Physical activity in the community improves mobility for cancer survivors

Programmes to encourage physical activity for people with cancer at home or in local communities have a positive impact on physical function | NIHR Signal

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The changes were generally small to moderate, for example those receiving rehabilitation could walk on average 28 metres further in six minutes. The studies mostly included older people with breast cancer, in whom these small improvements may be important.

Cancer survivors experience changes to their physical function resulting from cancer and its treatments. Restoring function can help people maintain independence.

This review looked at a range of interventions. Those delivered in people’s homes or nearby community settings may be more convenient for people with reduced physical function, and might enable more people to attend. Further research would help to confirm these findings in the UK and to explore implementation issues.

 

‘Burden of cancer’ increasing as UK trails behind Europe in cancer care

A new report published today shows that the UK is trailing behind the rest of Europe in the treatment of cancer | ABPI

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Image source: ABPI

British patients have worse survival rates after five years – the international benchmark for measuring the quality of cancer care – compared to the European average in nine out of ten cancers – only exceeding the EU average in melanoma.

​​​​​​​​​​​​Despite the increasing burden of cancer on society, the UK spends over 20 per cent less per person on cancer than the top five EU economies; 20 per cent less of its total health budget on cancer than the rest of the EU; and 10 per cent less of its GDP on healthcare than the rest of the EU.

On cancer survival:

  • UK cancer survival rates lag behind the European average in 9 out of 10 cancers
  • If the UK achieved the cancer survival rates of Germany, over 35,000 more people would be alive five years after diagnosis.
  • The UK has the worst survival outcomes across Europe for ovarian cancer. The UK’s Ovarian cancer survival rate is 34.0% of patients surviving for five years or more. European average is 40.8%​
  • The UK has the second worst survival rates for lung cancer – 8 per cent of patients surviving more than five years (ahead only of Bulgaria – 7 per cent). European average is 12.62 per cent.​
  • The UK has the second worst survival rates for pancreatic cancer – 3 per cent of patients surviving more than five years (ahead only of Iceland – 2.56 per cent) European average is 5.84 per cent.​
  • If the UK had the mortality rates of France, more than 100,000 women’s deaths could be prevented over the next ten years.

View the full report here

Cancer app developed by GPs being trialled by CCGs

A GP-developed app aiming to help GPs navigate the tests and urgent referrals necessary for patients presenting with cancer symptoms is being trialled by two CCGs | Pulse

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C the Signs was co-founded by newly qualified GP Dr Bhavagaya Bakshi and fellow doctor Miles Payling and quickly checks symptoms of more than 200 cancers against multiple diagnostic referral pathways.

Last week the app won the People’s award at the Tech4Good awards and is now set to be trialled with GPs in the East of England to test its real world cost and clinical effectiveness.

Read the full news story here

Transferring Palliative Care Inpatients to Residential Care

The survival of patients with advanced cancer, coupled with the increased presence of end-stage chronic illnesses in an aging population, is leading to a demand in palliative care | Journal of Social Work in End-of-Life & Palliative Care

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Due to the ongoing need for acute-pain and symptom control in hospice/palliative care units, few are able to offer long-stay admission for those whose symptoms have stabilized. When a patient no longer requires specialist palliative care services, transfer from an inpatient palliative care facility may then be necessary. A core component of the role of palliative-care social workers involves working with patients and their families/carers when the care pathway shifts and the option of residential aged care facility (RACF) needs to be considered.

This research explored several issues, including the impact of this transition on the patient and their families and on the interdisciplinary health care team treating the patient. An investigation was undertaken to identify concerns and barriers regarding the transition from hospice care to RACF and opportunities were highlighted to improve clinical practice in this area. A tripartite approach was adopted conducting face-to-face interviews with patients, their families/carers, and health care professionals. Members of the interdisciplinary team were interviewed and social workers working in similar inpatient palliative-care facilities undertook telephone interviews to gauge their experiences. A thematic analysis discerned a number of themes highlighting the impact of this transition on key stakeholders and incorporated recommendations to improve or best manage this process.

