[NICE Technology appraisal guidance] Abemaciclib with fulvestrant for treating hormone receptor-positive, HER2-negative advanced breast cancer after endocrine therapy

NICE |  May 2019| Abemaciclib with fulvestrant for treating hormone receptor-positive, HER2-negative advanced breast cancer after endocrine therapy Technology appraisal guidance [TA579]

NICE have publsihed technology appraisal guidance: Evidence-based recommendations on abemaciclib (Verzenios) for hormone receptor-positive, human epidermal growth factor 2 (HER2)-negative locally advanced or metastatic breast cancer in adults who have had endocrine therapy.

Full details from NICE 

[NICE Guideline] Prostate cancer: diagnosis and management [NG131]

NICE |  May 2019 | Prostate cancer: diagnosis and management NICE guideline [NG131]

This guideline covers the diagnosis and management of prostate cancer in secondary care, including information on the best way to diagnose and identify different stages of the disease, and how to manage adverse effects of treatment. It also includes recommendations on follow-up in primary care for people diagnosed with prostate cancer.

Full details from NICE 

Improving the care of head and neck cancer patients with collaborative dietetics and speech and language therapy intervention

NICE | April  2019 | Improving the care of head and neck cancer patients with collaborative dietetics and speech and language therapy intervention

NICE’s shared learning database highlights the work and benefits to patients of  a project at the University Hospital Birmingham NHSFT; where patients are being seen by Speech and Language Therapists and Dietitians whilst they have radiotherapy (plus or minus chemotherapy) to minimise the morbidity associated with oncology treatments to the head and neck.

The paper describes the individual and operational benefits of this clinical intervention, including reduced weight loss, and admissions to hospital as well as a shortened length of stay for patients who were admitted.   

Improving the care of head and neck cancer patients with collaborative dietetics and speech and language therapy intervention

Exposing a hidden crisis in the NHS this winter

BMA | May 2019 | Exposing a hidden crisis in the NHS this winter

The BMA’s latest report- Exposing a hidden crisis in the NHS this winter– highlights how winter pressure reoccurred in the NHS. It shows that nearly a quarter of patients (24 %) with a cancer diagnosis waited over 2 months for their first treatment.

Image source: bma.org

In cancer care, trusts failed to meet the target of 93% of patients to be seen by a specialist within 2 weeks of an urgent GP referral. Far more providers missed the 93% target than last year. A significant majority of providers, close to 70%, missed the target for 85% to be treated within 62 days of referral (Source: BMA).

Read the 2018/19 NHS Pressures report

BMA [press release] Exposing a hidden crisis in the NHS this winter


Only 1 in 10 GPs say they have the tools to diagnose pancreatic cancer

Pancreatic Cancer UK | May 2019 | Only one in ten GPs have the tools needed to diagnose pancreatic cancer in time to treat

A little over 1,000 UK GPs were polled by ComRes on behalf of the charity Pancreatic Cancer UK. 3 per cent of GPs polled said they were very confident they could recognise the symptoms of pancreatic cancer in a patient.  One in 10 (11 per cent) felt they had the necessary tools to recognise the signs of the cancer.  


Over half of GPs (54 per cent)  say that they have some of the tools they need, but could do with more. Of even greater concern is that three in ten (28 per cent) say that they do not have the tools that they need to detect pancreatic cancer at a stage where it is possible to treat. The charity’s findings mark the launch of their new campaign Unite-Diagnose-Save Lives to help fund the first-ever simple test for pancreatic cancer by 2024.

A quarter of pancreatic cancer patients die within a month of diagnosis, making it the quickest killing cancer. Currently no screening or early detection tests exist for the disease and half of all patients (53 per cent) are diagnosed at stage 4. Vague symptoms – such as back pain, indigestion and weight-loss – mean pancreatic cancer often goes undetected until after it has spread, leaving patients ineligible for the only potential cure – surgery to remove their tumour.

GPs who suspect the disease can refer patients for ultrasound, CT, or MRI scans. However nearly half of all pancreatic cancer patients are currently diagnosed via an emergency (such as through visiting A&E). The impact is significant: one-year survival for patients diagnosed through a GP referral is three times higher.

Pancreatic Cancer UK is investing an initial £750,000 in the research and is asking for the public’s support to help ensure a desperately needed breakthrough in diagnosis can be made (Source: Pancreatic Cancer UK).

