Reduction in breast cancer deaths is due to treatment not screening, finds study

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The fall in breast cancer mortality seen after widespread mammography screening was introduced in the US was mainly due to improved systemic therapy and not earlier detection of tumours, a comparison of national cancer data before and after the introduction of screening programmes has shown.

Combined HRT may raise breast cancer risk, study finds

Women taking combined hormone replacement therapy (HRT) are 2.7 times more likely to develop breast cancer than non-users, and the risk may increase with longer use, a study published in the British Journal of Cancer has found.

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The researchers, from the Institute of Cancer Research in London, said that previous studies may have substantially underestimated the risk of breast cancer from combined HRT, as they did not update information about a woman’s HRT use or analyse accurately to allow for her age at menopause.

The new research was part of the Breast Cancer Now Generations Study, which is following more than 100 000 women for 40 years to investigate the causes of breast cancer.

Frozen tissue service offers fertility hope to young people with cancer

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Scientists at Edinburgh University have developed a service to store testicular tissue from boys as young as 1 who are at risk of infertility because of cancer treatment. In future boys as well as girls might be able to have their fertility restored subsequent to chemotherapy.

The announcement comes after the birth of the first UK baby to be born after his mother had a transplant of her own, previously frozen, ovary tissue.

Review of Cancer Drugs Funds list leads to changes

The Cancer Drugs Fund (CDF) has today completed a further review of the effectiveness of treatments it funds to ensure it delivers the best outcomes for patients. The fund will no longer pay for 16 medicines used to treat a variety of cancers, including breast prostate and pancreatic cancer.

An update on the list can be found here

BBC Health News also recently reported the changes, read the news item here

The decision summaries can be found on NHS England website 

Long term NSAIDs are associated with lower colorectal cancer risk, study shows

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Taking low dose aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) continuously in the long term is associated with a lower risk of colorectal cancer, a Danish case-control study has shown.

The study, published in the Annals of Internal Medicine, analysed data on drug use, comorbid conditions, and history of colonoscopy from Danish prescription and patient registries.

NICE Guideline updated to support GP’s and help diagnose cancer faster

NICE

NICE has updated and redesigned its guideline to support GP’s in recognising the signs and symptoms of 37 different cancers and to aid faster referral  for the right tests.

The guideline focuses on the symptoms that a patient might experience and present with in surgeries. It should enable GP’s to monitor people presenting with less severe symptoms, so that fewer cancers are missed.

NICE hope that the guideline will make its recommendations easier for GP’s to use, speeding  up the referral process and make diagnosis quicker.

Find the NICE Guideline: NG12 Suspected Cancer : Recognition and Referral 

Read the full story here

Women are four times less likely to have curative surgery if breast cancer is diagnosed as emergency rather than urgent GP referral

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Women with breast cancer are four times less likely to have potentially curative surgery if their condition is diagnosed as an emergency rather than through an urgent GP referral, a report from Public Health England and Cancer Research UK has shown.

On a national level the report looked at how treatment varies in different cancers, depending on the patient’s route to diagnosis.

Experts call for tobacco industry to pay for smoking cessation work

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The tobacco industry should be forced to pay towards smoking cessation efforts in England as part of a new national tobacco control strategy, a multi-agency report has claimed.

Experts have called for a national annual levy on tobacco companies, fresh targets such as a drop in smoking rates to 5% by 2035, a new five year government tobacco strategy for England, and an increase to the tax escalator on tobacco products to 5% above the level of inflation.

Stand during working day to prevent health risks of sedentary jobs, says guidance

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People whose jobs are predominantly desk based should be encouraged to stand up and walk about for at least two hours during each working day, says the first UK guidance developed to reduce the health risks of prolonged sitting at work.

Growing evidence has shown links between a sedentary lifestyle and an increased risk of cardiovascular disease, diabetes, and some cancers. To help reduce this risk Public Health England and a UK community interest company, Active Working, asked an international group of experts in the field to review the available evidence and develop guidelines for employers to promote avoidance of prolonged periods of sedentary work

Diagnosis and treatment of cancer using genomics

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The field of cancer diagnostics is in constant flux as a result of the rapid discovery of new genes associated with cancer, improvements in laboratory techniques for identifying disease causing events, and novel analytic methods that enable the integration of many different types of data. These advances have helped in the identification of novel, informative biomarkers

Terminally ill patients could benefit from stopping statins, study says

Discontinuing treatment with statins in patients with terminal illnesses is safe, could improve quality of life, and could reduce costs, US research published in JAMA Internal Medicine concludes.

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The pragmatic randomized trial looked at 381 patients with a mean age of 74.1 years. Half of the patients had cancer, and all had an estimated life expectancy of between one month and one year. The patients had been taking prescribed statins for three months or more for primary or secondary prevention of cardiovascular disease but had no recent active cardiovascular disease

Vegetarians have lower risk of colon cancers, study finds

thebmj_logoVegetarian diets are associated with an overall lower incidence of colorectal cancers, a large prospective cohort trial has found.

The US study, published online by JAMA Internal Medicine, included 77 659 men and women who were assessed by a food frequency questionnaire and categorised into four vegetarian groups (vegan, lacto-ovo vegetarian, pesco-vegetarian, and semi-vegetarian) or a non-vegetarian group. During a mean follow-up of 7.3 years 380 cases of colon cancer and 110 cases of rectal cancer were recorded.

Compassion in care campaign hits new milestone

hello-my-name-is-logo-web-smallNHS England’s Chief Nursing Officer (CNO) Jane Cummings has praised the “Hello My Name Is…” campaign started by terminally ill Dr Kate Granger.

 

The CNO spoke out as it was revealed that more than 100 NHS organisations have now signed up to the social media campaign launched by the 31-year-old hospital consultant.

