I have now been back in the Practice at SMP for two weeks. It has been a great pleasure to have so many people “welcoming me back”. I have missed you all too!

My experience in Indianapolis has been very interesting and challenging. This has been a one-off sabbatical for me, and I have been extremely privileged to have this time for education and reflection. I find that “top end” American Cancer care is second to none, but at the other end of the scale, it is limited by serious cost constraints.

I have had the privilege of meeting and working with a range of academic cancer doctors and this has been an inspiration. I am now assimilating the lessons that I have learnt and working out how to put these into practice at SMP.

It is quite clear that the best chances of surviving cancer are firstly to prevent it, and secondly to catch it early. These are the areas that we can concentrate on, in primary care medicine. There is another group of patients who are called “cancer survivors”, and I happy to say that there are an increasing number of these patients within the practice. They themselves present certain long-term problems which I shall be addressing.

The main thrust of academic cancer research in Indianapolis has been to concentrate on the genome, which is now measurable in six hours at the cost of $1000. This is likely to get quicker and cheaper, so that future research may even become less costly.

I was delighted to see that our Prime Minister has announced a similar research programme in the UK.

Like all basic research, it is unlikely to yield practical changes in cancer treatment, for many years to come. However this approach offers the chance of much more individualised cancer treatment, which is generally considered to be the way forward.

I am delighted to be back and able to share Christmas with my family, now including six grandchildren. I look forward to 2013, and to being much more available to my loyal patients.

With best wishes and a very happy Christmas to you all.

Robert Hancock