollution and devise treatment options, said Dr Lee. “We’re not there yet clinically. But you could hope that in the future we could quantify people at risk from other factors that they’ve been exposed to,” he said.
What is dialysis?
Dialysis is a way of cleaning your blood when your kidneys fail and can no longer do the job.
It gets rid of your body's wastes, extra salt and water, and helps to control your blood pressure. The main cause of kidney failure is diabetes and hypertension.
There are two kinds of dialysis — haemodialysis and peritoneal.
In haemodialysis, blood is pumped out of your body to an artificial kidney machine that filter your blood and returns it to your body by tubes.
In peritoneal dialysis, the inside lining of your own belly acts as a natural filter. Wastes are taken out by means of a cleansing fluid which is washed in and out of your belly in cycles.
It isn’t an option for everyone but if eligible, can be done at home by the patient or caregiver. This, as opposed to home haemodialysis, is covered by insurance in the UAE.
How to protect yourself when air quality drops
Install an air filter in your home.
Close your windows and turn on the AC.
Shower or bath after being outside.
Wear a face mask.
Stay indoors when conditions are particularly poor.
If driving, turn your engine off when stationary.
UAE currency: the story behind the money in your pockets
The%20specs
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WITHIN%20SAND
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Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
COMPANY%20PROFILE
%3Cp%3E%3Cstrong%3EName%3A%3C%2Fstrong%3E%20Floward%0D%3Cbr%3E%3Cstrong%3EBased%3A%20%3C%2Fstrong%3ERiyadh%2C%20Saudi%20Arabia%0D%3Cbr%3E%3Cstrong%3EFounders%3A%20%3C%2Fstrong%3EAbdulaziz%20Al%20Loughani%20and%20Mohamed%20Al%20Arifi%0D%3Cbr%3E%3Cstrong%3ESector%3A%20%3C%2Fstrong%3EE-commerce%0D%3Cbr%3E%3Cstrong%3ETotal%20funding%3A%20%3C%2Fstrong%3EAbout%20%24200%20million%0D%3Cbr%3E%3Cstrong%3EInvestors%3A%20%3C%2Fstrong%3EAljazira%20Capital%2C%20Rainwater%20Partners%2C%20STV%20and%20Impact46%0D%3Cbr%3E%3Cstrong%3ENumber%20of%20employees%3A%20%3C%2Fstrong%3E1%2C200%3C%2Fp%3E%0A
The candidates
Dr Ayham Ammora, scientist and business executive
Ali Azeem, business leader
Tony Booth, professor of education
Lord Browne, former BP chief executive
Dr Mohamed El-Erian, economist
Professor Wyn Evans, astrophysicist
Dr Mark Mann, scientist
Gina MIller, anti-Brexit campaigner
Lord Smith, former Cabinet minister
Sandi Toksvig, broadcaster
'Brazen'
Director: Monika Mitchell
Starring: Alyssa Milano, Sam Page, Colleen Wheeler
Rating: 3/5
Specs
Engine: Dual-motor all-wheel-drive electric
Range: Up to 610km
Power: 905hp
Torque: 985Nm
Price: From Dh439,000
Available: Now
Closing the loophole on sugary drinks
As The National reported last year, non-fizzy sugared drinks were not covered when the original tax was introduced in 2017. Sports drinks sold in supermarkets were found to contain, on average, 20 grams of sugar per 500ml bottle.
The non-fizzy drink AriZona Iced Tea contains 65 grams of sugar – about 16 teaspoons – per 680ml can. The average can costs about Dh6, which would rise to Dh9.
Drinks such as Starbucks Bottled Mocha Frappuccino contain 31g of sugar in 270ml, while Nescafe Mocha in a can contains 15.6g of sugar in a 240ml can.
Flavoured water, long-life fruit juice concentrates, pre-packaged sweetened coffee drinks fall under the ‘sweetened drink’ category
Not taxed:
Freshly squeezed fruit juices, ground coffee beans, tea leaves and pre-prepared flavoured milkshakes do not come under the ‘sweetened drink’ band.
Our legal consultant
Name: Hassan Mohsen Elhais
Position: legal consultant with Al Rowaad Advocates and Legal Consultants.
TUESDAY'S ORDER OF PLAY
Centre Court
Starting at 2pm:
Elina Svitolina (UKR) [3] v Jennifer Brady (USA)
Anastasia Pavlyuchenkova (RUS) v Belinda Bencic (SUI [4]
Not before 7pm:
Sofia Kenin (USA) [5] v Elena Rybakina (KAZ)
Maria Sakkari (GRE) v Aryna Sabalenka (BLR) [7]
Court One
Starting at midday:
Karolina Muchova (CZE) v Katerina Siniakova (CZE)
Kristina Mladenovic (FRA) v Aliaksandra Sasnovich (BLR)
Veronika Kudermetova (RUS) v Dayana Yastermska (UKR)
Petra Martic (CRO) [8] v Su-Wei Hsieh (TPE)
Sorana Cirstea (ROU) v Anett Kontaveit (EST)
THE SPECS
Engine: 3.5-litre V6
Transmission: six-speed manual
Power: 325bhp
Torque: 370Nm
Speed: 0-100km/h 3.9 seconds
Price: Dh230,000
On sale: now
Our legal columnist
Name: Yousef Al Bahar
Advocate at Al Bahar & Associate Advocates and Legal Consultants, established in 1994
Education: Mr Al Bahar was born in 1979 and graduated in 2008 from the Judicial Institute. He took after his father, who was one of the first Emirati lawyers
The biog
Name: Timothy Husband
Nationality: New Zealand
Education: Degree in zoology at The University of Sydney
Favourite book: Lemurs of Madagascar by Russell A Mittermeier
Favourite music: Billy Joel
Weekends and holidays: Talking about animals or visiting his farm in Australia
Who's who in Yemen conflict
Houthis: Iran-backed rebels who occupy Sanaa and run unrecognised government
Yemeni government: Exiled government in Aden led by eight-member Presidential Leadership Council
Southern Transitional Council: Faction in Yemeni government that seeks autonomy for the south
Habrish 'rebels': Tribal-backed forces feuding with STC over control of oil in government territory
Top 10 most polluted cities
- Bhiwadi, India
- Ghaziabad, India
- Hotan, China
- Delhi, India
- Jaunpur, India
- Faisalabad, Pakistan
- Noida, India
- Bahawalpur, Pakistan
- Peshawar, Pakistan
- Bagpat, India
Monster
Directed by: Anthony Mandler
Starring: Kelvin Harrison Jr., John David Washington
3/5
The specs
Engine: 3.9-litre twin-turbo V8
Power: 620hp from 5,750-7,500rpm
Torque: 760Nm from 3,000-5,750rpm
Transmission: Eight-speed dual-clutch auto
On sale: Now
Price: From Dh1.05 million ($286,000)
