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


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.


GPs should have direct access to wider range of tests for suspected cancer, says NICE

Mayor, S. BMJ. 2016. 354:i3686

L0028329 Endoscopy operations. Colour lithograph by Virginia Powell,
Image source: Virginia Powell – Wellcome Images // CC BY-NC-ND 4.0

Image shows colour lithograph of endoscopy operations.

GPs should have direct access to a wider range of tests for people with suspected cancer including diagnostic endoscopy, ultrasound, x ray, and scans, the National Institute for Health and Care Excellence (NICE) has recommended in a new quality standard aiming to speed up cancer diagnosis.

The quality standard sets out measures the NHS should include in planning and delivering services. In addition to recommending that GPs have direct access to ultrasound, x ray, magnetic resonance imaging (MRI), and computed tomography (CT) scans, it says that they should be able to directly refer people with symptoms suggestive of oesophageal or stomach cancer for urgent upper gastrointestinal endoscopy.

After reviewing relevant research evidence NICE says that GPs should be able to refer patients of any age with dysphagia and those aged over 55 with weight loss and upper abdominal pain, reflux, or dyspepsia for upper gastrointestinal endoscopy. This test should be performed and results sent back to the GP within two weeks of the request.

Read the full article here

The impact of a new public health approach to end-of-life care: A systematic review

Sallnow, L. et al. Palliative Medicine. March 2016: vol. 30 no. 3200-211

N0030869 A carer comforting an elderly lady
Image source: Libby Welch

Background: Communities play an increasingly significant role in their own health and social care, and evidence demonstrates the positive impact of this work on a range of health outcomes. Interest is building regarding the application of the principles of the new public health approach to those facing the end of life and their families and communities.

Aim: To review the evidence relating to the impact of a new public health approach to end-of-life care, specifically as this applies to efforts to strengthen community action.

Design: A systematic review employing narrative synthesis. Both meta-ethnography and the use of descriptive statistics supported analysis.

Data sources: Eight databases (AMED, ASSIA, BiblioMap, CINAHL, Cochrane Reviews, EMBASE, MEDLINE and PsycINFO) were searched from the earliest record to March 2015 using set eligibility criteria.

Results: Eight articles were included in the analysis. Three main themes emerged from the meta-ethnography: making a practical difference, individual learning and personal growth and developing community capacity. The quantitative findings mapped to the meta-ethnography and demonstrated that engaging communities can lead to improved outcomes for carers such as decreased fatigue or isolation, increase in size of caring networks and that wider social networks can influence factors such as place of death and involvement of palliative care services.

Conclusion: Evidence exists for the impact of community engagement in end-of-life care. Impact assessment should be an integral part of future initiatives and policy makers should recognise that these approaches can influence complex issues such as carer support, community capacity, wellbeing and social isolation.

Read the abstract here