Effect of ultrasonography surveillance in patients with liver cancer

Liver cancer is a growing global public health problem. Ultrasonography is an imaging tool widely used for the early diagnosis of liver cancer | BMJ Open

433px-hepatocellular_carcinoma_low_mag

Image source: Nephron – Wikimedia // CC SA 3.0

Image shows low magnification micrograph of hepatocellular carcinoma the most common form of primary liver cancer.

Objective: The effect of ultrasonography surveillance (US) on the survival of patients with liver cancer is unknown. Therefore, this study examined the association between survival and US frequency during the 2 years preceding patients’ liver cancer diagnosis.

Methods: This population-based longitudinal study was conducted in Taiwan, a region with high liver cancer incidence, by using the National Health Insurance Research Database. We compared survival between patients who received US three times or more (≥3 group) and less than three times (<3 group) during the 2 years preceding their liver cancer diagnosis, and identified the predictors for the ≥3 group.

Results: This study enrolled 4621 patients with liver cancer who had died between 1997 and 2010. The median survival rate was higher in the ≥3 group (1.42 years) than in the <3 group (0.51 years). Five-year survival probability was also significantly higher in the ≥3 group (14.4%) than in the <3 group (7.7%). The multivariate logistic regression results showed that the three most common positive predictors for receiving three or more US sessions were indications of viral hepatitis, gallbladder diseases and kidney–urinary–bladder diseases; the most common negative predictors for receiving three or more US sessions were male sex and indications of abdominal pain.

Conclusion: Patients with liver cancer who received US three times or more during the 2 years preceding their liver cancer diagnosis exhibited a higher 5-year survival probability.

Full reference: Chiang, J. et al. (2017) Effect of ultrasonography surveillance in patients with liver cancer: a population-based longitudinal study. BMJ Open. 7:e015936

Return to work of cancer patients

To support return to work (RTW) among cancer patients, a multidisciplinary rehabilitation programme was developed which combined occupational counselling with a supervised physical exercise programme during chemotherapy | BMJ Open

cravat-987584_960_720.jpg

Objectives: The aim was to investigate RTW rates of cancer patients and to evaluate changes in work-related quality of life and physical outcomes.

Conclusions: RTW rates of cancer patients were high after completion of the multidisciplinary rehabilitation programme. A multidisciplinary rehabilitation programme which combines occupational counselling with a supervised physical exercise programme is likely to result in RTW, reduced fatigue and increased importance of work, work ability, and quality of life.

Full reference: Leensen, M.C.J. et al. (2017) Return to work of cancer patients after a multidisciplinary intervention including occupational counselling and physical exercise in cancer patients: a prospective study in the Netherlands. BMJ Open 7:e014746.

Comments from the first National Cancer Patient Experience Survey in Scotland

Analysis free-text responses from the first Scottish Cancer Patient Experience Survey (SCPES) to understand patients’ experiences of care, identify valued aspects and areas for improvement | BMJ Open

Design: Inductive thematic analysis of seven free-text comment boxes covering all stages of the cancer experience, from a national cohort survey.

 

Results: Participants made more positive than negative comments (1:0.78). Analysis highlighted the importance to patients of Feeling that Individual Needs Are Met and Feeling Confident Within the System. Comments also provided insight into how Processes and Structures within the system of care can negatively impact on patients’ experience. Particular issues were identified with care experiences in the lead-up to diagnosis.

Conclusions: This analysis provides a detailed understanding of patients’ cancer care experiences, therefore indicating what aspects matter in those experiences. Although the majority of comments were positive, there were a significant number of negative comments, especially about the lead-up to diagnosis. Comments suggest patients would value greater integration of care from services involved in their treatment for cancer.

Full reference: Cunningham, M. & Wells, M. (2017) Qualitative analysis of 6961 free-text comments from the first National Cancer Patient Experience Survey in Scotland. BMJ Open. 7:e015726. 

NICE set to approve trastuzumab emtansine for breast cancer

The NHS in England will soon be able to routinely fund the use of trastuzumab emtansine for people with certain categories of breast cancer, the National Institute for Health and Care Excellence (NICE) has announced in new draft guidance | OnMedica

NICE’s decision means that, by late summer, more than a thousand women and men could benefit from the drug.

HER2-positive breast cancer accounts for about a fifth of the roughly 41,500 women and 300 men who are diagnosed with breast cancer each year in England, but HER2-positive tumours are typically more aggressive than other types of breast cancer. The targeted treatment trastuzumab (Herceptin) is only effective for this type of breast cancer. Trastuzumab emtansine (Kadcyla) is licensed for the treatment of locally advanced or metastatic HER2-positive breast cancer, after trastuzumab and a taxane, taken either in combination or separately.

Currently, trastuzumab emtansine – which at full list price costs about £90,000 per patient – is only available on the NHS through the Cancer Drugs Fund (CDF). But NICE revealed yesterday afternoon that the drug’s manufacturer Roche had agreed a new commercial access arrangement with NHS England. When NICE factored this confidential agreement into a new clinical and cost-effectiveness analysis, also applying end-of-life criteria, it concluded that it can now recommend the drug as cost effective for routine use on the NHS.

Men dangerously unaware of family link to prostate cancer

Two-thirds of men with a family history of prostate cancer are dangerously unaware of their increased risk of the disease and half of all UK men don’t know that a family link makes you two-and-a-half times more likely to get it, according to new research by Prostate Cancer UK.

It’s prompted urgent calls from the charity for men and their families to have a potentially life-saving talk about the disease with their relatives and doctor. Especially since an accompanying study  showed that only 1-in-10 GPs are likely to always ask a man whether any close relatives have had the disease. Although where men did take the lead and initiate a discussion with their doctor, it found their experiences were overwhelmingly positive.

Adult smoking habits in the UK: 2016

Cigarette smoking among adults including the proportion of people who smoke including demographic breakdowns, changes over time, and e-cigarettes. | Office for National Statistics

smoke-933237_1920 (1)

Main points

  • In 2016, of all adult survey respondents in the UK, 15.8% smoked which equates to around 7.6 million in the population.
  • Of the constituent countries, 15.5% of adults in England smoked; for Wales, this figure was 16.9%; Scotland, 17.7% and Northern Ireland, 18.1%.
  • In the UK, 17.7% of men were current smokers which was significantly higher in comparison with 14.1% of women.
  • Those aged 18 to 24 in the UK experienced the largest decline in smoking prevalence of 6.5 percentage points since 2010.
  • Among current smokers in Great Britain, men smoked 12.0 cigarettes each day on average whereas women smoked 11.0 cigarettes each day on average; these are some of the lowest levels observed since 1974.
  • In Great Britain, 5.6% of respondents in 2016 stated they currently used an e-cigarette in 2016, which equates to approximately 2.9 million people in the population.

Access the full document: Adult smoking habits in the UK: 2016