Cancer Treatment Today
GPs are blamed for cancer care referral lottery
Cancer patients face a lottery over how quickly their GP will send them to a specialist or whether they will be referred at all, a report warned yesterday.
It shows a 35-fold variation in referral rates nationwide, with some patients sent to hospital unnecessarily while others never get to see a consultant at all.
The study by The King’s Fund think-tank says most GPs refer patients within the two-week deadline for suspected cancer.
But it also found many late referrals, particularly for certain cancers.
One in three patients with stomach or oesophageal cancer requiring urgent investigation were given a non-urgent referral instead, delaying their treatment.
The report said: ‘An important component of cancer referral relates to the assessment of urgency, and there is growing evidence questioning GPs’ ability to do this accurately.’
Britain has one of the lowest cancer survival rates in Europe, partly due to late diagnosis.
Evidence from cancer charities shows a quarter of cancer sufferers are being sent away by family doctors who dismiss their early warning signs as minor ailments. The King’s Fund report is based on the findings of an inquiry into general practice started by the think-tank in 2009.
An analysis of GP referral rates for suspected cancers from 51 practices in South London found wide variations. Referral rates for seeing a specialist within two weeks ranged from 0.7 to 25 per 1,000 patients, representing a 35-fold difference.
The percentage of diagnoses of cancer from these referrals also ranged from zero to 24 per cent.
The think-tank said that if the findings were replicated across England, practices that sent too many patients to see specialists – leading to a low rate of diagnosis because not many of them actually had the illness – risked creating anxiety and overburdening services.
On the other hand, GPs who did not refer enough suspected cases, which led to a high rate of diagnosis, could be leaving out patients with the disease who needed prompt specialist treatment.
Dr Laurence Buckman, of the British Medical Association’s GPs committee, said: ‘Given the increased intensity and complexity of general practice work, GPs need time off the treadmill so they can look critically at what they do and make improvements.
‘Reducing bureaucracy would help them, as would stopping the constant reorganisations within the NHS. Where GPs fall short, they need to be helped to see where they can make their service better and given the time, resources and staff support to do this.’
Chris Ham, chief executive of The King’s Fund, said: ‘Although general practice in this country remains the envy of the world, there is no room for complacency. Too many GPs remain unaware of significant variations in performance and do not give priority to improving quality.’
Health minister Lord Howe said: ‘We have a very strong system of general practice, but there is too much variation in quality.’
New brain cancer treatment closer to reality
Brain cancer often strikes suddenly, and it usually shows no mercy.
For people diagnosed with Glioblastoma, the odds are not good. Life expectancy for this deadliest form of brain cancer is about a year, but that might change if the Food and Drug Administration approves a new treatment.
It would be the first non-chemical treatment for brain cancer. That would mean no radiation and no chemotherapy. It’s undergoing clinical testing at the Swedish Neuroscience Institute in Seattle.
Doctor John Henson says the treatment consists of bombarding the tumors with focused electricity. Patients wear hats with electrodes inside that have shown signs of preventing cancer cells from dividing.
“If we can inhibit cell division within the tumor, then that will cause the tumor to stop growing or perhaps even make it shrink,” he said.
Dellann Elliott went before a Food and Drug Administration panel last week asking that this new treatment be approved.
Glioblastoma took her husband Chris nine years ago, and she’s been fighting ever since for increased funding for research and new and better treatments.
“I feel like I just jumped across the Grand Canyon for brain tumor patients,” she said after that panel approved the treatment and sent it to the FDA for the final OK.
“There have only been three approved chemo’s in the last 35 years for brain cancer,” Elliott said. “When you look at that and see a new option that is completely safe and has a higher quality of life versus chemo, you know my message to the FDA panel was ‘Why would you not approve this?'”
Elliott said it doesn’t have the side effects and sickness associated with the current treatments for brain cancer. The only thing patients complain of, she said, is that their heads get warm.
Dr. Henson is excited to potentially have another option for treating patients because there are so few choices.
“After one episode of progressive disease, we run out of effective treatment options,” he said. “This is a completely new angle of attack, if you will, on the tumor.” It might make living with Glioblastoma manageable or even increase the odds or length of survival.
The FDA is expected to announce its decision on this new brain cancer treatment in a few months.
Jason Bargwanna hands drive to `inspiring’ Jason Richards
The Holden driver will take time out from cancer treatment to return to the track in an inspirational outing.
Richards will drive Team BOC’s second car alongside Jason Bright after Jason Bargwanna agreed to step aside to give the sick Kiwi a spirit-lifting ride as he prepares to head to the United States for experimental medical treatment.
The V8 world is rallying behind the talented driver following the revelation that Richards is battling a rare form of stomach cancer.