The research has highlighted the difficulties that patients/families encounter in this transition, as well as the emphases of protecting the integrity of the patient and family. This is achieved by holding open and ongoing dialogue, particularly through family meetings and working in collaboration with the patient, the family, and the team. Understanding the experience and impact of this transition on key stakeholders is helpful in building up a knowledge base and to ensure a more effective relationship occurs. This research incorporated the voices of terminally ill patients, families, and members of the health care team in order to understand their views and recommendations for best managing the transition from a hospice/inpatient palliative-care facility to a RACF. This enables their input to have some real impetus in clinical practice and service delivery.

Full reference:  Kallianis, V. et al. (2017) “Unexpected and Distressing”: Understanding and Improving the Experience of Transferring Palliative Care Inpatients to Residential Care. Journal of Social Work in End-of-Life & Palliative Care. Published online: 1 June 2017

Young adult cancer survivors struggle to get back to normal

Cancer survivors often talk about wanting to get back to normal, but a new study indicates many young adults who survived the disease struggle with attaining this goal two years after their initial diagnosis |ScienceDaily

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Researchers collected data from 215 cancer patients aged 14 to 39 years who visited five medical facilities nationwide between March 2008 and April 2010. Patients completed a self-report measure of social functioning within the first four months of diagnosis, and again at 12 months and 24 months later. They also answered questions about their social interactions with family and friends, psychological needs and mental health.

Thirty-two percent of the survivors reported consistently low social functioning over time — and some had been off treatment. Zebrack and colleagues say this could stem from the transition from treatment to off-treatment survivorship, a time fraught with new challenges to a cancer survivor, including the negative impact on finances, body image, work plans, relationship with spouse/significant other and plans for having children.

In addition, those reporting low scores on social functioning also had high levels of distress, possibly reflecting an impaired ability to reintegrate into social activities due to the effects of cancer, the study showed.

National cancer patient experience survey

Quality Health has published the latest National Cancer Patient Experience Survey 2016.

The survey asked people with cancer across England for their views on their care, with 72,788 responding.

Key findings of the national cancer patient experience survey 2016 include:

  • 87.5% of patients said they got their cancer tests at the right time, up from 86.6% last year
  • 78% of respondents said that they were definitely involved as much as they wanted to be in decisions about their care
  • 90% of respondents said they were given the name of a Clinical Nurse Specialist who would support them through their treatment. When asked how easy or difficult it had been to contact their Clinical Nurse Specialist, 86% of respondents said that it had been “quite easy” or “very easy”
  • 88% of respondents said that, overall, they were always treated with dignity and respect while they were in hospital
  • 94% of respondents said that hospital staff told them who to contact if they were worried about their condition or treatment after they left hospital

Additional link: NHS England news

Prognosis following cancer surgery during holiday periods

This study aimed to test the new hypothesis that cancer surgery performed during holiday periods is associated with worse long-term prognosis than for non-holiday periods | International Journal of Cancer

This nationwide Swedish population-based cohort study included 228,927 patients during 1997-2014 who underwent elective resectional surgery for a cancer where the annual number of resections was over 100. The 16 eligible cancer sites were grouped into 10 cancer groups. The exposure, holiday periods, was classified as wide (14-weeks) or narrow (7-weeks). Surgery conducted inside versus outside holiday periods was compared regarding overall disease-specific (main outcome) and overall all-cause (secondary outcome) mortality.

Cox regression provided hazard ratios (HR) with 95% confidence intervals (CI) adjusted for age, sex, comorbidity, hospital volume, calendar period, and tumor stage. Surgery conducted during wide and narrow holiday periods were associated with increased HRs of disease-specific mortality for cancer of the breast (HR 1.08, 95% CI 1.03-1.13 and HR 1.06, 95% CI 1.01-1.12) and possibly of cancer of the liver-pancreas-bile ducts (HR 1.09, 95% CI 0.99-1.20 and HR 1.12, 95% CI 0.99-1.26).

Sub-groups with cancer of the colon-rectum, head-and-neck, prostate, kidney-urine bladder, and thyroid also experienced statistically significantly worse prognosis following surgery conducted during holiday periods. No influence of surgery during holiday was detected for cancer of the esophagus-stomach, lung, or ovary-uterus. All-cause HRs were similar to the disease-specific HRs. The prognosis following cancer surgery might not be fully maintained during holiday periods for all cancer sites.

Full reference: Lagergren, J. et al. (2017) Prognosis following cancer surgery during holiday periods. International Journal of Cancer. Published online: 21 July 2017