Pathology services capacity

Cancer Research UK has published Testing times to come? An evaluation of pathology capacity across the UK.

microscope-275984_1280

This report highlights lack of capacity for pathology services as a result of the increasing number of patient samples that need to be tested.  The report recommends that action is taken now to address current and future workforce shortfalls.  It also recommends the Royal College of Pathologists should update their guidance and look at ways to attract staff to train in pathology.

Download the executive summary for England

Additional links:  Cancer Research UK press release  | BBC News report

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

Mayor, S. BMJ. 2016. 354:i3686

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

New test may improve diagnosis, treatment of pancreactic cancers

ScienceDaily, 23 November 2015.

By collecting samples from the portal vein–which carries blood from the gastrointestinal tract, including from the pancreas, to the liver–physicians can learn far more about a patient’s pancreatic cancer than by relying on peripheral blood from a more easily accessed vein in the arm.

Carry on reading via ScienceDaily

pancreas.jpg

Credit: Irving Waxman, University of Chicago Medicine

View the original research article:

Daniel V.T. Catenacci, Christopher G. Chapman, Peng Xu, Ann Koons, Vani J. Konda, Uzma D. Siddiqui, Irving Waxman. Acquisition of Portal Venous Circulating Tumor Cells From Patients With Pancreaticobiliary Cancers by Endoscopic Ultrasound.Gastroenterology, 2015; DOI: 10.1053/j.gastro.2015.08.050

UK researchers improve ovarian cancer detection test

Measuring changes in the level of a protein in the blood detects more cases of ovarian cancer than a single measurement on its own, according to the research team behind a large screening trial.

The new method, detailed in the Journal of Clinical Oncology, appears to be able to detect twice as many women with the disease than existing techniques, and could ultimately lead to routine ovarian screening.

But experts cautioned that the overall results of the trial need analysing before they will know for sure whether screening can reduce deaths from ovarian cancer.

Levels of the CA125 protein have long been used to test for ovarian cancer, but converting this knowledge into a reliable screening test has proved elusive.

The team, led by researchers at University College London (UCL), developed a calculation of ovarian cancer risk based on changing levels of the protein in women’s blood.

They used the method on samples taken from women on the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) – a 14-year-long trial of more than 200,000 UK women.

The test correctly identified more than eight out of 10 (86 per cent) women with ovarian cancer.

The conventional test, which relies on a fixed cut-off point for CA125 levels to detect the disease, generally only identifies about four in 10 women, the researchers say.

Reference: Risk Algorithm Using Serial Biomarker Measurements Doubles the Number of Screen-Detected Cancers Compared With a Single-Threshold Rule in the United Kingdom Collaborative Trial of Ovarian Cancer Screening  Journal of Clinical Oncology Published online before print May 11, 2015

Urine test could lead to better treatment of bladder cancer

Researchers at the University of Birmingham believe that a simple urine test could help to guide clinicians in the treatment of bladder cancer patients. Being able to reliably identify those patients with the most aggressive cancers early via urine tests, and expediting aggressive therapeutic strategies, may significantly improve outcomes. The scientists believe that the validation of two urinary biomarkers could spell a new way of tailoring treatment. Patient management has changed little over the last three decades, so it is hoped that this research, published in British Journal of Cancer, will prove to be a step forward for the field with a view to providing improved care for each patient.

Link to the research: Bryan, R.T et al. Protein shedding in urothelial bladder cancer: prognostic implications of soluble urinary EGFR and EpCAM.  British Journal of Cancer Advance online Feb 2015

‘Targeted’ biopsy could better identify aggressive prostate cancers

An experimental biopsy procedure appears to be more effective than the current tests in identifying ‘high-risk’ prostate cancers, according to a US clinical trial. If confirmed in larger studies, the results could lead to fewer men subsequently having more invasive tests that they may not need. ‘Targeted’ biopsies use a combination of ultrasound and MRI scans to try to ensure a more accurate sample, compared with the current biopsy method.

Link to the research: Siddiqui, M., et al. (2015). Comparison of MR/Ultrasound Fusion–Guided Biopsy With Ultrasound-Guided Biopsy for the Diagnosis of Prostate Cancer JAMA, 313 (4)

‘Liquid biopsies’ could help spot genetic faults in lung cancer

Blood samples could offer an alternative to tumour biopsies in lung cancer patients, according to European researchers. Experts believe the findings could aid future research by overcoming the difficulty of accessing some tumour samples.

The researchers analysed blood samples from patients with advanced non-small-cell lung cancer and looked for ‘circulating free DNA’ – bits of DNA shed from tumour cells that can be isolated from the blood. They found that the tumour DNA present in blood samples could be used to identify different types of tumour-causing genetic faults in a gene called EGFR.

Link to the research: Karachaliou N. et al. (2015). Association of EGFR L858R Mutation in Circulating Free DNA With Survival in the EURTAC Trial, JAMA Oncology.