The Battle for Breath – the impact of lung disease in the UK

British Lung Foundation. Published online: June 2016

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Image source: BLF

The Battle for Breath examines the overall extent and impact of lung disease across the UK. It also takes a closer look at the impact of 15 major lung conditions.

The new report is a valuable resource for policymakers, researchers, health care providers and more.

It explains in detail our new findings, and the changes that need to be made to tackle them.

Key findings

  • Lung disease is one of the top three killer diseases in the UK
  • 115,000 people a year die from lung disease – 1 person every 5 minutes
  • Mortality figures are roughly the same as 10 years ago, yet heart disease has fallen 15%
  • 1 in 5 people in the UK have been diagnosed with a lung disease
  • Every day, 1,500 new people are diagnosed with a lung disease
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Image source: BLF

Read the full report here

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A combined approach to treating metastatic melanoma

ScienceDaily. Published online: 30 May 2016.

Image shows photomicrograph (magnification X400) of fine needle aspiration from breast in metastatic malignant melanoma.

Oncologists at the Fred Hutchinson Cancer Research Center have successfully treated a patient with metastatic melanoma by combining two different types of immunotherapy. Cassian Yee and colleagues describe their approach in a paper, “Combined IL-21-primed polyclonal CTL plus CTLA4 blockade controls refractory metastatic melanoma in a patient,” that will be published online May 30 in The Journal of Experimental Medicine.

The researchers tested their idea on a 53-year-old patient with multiple metastases who had previously shown little response to either T cell transfers or ipilimumab treatment. The patient now received an infusion of his own antitumor T cells that had been treated with an immune signaling protein, called interleukin-21, that promotes T cell survival. Immediately afterward, the patient received a dose of ipilimumab. Within weeks, the patient’s tumors began to shrink, and they eventually disappeared completely. Yee and colleagues report that, over five years later, the patient remains disease free.

The researchers found that their combined approach boosted the number of antitumor T cells circulating in the patient’s blood in both the short and long term. Moreover, the enhanced immune response induced by this treatment allowed the patient to develop new types of T cells that attacked the melanoma in additional ways, a phenomenon known as epitope spreading.

Read the full commentary here

Read the original research abstract here

Study shows patients require less painkilling medication after breast-cancer surgery if they have opiate-free anesthesia

ScienceDaily. Published online: 30 May 2016.

Image shows Remifentanil’s 3D molecular structure

In this study, painkiller requirements were examined after patients received opiate anaesthesia and non-opiate anaesthesia. A randomised controlled trial was conducted, containing two groups each containing 33 breast cancer patients undergoing a mastectomy or lumpectomy. The study took place between September 2014 and July 2015 at the Jules Bordet Institute, Brussels.

Perioperative non-opiate analgesia was obtained by combining clonidine (0.2 mcg/kg), ketamine (0.3 mg/kg) and lidocaine (1.5 mg/kg). An extra bolus of ketamine (0.2mg/kg) was given if necessary. Opiate analgesia was obtained via a combination of remifentanil infusion, ketamine (0.3 mg/kg) and lidocaine (1.5 mg/kg). Both groups received intravenous paracetamol (1000mg/6h) and intravenous diclofenac (75 mg/12h). Patients received a PCA (patient-controlled analgesia) pump for breakthrough pain during the first 24 hours post-operatively.

Clinical characteristics and post-operative piritramide painkiller consumption (through the patient controlled pump) were assessed during the first 24 hours post-operatively. Data were not complete for two patients in the non-opiate group, and thus a total of 64 patients were included in the study. The total mean piritramide usage 24 hours post-operatively was 8.1 mg (range 2.0-14.5) in the non-opiate group and 13.1 mg (range 6.0-16.0) in the opioid group. The difference observed was statistically significant.

Read the full commentary here

230,000 waiting more than a month for radiology test results in England

Hundreds of thousands of patients in England are waiting more than a month for radiology test results

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image source: http://www.rcr.ac.uk

A report into NHS services in England by the Royal College of Radiologists (RCR) found three-quarters of hospitals have a backlog for radiology, which includes CT and MRI scans.

Some 126 out of 155 NHS trusts responded to enquiries from the RCR about the state of radiology services.

The report found that on one particular day in February 2016, 230,000 patients had been waiting more than a month for test results. These included at least 12,000 who were waiting for the result of CT or MRI scans, which are often used to diagnose or monitor cancer.

Read more via The Royal College of Radiologists survey Diagnostic radiology: Our patients are still waiting….

Statistics on Smoking, England – 2016

This statistical report presents a range of information on smoking which is drawn together from a variety of sources. The report aims to present a broad picture of health issues relating to smoking in England and covers topics such as smoking prevalence, habits, behaviours and attitudes among adults and school children, smoking-related ill health and mortality and smoking-related costs.

The topics covered include:

Part 1: Smoking patterns in adults

Part 2: Smoking patterns in children

Part 3: Availability and affordability of tobacco

Part 4: Behaviour and attitudes to smoking

Part 5: Smoking-related costs, ill health and mortality

Each part provides an overview of the key findings on these topics, as well as providing links to sources of further information and relevant documents.

Lung cancer survival rate increases by 73 percent if caught early

The UK Lung cancer screening trial has demonstrated that patients with a high risk of developing lung cancer can be identified with early stage disease and have up to a 73 percent chance of surviving for five years or more. | via Science Daily

The UK Lung cancer screening trial (UKLS) has been successfully completed and demonstrated that patients with a high risk of developing lung cancer can be identified with early stage disease and have up to a 73% chance of surviving for five years or more. The UKLS trial was conducted by experts in the University of Liverpool.

The UKLS was undertaken in partnership with Liverpool Heart & Chest Hospital, Papworth Hospital and the Royal Brompton & Harefield Hospital with the aim of highlighting the need for a screening programme to help benefit people who are at risk of developing lung cancer.

The results of the UKLS trial provide further evidence for the UK National Screening Committee (UKNSC) to consider when making a decision whether to implement a national screening programme in the UK in the future.

Funded by the NIHR Health Technology Assessment programme the trial was the first and only lung cancer screening trial to take place in the UK and has provided in depth information on how to set up a national lung cancer CT screening programme, including using a risk prediction model to identify high risk individuals in the population.

Read more from Science Daily here

Link to the research: Field, J.K. et. al.  The UK Lung Cancer Screening Trial: a pilot randomised controlled trial of low-dose computed tomography screening for the early detection of lung cancer. Health Technology Assessment, 2016; 20 (40): 1

Should doctors standardize their expressions of sympathy?

A majority of oncology professionals believe that writing condolence letters to the families of deceased patients is an important component of cancer palliative care, the results of a new survey indicate. | Story via Science Daily

The results of a new survey published in ecancermedicalscience indicate that a majority of oncology professionals believe that writing condolence letters to the families of deceased patients is an important component of cancer palliative care.

The study explored whether institutions should consider changing policies to raise condolence letters to a more official standing.

But because this practice is a personal grace note, it has rarely been studied or discussed. In particular, this issue hasn’t been researched in the UK, where cultural practices surrounding grief are often private.

Abstract available here

Full reference: Letters of condolence: assessing attitudes and variability in practice amongst oncologists and palliative care doctors in Yorkshire ecancermedicalscience, 2016; 10 DOI: 10.3332/ecancer.2016.642