Expensive chemotherapy does little to improve survival for people with advanced cancer, who often have “unrealistic expectations”, an expert has said.

Former consultant physician at Charing Cross Hospital in London Peter Wise said spending “six figure” sums on chemotherapy drugs is inappropriate for many people with advanced cancer who will “almost inevitably die” from their tumours.

Chemotherapy - one of the cornerstones of cancer treatment and can be used alongside other targeted drugs or radiotherapy - has only been shown to extend life by a few months on average, he said.

Instead of wasting money on these drugs, cash should be ploughed into “under-financed” areas which can actually extend survival, such as prevention, early diagnosis and more prompt treatment of single tumours, he said.

Writing in the British Medical Journal (BMJ), Mr Wise said cancer survival has improved in recent decades, but only a small part of this can be attributed to expensive drugs.

Some 48 new regimens approved by the US Food and Drug Administration (FDA) between 2002 and 2014 led to a typical two months survival benefit, while more historic data shows little evidence of overall benefit of chemotherapy.

Mr Wise also pointed to problems with clinical trials of new drugs, saying that the end result of any trial should be whether survival rates improve.

But “surrogate endpoints” are used as a way of shortening clinical trials and getting drugs to market quickly.

These endpoints include patients having early tumour shrinkage and longer periods of time before disease gets worse - known as progression-free survival.

Mr Wise said: “These endpoints are more rapidly available but, with some exceptions, have been shown to correlate poorly with overall survival.

“Many drugs approved on the basis of better progression-free survival have been subsequently found not to produce better overall survival than the comparator drug.”

He said both US and EU regulators accept these surrogate endpoints for “what are judged to be urgently needed new drugs”, while patients who often “overestimate” potential benefits are often not aware of the debilitating side-effects of treatment.

Turning to England, Mr Wise said he was hopeful the recent integration of the Cancer Drugs Fund into the National Institute of Health and Care Excellence (Nice) might make it possible to monitor the “real world benefit” of drugs.

He criticised the way “market-driven” priorities stand above “health-driven” priorities when it comes to treatment, which “do not benefit cancer patients”.

His views differ to that of some health experts, who point to the success of chemotherapy for individual cancers, and in combination with other treatments.

In 2015, a UK-led trial funded by Cancer Research UK found combining a chemotherapy drug with hormone treatment extended the lives of men with advanced prostate cancer by many months.

Emlyn Samuel, senior policy manager at Cancer Research UK, said: “Drugs are vital in cancer treatment. Advances in drug development, with the emergence of immunotherapy and precision drugs, give cancer patients much better prospects.

“It's crucial that patients don't miss out on the best treatments for their condition.

“The recent changes to the cancer drugs fund in England are a step in the right direction and we're monitoring this closely. But we also need further consideration of Nice reform to make sure its processes reflect advances in drug development.”