Dr Granger started it as a way of encouraging healthcare professionals to introduce themselves while she has been treated for cancer.

She felt frustrated by staff who failed to tell her their names.

 

News from Health Technology Assessments

NHS patients will benefit from £20 million investment into surgical research

Patients will benefit from £20 million funding into research on new cutting-edge surgical techniques, the President of the Royal College of Surgeons (RCS) has said. Ten of these projects have been funded by the NIHR HTA Programme. These include a project looking at total ankle replacement versus ankle arthrodesis and bypass versus angioplasty in severe ischaemia of the leg. [more…]

Intraoperative Radiation for Breast Cancer Study in The Lancet

The five year results of an NIHR HTA-funded study, on targeted intraoperative radiotherapy (TARGIT) for patients with breast cancer, have been published in The Lancet. [more…]

NIHR launches “Focus on Stroke” as ground-breaking stroke trial opens in the UK

EuroHYP-1, the largest worldwide clinical trial of a new revolutionary stroke treatment called Therapeutic Hypothermia, is due to open in the UK. The study is just one of those featured on “Focus on Stroke”, a new online resource from the NIHR aimed at raising public awareness of the exciting developments happening in stroke research. [more…]

The Kings Fund: Acute oncology on the acute medical unit

This toolkit aims to improve the care of cancer patients admitted to hospital as an emergency with medical problems due to their cancer or their treatment. It stresses the importance of patients having access to cancer specialists as soon as possible, and suggests that NHS trusts set up acute oncology services, which can work with the team in the acute medical unit to help in the management of patients with acute oncology problems.

BMJ Editorials: September 2013

What to do about unsafe medicines?         Gillian J Buckley, Jim E Riviere, and Lawrence O Gostin
The word “cancer”: how language can corrupt thought BK Dunn, Sudhir Srivastava, and Barnett S Kramer
Secondary prevention of venous thromboembolism      Sam Schulman and James Douketis

Latest modules from BMJ Learning: communication skills

Extract from BMJ Learning

Many symptoms of cancer are non-specific, which makes diagnosis difficult. Cancers in childhood are rare and there are also potential barriers to communication during consultations. These are just some of the problems in this field – this module will help you overcome them. It highlights the potential difficulties with diagnosing children and young people with osteosarcomas and brain tumours, outlines red flag symptoms, and suggests approaches to addressing potential barriers to communication. See the link below.

bmj learningDiagnosing osteosarcomas and brain tumours in children: communication skills – in association with the Department of Health

Also in this week’s edition are some modules on ENT disorders. They give an important update on a range of common dilemmas.

Ear discharge: diagnosis and treatment

Hoarseness: diagnostic picture tests

Nasal symptoms: diagnostic picture tests

The tympanic membrane: diagnostic picture tests

Neck lumps: diagnostic picture tests

European Radiology, July 2012; Imaging vascular function for early stage clinical trials …

Imaging vascular function for early stage clinical trials using dynamic contrast-enhanced magnetic resonance imaging
Citation: European Radiology, July 2012, vol./is. 22/7(1451-1464), 0938-7994;1432-1084 (July 2012)
Author(s): Leach M.O.; Morgan B.; Tofts P.S.; Buckley D.L.; Huang W.; Horsfield M.A.; Chenevert T.L.; Collins D.J.; Jackson A.; Lomas D.; Whitcher B.; Clarke L.; Plummer R.; Judson I.; Jones R.; Alonzi R.; Brunner T.; Koh D.M.; Murphy P.; Waterton J.C.; Parker G.; Graves M.J.; Scheenen T.W.J.; Redpath T.W.; Orton M.; Karczmar G.; Huisman H.; Barentsz J.; Padhani A.

Abstract: Many therapeutic approaches to cancer affect the tumour vasculature, either indirectly or as a direct target. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has become an important means of investigating this action, both pre-clinically and in early stage clinical trials. For such trials, it is essential that the measurement process (i.e. image acquisition and analysis) can be performed effectively and with consistency among contributing centres. As the technique continues to develop in order to provide potential improvements in sensitivity and physiological relevance, there is considerable scope for between-centre variation in techniques. A workshop was convened by the Imaging Committee of the Experimental Cancer Medicine Centres (ECMC) to review the current status of DCEMRI and to provide recommendations on how the technique can best be used for early stage trials. This review and the consequent recommendations are summarised here. Key Points Tumour vascular function is key to tumour development and treatment Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can assess tumour vascular function Thus DCE-MRI with pharmacokinetic models can assess novel treatments Many recent developments are advancing the accuracy of and information from DCE-MRI Establishing common methodology across multiple centres is challenging and requires accepted guidelines.

European Society of Radiology 2012.

Publication Type: Journal: Article
Source: EMBASE

BMJ Learning: 14 January 2013

This module will help you support patients who have a diagnosis of cancer, especially after they have finished their primary treatment in hospital. It will also provide information and guidance about what you should cover in the cancer care review.

Additional modules include:

Future event: Cervical Cancer

20 – 26 January 2013 is Cervical Cancer Prevention Week (CCPW). CCPW is a European wide initiative led by the European Cervical Cancer Association and Jo’s Cervical Cancer Trust take the lead role in promoting the week in the UK. “Prevention Week will focus on all things relating to cervical cancer including information about symptoms and causes of the disease, ways to prevent it and support us.

As you will be aware cervical cancer is a preventable disease yet the charity supports too many women diagnosed because they delayed or ignored their cervical screening invitation and we are greatly concerned that uptake is getting worse. In addition to raising awareness about prevention we will also be highlighting cervical cancer symptoms based on data from a survey we ran to women diagnosed with the disease that showed a high percentage were not aware that their symptoms were related to cervical cancer. As a result we will be launching a new poster which will help increase awareness of symptoms. “