New device will protect prostate cancer patients during radiation treatment

An innovation that can reduce the side-effects of radiotherapy for prostate cancer patients by over 70 per cent will be rolled out across the NHS, as part of the Long Term Plan to put cutting-edge treatments at the heart of people’s care.

Thanks to a deal struck by the NHS with manufacturer Boston Scientific, hospitals in England will now be encouraged to use its hydrogel device for all patients who could benefit, making radiotherapy a safer and less painful treatment option for many men.

The hydrogel acts as a spacer, reducing the amount of radiation that can pass through the prostate and damage the rectum during treatment, by temporarily positioning it away from the high dose radiation used in treatment.

The gel, made mostly of water, is injected before treatment starts and then remains in place during radiation therapy, before being naturally absorbed by the body after about 6 months.

In studies, its use has been shown to relatively reduce life-changing side effects, such as rectal pain, bleeding and diarrhoea, by over 70%, meaning significant improvements in quality of life for those battling prostate cancer.

Full story at NHS England

National Lung Cancer Audit

National Lung Cancer Audit annual report 2018  | The Healthcare Quality Improvement Partnership 

lung audit
Image source: http://www.hqip.org.uk

This report represents the culmination of nearly two years of patient care and follow up, data collection, data analysis and interpretation. Its purpose is to understand the current quality of care and outcomes for patients with lung cancer, to celebrate good practice and to highlight variability, to ensure that all patients have access to the best care.

The results demonstrate improving data quality, higher rates of surgical treatment, and higher rates of systemic anti-cancer treatment across both small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC), such that four out of our five key auditable measures have been achieved. Additionally, continuing improvements in data completeness can be observed with 85% completeness seen for performance status (PS), 96% for stage and 64% for recording of lung function in patients potentially suitable for curative treatment, as compared to 82%, 96% and 56% respectively in the previous reporting period.

National Audit of Breast Cancer in Older Patients: 2019 Annual Report

Health Quality Improvement Programme | May 2019 | National Audit of Breast Cancer in Older Patients: 2019 Annual Report

The third Annual Report from Health Quality Improvement Programme describes the process and outcomes of care for 147,162 patients, diagnosed with breast cancer between 1st January 2014 and 31st December 2017 in England and Wales. The patterns of care received by people aged 70+ years are compared with the care received by people diagnosed with breast cancer aged 50–69 years. We also distinguish between the following groups of people with breast cancer:

1. Ductal carcinoma in situ.
2. Early invasive breast cancer.
3. Metastatic breast cancer.

 

hqip.org.uk
Image source: hqip.org.uk

The report is written primarily for clinicians, providers of breast cancer services, commissioners and healthcare regulators. A version for patients and the
wider public is being produced separately and will be available in summer 2019. 

National Audit of Breast Cancer in Older Patients: 2019 

 

[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.

bma.org
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.  

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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. 

Highlights

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.

Abstract

Purpose

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.

Method

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

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.

Conclusions

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 

[NICE Technology Appraisal Guidance] Durvalumab for treating locally advanced unresectable non-small-cell lung cancer after platinum-based chemoradiation

NICE | April 2019 | Durvalumab for treating locally advanced unresectable non-small-cell lung cancer after platinum-based chemoradiation Technology appraisal guidance [TA578]

Evidence-based recommendations on durvalumab (Imfinzi) for treating locally advanced unresectable non-small-cell lung cancer after platinum-based chemoradiation in adults.

More evidence on durvalumab is being collected, until September 2021. After this NICE will decide whether or not to recommend it for use on the NHS and update the guidance. It will be available through the Cancer Drugs Fund until then.

Full details from NICE