Read the full press release from Pancreatic Cancer UK 

See also:

Pancreatic Cancer UK The Pancreatic Cancer UK Early Diagnosis Research Alliance

OnMedica GPs need better tools to diagnose pancreatic cancer

Mindfulness dispositions and defense style as positive responses to psychological distress in oncology professionals

Di Giuseppe, M., Ciacchini, R., Piarulli, A., Nepa, G., & Conversano, C. |2019|Mindfulness dispositions and defense style as positive responses to psychological distress in oncology professionals| European Journal of Oncology Nursing |Vol.40|2019| P.104-110

A new study published in the European Journal of Oncology Nursing looks at mindfulness dispositions and defense mechanisms as responses to psychological distress in oncology professionals. 


Oncology professionals are exposed to work-related stress responses that can be handled with defense style and mindfulness dispositions.

Depression symptoms are reduced by both mindfulness and defense mechanisms, whereas immature defense style increase anxiety symptoms.

The early detection of pitfalls in defensive functioning and mindfulness dispositions might help in providing psychological interventions.



Working in oncology departments is a stressful and emotionally consuming experience and oncology professionals are particularly at risk for developing stress-related syndromes. Defense mechanisms (high-adaptive) and mindfulness dispositions are known as facilitators of well-being and adaptation. In this study we analysed the role of these unconscious and conscious strategies in protecting the oncology clinicians from stress-related symptoms.


A convenience sample of 63 oncology professionals was assessed on defense style, mindfulness disposition, depression and anxiety symptoms using self-reported questionnaires. Demographic and professional information was included in data collection.


Results did not show significance differences in demographic and professional characteristics among all studied variables. Mature defense style and mindfulness were highly and negatively correlated with depression and anxiety, while a positive association was found between immature defense style and both depression and anxiety symptoms. Hierarchical multiple regression analyses found defense styles and mindfulness as predictors of depression, whereas only immature defense style predicted anxiety.


The present study provides the first empirical evidence of the influence of unconscious defense mechanisms and conscious mindfulness dispositions in protecting oncology professionals from depression and anxiety symptoms. Defense mechanisms and mindfulness share several common-points and should be seen as complementary in enhancing physical and psychological well-being. Further studies are required for a deeper understanding of the impact of mindfulness and defenses in improving adaptation.

The Library & Knowledge Service can provide access to this article for Rotherham NHS Staff, request a copy here 

Manifesto calls for action on cancer drug access as survey shows patient delays

Institute of Cancer Research | April 2019 | Manifesto calls for action on cancer drug access as survey shows patient delays

The Institute of Cancer Research has issued a 10-point manifesto which calls for action to accelerate access to innovative cancer drugs. The manifesto is the result of a survey conducted by the ICR, which involved over 1000 people who had been treated for cancer to contribute to shape recommendations to improve access to the latest treatments. 

The 10 points are:

1. NICE needs to prioritise the most innovative cancer treatments with the greatest potential to deliver step-change advances for patients. That means changing NICE’s definition of innovation to promote treatments that tackle cancer in brand new ways.

2. We need radical action to bring down the extremely high prices of modern cancer drugs, allowing as many patients as possible to benefit from advances in cancer treatment while not overburdening the NHS.

3. We need to embrace personalised medicine by developing tests for every drug developed. Better access to biomarker tests can ensure modern targeted drugs are directed at those who will benefit. This is better for patients and more efficient for the NHS.

4. We need to test drugs in smaller, smarter clinical trials to generate findings more quickly and cheaply – giving the NHS fast access to drugs at affordable prices.

5. We need to incentivise pharmaceutical companies to trial new medicines in novel combinations – including with other drugs manufactured by commercial rivals.

6. Drug regulators need to be more flexible in assessing evidence, so that innovative new treatments can reach patients as quickly as possible.

7. We need to ensure all cancer patients have access to suitable clinical trials at all appropriate stages of their disease, irrespective of where they are treated.

8. We need to increase access to precision medicine for children with cancer – so they can benefit from the same kind of advances in treatments that adults have.

9. We must be flexible on the age limits for clinical trials to avoid denying older children and young adults access to new treatments simply because they are judged too young or old.

10. We need to incentivise companies, universities and charities to work together to turn research into innovative, medicines for patients (Source: Cancer Drug Manifesto).

Full details from Institute of Cancer Research Cancer Drug Manifesto 

Press release Institute of Cancer Research  Manifesto calls for action on cancer drug access as survey shows patient delays

In the news:

The Daily Telegraph One in six cancer patients is being denied drugs recommended by doctors

The Independent One in 10 cancer patients denied drugs recommended by their doctor, study says

The Daily Mail Cancer drugs are NOT reaching the patients: One in six sufferers have faced an NHS block to treatments that are recommended by their doctors, report warns