Teenage and young adult cancer clinical network specification

NHS England – 2023

The Teenage and Young Adult (TYA) Cancer Network, (the ‘Network’) is designed to bring the key teams and personnel together that comprise the clinical and holistic components of the pathway of care for teenagers and young adults with cancer. The goal of the Network is to enable service users to access the right care in the right place and at the right time, including clinical trials, while benefiting from co-ordinated holistic and psychosocial support.

This document must be read in conjunction with the service specifications for TYA Principal Treatment Centres (TYA PTC) and TYA Designated Hospitals (TYA DH).

Teenage and young adult cancer clinical network specification

Bladder cancer RCR consensus statements

RCR – May 2023

The RCR consensus process was initially developed in 2016 to help reduce variation in UK radiotherapy practice. The bladder cancer consensus statements should serve as a practical stimulus for bladder cancer teams to review their current radiotherapy service to ensure that they are able to deliver optimal treatment for their patients. They should be adopted in parallel with relevant National Institute for Health and Care Excellence (NICE) guidance.

The areas covered by the consensus statements in this document are:

1. Pathway and Follow up
2. Systemic Anti-Cancer Treatment
3. Technical Aspects of Radiotherapy – radical, high dose palliative and palliative
4. Node Positive Disease
5. Variant Pathology

Further information – Bladder cancer RCR consensus statements

Results of the 10-Year Cancer Plan call for evidence

Department for Health and Social Care – Updated 17 May 2023

In February 2022, the then Secretary of State for Health and Social Care launched a call for evidence to inform the development of a 10-Year Cancer Plan for England. We received 5,557 responses which were eligible for inclusion in our analysis:

• 4,822 were from individuals who live in England and wanted to share their personal experiences
• 735 were from professionals or organisations who operate in England or across the UK

The call for evidence was structured around a range of topics with a mixture of multiple-choice questions and free text boxes where people could give their views. Respondents were asked to select which priorities should be included in the 10-Year Cancer Plan and were able to select more than one priority.

This call for evidence was originally intended to inform a stand-alone 10-year Cancer Plan for England. The decision has since been taken to incorporate this into a major conditions strategy. The strategy will cover the 6 major groups of conditions that most affect the population in England, namely:

• cancers
• cardiovascular disease
• chronic respiratory diseases
• dementia
• mental ill health
• musculoskeletal conditions

Results of the 10-Year Cancer Plan call for evidence

Cancer waiting times: Latest updates and analysis

Cancer Research UK – 11th May 2023

Over the past few years, pressure on NHS cancer services has been mounting. Cancer waiting times, which show whether the health system is meeting its targets for quickly diagnosing and treating cancer help show us the extent of this pressure.

Testing for cancer, diagnosing it and starting treatment quickly saves stress and anxiety for people. Not only this, but cancer that’s diagnosed and treated at an early stage, when it isn’t too large and hasn’t spread, is more likely to be treated successfully. Prompt diagnosis and treatment underpin this.

There are four important targets that indicate how well cancer services are doing. Here are the latest results in England for March 2023:

Urgent suspected cancer referrals standard: Target Missed

• 83.9% of people were seen by a specialist within 2 weeks of an urgent suspected cancer referral. The target is 93%.

The Faster Diagnosis Standard: Target Missed

• 74.2% of people were diagnosed, or had cancer ruled out, within 28 days of an urgent referral in March 2023. The target is 75% and was introduced in 2021, but has only been met once since then, in February 2023.

The 62-day standard: Target Missed

• Only 63.5% of people in England received their diagnosis and started their first treatment within 2 months (or 62 days) of an urgent referral in March 2023. This is well below the target of 85% and this target has not been met since 2015, with a record low in January 2023.

The 31-day standard: Target Missed

• 91.9% of people started treatment within 31 days of doctors deciding a treatment plan in March 2023. The target is 96% and this performance was the 7th worst on record.

The above data are specific to England. Scotland, Wales and Northern Ireland also have their own cancer waiting times targets.

Further information – Cancer waiting times: Latest updates and analysis

Inequalities in cancer screening participation between adults with and without severe mental illness: results from a cross-sectional analysis of primary care data on English Screening Programmes

Br J Cancer (2023).

Background

People with severe mental illness (SMI) are 2.5 times more likely to die prematurely from cancer in England. Lower participation in screening may be a contributing factor.

Methods

Clinical Practice Research Datalink data for 1.71 million, 1.34 million and 2.50 million adults were assessed (using multivariate logistic regression) for possible associations between SMI and participation in bowel, breast and cervical screening, respectively.

Results

Screening participation was lower among adults with SMI, than without, for bowel (42.11% vs. 58.89%), breast (48.33% vs. 60.44%) and cervical screening (64.15% vs. 69.72%; all p < 0.001). Participation was lowest in those with schizophrenia (bowel, breast, cervical: 33.50%, 42.02%, 54.88%), then other psychoses (41.97%, 45.57%, 61.98%), then bipolar disorder (49.94%, 54.35%, 69.69%; all p-values < 0.001, except cervical screening in bipolar disorder; p-value > 0.05). Participation was lowest among people with SMI who live in the most deprived quintile of areas (bowel, breast, cervical: 36.17%, 40.23%, 61.47%), or are of a Black ethnicity (34.68%, 38.68%, 64.80%). Higher levels of deprivation and diversity, associated with SMI, did not explain the lower participation in screening.