Doctors have been unable to fight the tumour with chemotherapy and he will fly to Michigan in early April.
Richards last week won a development series race at Adelaide’s Clipsal 500 and says the return to racing was “like therapy”.
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“Team BOC’s cars have been doing extremely well recently so it’s hard to sit on the couch and watch,” Richards said.
“I can’t wait to get back racing with my team, who have been so supportive through everything, and having the test run in a Fujitsu V8 Supercar last week was a good indication that I am physically able to do it. Having said that, this is definitely not my comeback; it was a last-minute deal.
“Bargs has been very generous. I know very well how hard it is for a racecar driver to step away from a seat, and I’m grateful.” Bargwanna has been inspired by Richards’s battle and didn’t think twice about giving away the drive.
“I have taken inspiration from JR and his strength and character throughout these past few months,” Bargwanna said. “And if holding the stopwatch for the weekend at the AGP helps him in this battle then it’s a pleasure to do so.”
Breast Cancer Can Be Treated – Seek Early Medical Care
The World Health Organisation (WHO) research unit on cancer, GLOBOCAN, ranks Ghana as the 10th in Africa with the breast cancer burden.
In 2002, GLOBOCAN reported that the top 10 causes of cancer mortality in descending order in females in Ghana were cervix, breast, liver, haematopoietic organs, stomach, colorectal, ovary, bladder, pancreas and Kaposi sarcoma.
The word ‘cancer’ evokes desperation that stirs grief and pain; a scourge that strains intellectual, social and emotional resources.
Statistics from the World Health Organisation (WHO) indicate that there are over 20 million people living with cancer in the world today, with the majority in the developing world.
According to medical experts, cancer, which is the term used for diseases in which abnormal cells divide without control and invade other tissues, is one of the killer diseases that afflict men and women.
Each cancer is thought to first start from one abnormal cell. What seems to happen is that certain vital genes which control how cells divide and multiply are damaged or altered. This makes the cell abnormal. If the abnormal cell survives, it may multiply “out of control” into a malignant tumour, which consists of cancer cells that have the ability to spread beyond the original area.
It is for this reason that the President of Breast Care International (BCI), Dr Beatrice Wiafe-Adae, has called for a concerted effort and intensive education to highlight the worldwide growing breast cancer crisis and its effect on women in particular.
She said it was necessary to demystify breast cancer to disabuse the minds of patients of the fear, misconception and myths surrounding the disease and encourage women to go for regular, medical examination of their breasts.
Dr Wiafe-Adae, who is a breast cancer specialist and surgeon in charge of the Peace and Love Hospitals at Kumasi and Accra, said the cause of the disease was unknown but women with breast cancer-positive family histories should have regular breast examinations and mammograms (breast x-ray), since they are at risk.
Just being a woman makes one at risk from breast cancer. Other risk factors are having a long menstrual cycle, women who never had children and women who have a history of lumps in their breasts.
However, being free from these factors does not mean a woman is free from getting breast cancer.
At the media launch of the Susan G. Komen Ghana Race Dr Wiafe-Addae said some myths about breast cancer in Ghana were that the disease was incurable and sometimes attributed to witchcraft, or the result of a curse in the family, and worst of all, disease sufferers face stigmatisation.
The Susan G. Komen Race for the cure series began 28 years ago in Dallas, Texas and is now recognised as the most successful campaign worldwide targeting the mobilisation and awareness of the general public with regard to breast cancer.
Since the first race that attracted 800 participants, it has now extended to annual races that attract more than 1.5 million participants and more than 100,000 volunteers.
The Ghanaian race for the cure of breast cancer, which will take place on June 25, African Union Day, is expected to attract between 5,000 and 10,000 young and old people who will walk to raise awareness for the cure of breast cancer.
It is widely known that breast cancer can be treated if reported early and doctors maintain that cancers need multi-disciplinary treatment and various specialists. However, if left untreated, it may spread and destroy surrounding tissues.
Given the complex nature of the disease, early detection of cancer is crucial for effective treatment and such detection is almost impossible without the requisite equipment and trained personnel.
Doctors contend that irrespective of the type of cancer a patient develops, he or she may need one of the following processes — surgery, chemotherapy, radiotherapy and hormonal therapy — and usually patients who have prostate and breast cancers undergo hormonal therapy.
Ghana received a boost to enhance the care and treatment of cancer cases in the country, when in April last year, the government secured a $13.5 million loan from the OPEC Fund and the Arab Bank for Economic Development in Africa to upgrade and expand the radiotherapy centres at the Korle Bu and Komfo Anokye Teaching hospitals in Accra and Kumasi respectively.