Opinion: The strange hierarchy of serious illness

Peter Cardy, chief executive of Macmillan Cancer Relief

The day Kylie Minogue announced she had breast cancer, I was visiting an old, run-down breast cancer unit that is shortly to be replaced through Macmillan funding. Warm, positive staff did much to compensate for the environment, but the shocked faces of women and their partners after hearing their diagnoses told their own story, bitter in any surroundings. Breast cancer is one of the success stories - much still to do, but the survival rate five years after treatment is rising steadily. The impact of this latest celebrity diagnosis on the breast cancer charities is a story yet to be told, but it has been huge.

A few days later I chaired a meeting of the main research funding bodies about how to accelerate research on lung cancer. Most people don't know that breast cancer is rarely a disease of 30-somethings - it usually hits from the late 60s. Cancer of the lung is the same. But there the similarity ends. There is stigma - "smokers bring it on themselves" - and widespread pessimism, few promising drugs or new treatments, and most people die only a few months after diagnosis. It can usually only be diagnosed when it is very advanced, so it doesn't often affect active celebrities. Roy Castle was an exception, and the foundation named after him remains the only lung cancer charity.

This is uncomfortable because it means that the charities reflect the profile of the diseases, not their impact or importance to society - and this reflects the social inequity that the diseases also embody. This isn't the fault of anybody in the charities, but it's not how charity is supposed to be - is it?

I applied to chair the Brain and Spine Foundation, a unique charity that serves all neurological diseases and punches far beyond its modest weight.

Ten years ago I predicted an epidemic of neurological disease as the population aged. Now it's here and little has been done to plan or cope with it.

Most Third Sector readers will have relatives over 70 with conditions such as a stroke, Parkinson's or Alzheimer's disease. Many more people are affected by these neglected diseases than by cancer, but the charity demographic tells the story once more: about 50 charities in the Neurological Alliance; more than 800 charities for cancer; 10 times as much research funding; 10 times as many specialist nurses; NHS cancer plans with money attached instead of good intentions. How do we challenge these inequities?

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