Conclusions

In England, participation in cancer screening is low among people with SMI. Support should be targeted to ethnically diverse and socioeconomically deprived areas, where SMI prevalence is greatest.

Kerrison, R.S., Jones, A., Peng, J. et al. Inequalities in cancer screening participation between adults with and without severe mental illness: results from a cross-sectional analysis of primary care data on English Screening Programmes. Br J Cancer (2023).

Scrap tax on sunscreen, say cancer charities

BBC / 15th May 2023

Value added tax – better known as VAT – should be scrapped on sunscreen to make it more affordable, say several UK cancer charities.

Sunscreen is classified as a “cosmetic” product and carries a 20% tax, adding around £1.50 to the cost of a bottle.

Charities want high-factor protective creams to be VAT exempt, citing the cost-of-living crisis which has seen many struggling to buy essential items.

Most skin cancers are caused by sun damage.

There are several types of skin cancer, and melanoma is the most dangerous, as well as the most common type among young people in the UK – with cases on the rise.

If untreated, the cancer can spread to other areas of the body…

“Few realise that getting painful sunburn just once every two years can triple your risk of skin cancer,” said Dr Louise Soanes, Chief Nurse, Teenage Cancer Trust.

“Preventing skin cancer by using an effective sun cream is essential – and sun cream shouldn’t be a luxury that only some can afford.”…

Possible signs of skin cancer

A mole that has changed shape, or colour, or looks and feels unusual.

Or skin that:

• has a sore or lesion that does not heal within four weeks
• looks unusual – such as visible lumps or patches
• hurts, itches, bleeds, crusts or scabs…

Scottish National Party MP Amy Callaghan is running a campaign and petition urging government to act. She was diagnosed with melanoma at 19.

“More people wearing sunscreen means fewer people getting melanoma,” said Ms Callaghan.

“But when 52% of people in my constituency can’t afford to turn on the heating, it’s unlikely they’ll take on extra expenses like sunscreen.

“That’s why we must make sunscreen more affordable, by removing VAT.”…

Full text: Scrap tax on sunscreen, say cancer charities

The Christie: World-renowned NHS centre downgraded by watchdog

BBC / 12th May 2023

A world-renowned cancer centre hit by whistleblowing concerns over alleged bullying has been downgraded by the health watchdog.

The Care Quality Commission (CQC) told The Christie NHS Foundation Trust in Manchester it “requires improvement” in safety and leadership.

A former trust nurse told the BBC leaders had intimidated staff to stop them voicing concerns to inspectors…

Full-text: The Christie: World-renowned NHS centre downgraded by watchdog

Druggable proteins influencing cardiac structure and function: Implications for heart failure therapies and cancer cardiotoxicity

Sci. Adv.9,eadd4984(2023)

Dysfunction of either the right or left ventricle can lead to heart failure (HF) and subsequent morbidity and mortality. We performed a genome-wide association study (GWAS) of 16 cardiac magnetic resonance (CMR) imaging measurements of biventricular function and structure. Cis-Mendelian randomization (MR) was used to identify plasma proteins associating with CMR traits as well as with any of the following cardiac outcomes: HF, non-ischemic cardiomyopathy, dilated cardiomyopathy (DCM), atrial fibrillation, or coronary heart disease. In total, 33 plasma proteins were prioritized, including repurposing candidates for DCM and/or HF: IL18R (providing indirect evidence for IL18), I17RA, GPC5, LAMC2, PA2GA, CD33, and SLAF7. In addition, 13 of the 25 druggable proteins (52%; 95% confidence interval, 0.31 to 0.72) could be mapped to compounds with known oncological indications or side effects. These findings provide leads to facilitate drug development for cardiac disease and suggest that cardiotoxicities of several cancer treatments might represent mechanism-based adverse effects.

Read the article – Druggable proteins influencing cardiac structure and function: Implications for heart failure therapies and cancer cardiotoxicity

Managing challenging conversations by telephone with people living with cancer.

Bell D (2022) , Cancer Nursing Practice

Nurses working in cancer care can often find themselves engaged in challenging conversations with patients and their family members or carers. These conversations can cover a range of emotive subjects due to the negative effects of cancer on people and those close to them. Such conversations have become more challenging due to the coronavirus disease 2019 (COVID-19) pandemic because increasingly they have had to be conducted over the telephone.
This article examines some of the psychological effects of cancer and considers some ways in which nurses can engage in challenging telephone conversations with patients with cancer, including the use of mnemonic frameworks. The article also explores the importance of nurses’ self-care and how this can underpin safe practice

Read the article – Managing challenging conversations by telephone with people living with cancer.