The Potential Role of an Acute Oncology Service

Bruce, C.M. et al. Clinical Oncology | Published online: 17 April 2017

Highlights:

  • There is ample scope to work with primary care to reduce cancer patient admissions.
  • Only one quarter of cancer patients had an inpatient oncologist review.
  • Median length of stay was 6 days; the literature suggests an AOS could reduce this.
  • A pilot suggests a reduction in number of bed days can be achieved with an AOS.
  • An AOS is likely to have a positive impact at an individual and national level.

Read the full abstract here

LGB people with cancer share video experiences

Cancer is complex, but so are our sexualities | The University of Manchester & Macmillan Cancer Support

The unique experiences of lesbian, gay, bisexual and queer people with cancer have been shared on a new video hub highlighting differences in their care, and issues around sex, support and bereavement.

The aim of the videos, which were filmed during 2016 by lecturer in nursing Dr Maurice Nagington are designed to help people understand the thoughts and feelings of LGB people with cancer and their own experiences of care.

The site https://lgbcancer.wordpress.com/ is designed for NHS staff as a resource to guide their contact with this group.

Read the full overview here

 

One Hospital System’s Journey to Reduce Clostridium Difficile

Delaney, M.B. Journal of Emergency Nursing | Published online: 4 April 2017

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Problem: Albert Einstein defines insanity as doing the same thing over again but expecting different results. Although the United States claims to reduce antibiotic abuse, practice strict isolation, and clean meticulously, the burden of Clostridium difficile outpaces goals. Unless innovative approaches are tried, we risk culling elderly, immunosuppressed, and otherwise debilitated populations. Emergency departments are a primary access point for patients who are unable to wait for primary care. As a result, many patients with diarrhea are seen in emergency departments.

Methods: This article describes one hospital system’s quality improvement trial of disposable commode pails (DCPs) for high-acuity patients in 3 of 5 institutions. The rationale was to prevent staff from touching surfaces heavily contaminated with C difficile. Staff members were not to wash or reuse commode buckets between patients. Instead, DCPs were substituted, and only the commode chairs were wiped. For quantitative date, C difficile infections (CDIs) were compared across hospitals. Staff members were surveyed for qualitative data.

Read the full abstract here

 

Cancer experts condemn cancer drug decision

Expert cancer clinicians have condemned a preliminary decision by the National Institute for Health and Care Excellence (NICE) not to approve use of the drug nivolumab (Opdivo) for the treatment of head and neck cancer on the NHS | OnMedica

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NICE has today issued new draft guidance which does not recommend nivolumab in this way, saying that it is not cost-effective.

Nivolumab is administered intravenously every two weeks and the drug works by blocking a protein on the surface of cells known as PD-L1, which reduces the activity of the body’s immune cells. There is more PD-L1 on cancerous cells which stops the immune system from attacking the tumour.

NICE said the anticipated marketing authorisation for nivolumab was for treating squamous cell carcinoma of the head and neck which has progressed during or after platinum-based chemotherapy.

The watchdog found that the evidence showed a significant improvement in overall survival rates in the short term after nivolumab. However, its value for money was considerably above that which is usually a cost-effective use of NHS resources.

Read the full commentary here

NICE draft guidance is available here

Effect of depression before breast cancer diagnosis on mortality

Liang, X. et al. Cancer | Published online: 7 April 2017

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Background: Few previous studies investigating depression before the diagnosis of breast cancer and breast cancer–specific mortality have examined depression measured at more than 1 time point. This study investigated the effect of depression (combining depressive symptoms alone with antidepressant use) measured at 2 time points before the diagnosis of breast cancer on all-cause mortality and breast cancer–specific mortality among older postmenopausal women.

Conclusions: Women with newly developed depression before the diagnosis of breast cancer had a modestly but significantly increased risk for death from any cause and for death from breast cancer at a late stage.

Read the full abstract here

Mindfulness-Based Stress Reduction as a Stress Management Intervention for Cancer Care

Rush, S.E. et al. (2017) Journal of Evidence-Based Complementary & Alternative Medicine. 22(2)

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Cancer is acknowledged as a source of stress for many individuals, often leading to suffering, which can be long-lasting. Mindfulness-based stress reduction offers an effective way of reducing stress among cancer patients by combining mindfulness meditation and yoga in an 8-week training program.

The purpose of this study was to inspect studies from October 2009 to November 2015 and examine whether mindfulness-based stress reduction can be utilized as a viable method for managing stress among cancer patients. A systematic search from Medline, CINAHL, and Alt HealthWatch databases was conducted for quantitative articles involving mindfulness-based stress reduction interventions targeting cancer patients.

A total of 13 articles met the inclusion criteria. Of these 13 studies, 9 demonstrated positive changes in either psychological or physiological outcomes related to anxiety and/or stress, with 4 describing mixed results. Despite the limitations, mindfulness-based stress reduction appears to be promising for stress management among cancer patients.

Read the full article here