Which types of cancer are most common for older men and what are the survival rates?

King Charles has started cancer treatment, around a week after being diagnosed while in hospital for a procedure on an enlarged prostate.

Many of those relying on the NHS for cancer care can be waiting far longer for tests and treatment.

The Palace has said that the King does not have prostate cancer, the most common kind of cancer among men of his age.

Fatality rates for cancers among older men vary significantly. While 95% of men over 75 diagnosed with pancreatic cancer die within five years of their diagnosis, just 36% of those diagnosed with prostate cancer do so.

King Charles has begun treatment for cancer around a week since being diagnosed while in hospital for procedure on an enlarged prostate. But many of those relying on the NHS for cancer care can be waiting far longer for tests and treatment.

Almost three in every 10 people (29%) referred by their GP are forced to wait more than four weeks to receive their diagnosis. More than a third (35%) only start treatment more than two months after first being referred.

That puts the NHS well behind in meeting its target, which is for 85% of people to begin treatment within two months of their referral.

Part of the problem is increased demand. The number of people referred for cancer treatment in England has tripled since 2010. The latest data, from November of last year, shows a record 270,000 people were referred for treatment, compared to just 74,000 in November 2010.

“Patients are presenting with symptoms and are often worried about cancer and so the referral rate goes higher because you do have to meet patient expectations,” says Mr Rajesh Nair, a consultant urological surgeon.

“There are a lot of cancers which have had a lot of publicity and therefore a lot of patients are more attuned to cancer symptoms,” he added.

The NHS is also dealing with the impact of an ageing population, a result of declining birth rates.

Mr Nair says: “As people get older, we’re going to see an increase in the number of age-related cancers and cancer diagnostics.”

The time taken for cancer patients to receive their diagnosis and begin treatment is also affected by pressures in the NHS as a whole.

“You hear a lot about cancer screening, but cancer screening only picks up a maximum 4-6% of cancers that we diagnose in the UK,” says Professor Richard Sullivan, director of the Institute of Cancer Policy and co-director of the Centre for Conflict & Health Research at King’s College London.

Much of the remainder, he says, enter the NHS through routes shared with non-cancer patients, such as elective care – where more than 7.6 million people are currently waiting for treatment.

The impact of the overall pressures is also visible in waiting times for diagnostic tests, where cancer and non-cancer patients will frequently wait in line together.

As of November, for instance, patients seeking a colonoscopy (which is often used to detect colorectal cancer) were forced to wait an average of 24 days, compared to just 14 days in 2019.

Those waits can be a matter of life or death.

“There are two places where delays are cumulatively lethal,” says Professor Sullivan.

“Once your symptoms start, you need to present as soon as possible and then be diagnosed as soon as possible, and once you’re diagnosed with cancer, you need to be treated.”

Data from NHS England shows that patients diagnosed with colon or rectal cancer have a 90% chance of living for at least five years if the cancer is caught at stage one, its earliest stage. If the cancer is caught at stage four, they have a 90% chance of dying within that time frame.

“This is why these delays due to waiting times are so important,” Professor Sullivan added.

As of 2020-21, 28% of colorectal cancer diagnoses were made at stage four. That’s up from just 21% a decade earlier.

People from more deprived backgrounds are particularly at risk from poor early detection.

Data from NHS England shows that adults living in England’s 20% most affluent neighbourhoods are significantly more likely to survive cancer than those from the country’s 20% most deprived areas.

Among people diagnosed with bowel cancer, for instance, 58% of those from more well-off areas can expect to live at least four more years – compared to just 48% of those from more deprived areas.

Mr Nair said: “Access to healthcare is the first thing. In areas which are socially deprived, the number of general practitioners and number of secondary care facilities per unit population may be slightly different to other parts of the country.

“People’s perception about healthcare can be quite variable, particularly in migrant groups and groups where going to the doctor may be frowned upon.

“Education and social deprivation go hand in hand and so if you’re ill-educated about red flag symptoms that would make you worry about potential cancer diagnoses, such as symptoms like blood in the urine or blood in the stool, they wouldn’t think that symptom would necessarily merit an appointment with a physician.”

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