Cancer patients have been warned there is “worse to come” after they faced huge delays during the coronavirus pandemic.

Macmillan Cancer Support says there is a “perfect storm” brewing following the pandemic, which caused a backlog of cancer diagnosis.

It says that is now coupled with a shortage of specialised cancer nurses in England and fears that the impact of the winter months and flu season could put further pressure on the NHS.

It has been estimated that the NHS is already short of 2,500 specialist cancer nurses, but around 1,000 of the nurses now working are close to retirement age.

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Macmillan Cancer Support says it fears fewer people will come forward with symptoms (Anthony Devlin/PA)

Macmillan says more people who could do the job need to come forward to clear the backlog of cancer diagnosis and delayed treatment created by the pandemic as “more people enter the system for cancer care”.

Since the start of the pandemic, the number of people starting cancer treatment in England is over 33,000 lower than expected.

The charity says the backlog means “the existing specialist cancer nursing workforce will be spread even more thinly than first thought, for many months to come, as the backlog is slowly cleared”.

It says the NHS would need to work at 110% for 13 months to clear the huge backlog, which means more people could miss out on specialised care.

A spokesman for Macmilllan said: “Further new analysis also reinforces fears that many of those with a missing diagnosis will be diagnosed at a later stage, which means they are at risk of having greater needs and requiring more intensive treatment and support.

“Macmillan is also concerned that the combination of ongoing Covid hospitalisations and the impact of flu could make it even harder for the system to cope with a higher number of people coming forward with cancer symptoms, compared with previous Covid peaks when huge numbers of people didn’t come forward with symptoms and many others still experienced delays to their diagnosis and treatment.”

The charity says it is requesting that the Government creates a training fund of £124m for specialist cancer nurses.

Steven McIntosh, executive director for advocacy and communications at Macmillan, said: “It is reassuring to see more people receiving a cancer diagnosis and starting the treatment they need, but we know that many patients are entering an overstretched system that was on its knees even before the pandemic.

“This risks a perfect storm, as the system experiences a considerable influx of patients alongside an overwhelmed workforce struggling to provide the care and support that people urgently need.

“We are not out of the woods yet – and we’re not even close. With worrying months to come in the NHS, the Government must act to both protect cancer services now and address the shocking shortfall in cancer nurses in the upcoming spending review.”