The current thinking on colorectal cancer

2015 ◽  
Vol 101 (1) ◽  
pp. 47-54
Author(s):  
P Spreadborough ◽  
C Doran
Keyword(s):  
Colorectal Cancer ◽  
Treatment Options ◽  
Military Population ◽  
Important Condition ◽  
Common Cancer ◽  
Current Thinking ◽  
Improved Outcomes ◽  
Surgical Options ◽  
The Uk ◽  
The Military

AbstractColorectal cancer (CRC) is the fourth most common cancer in the UK and the incidence has increased over recent decades. Although only 1.5% of cases are diagnosed in those aged under 40 years, it remains an important condition to be aware of in the military population. Patients who are genetically predisposed can have a lifetime risk of 80-100% of developing CRC and are likely to develop symptoms during their service. 20% of patients will present with metastatic disease. While surgical and oncological treatments have improved outcomes, early diagnosis of CRC is essential to reducing mortality. This paper provides an overview of the aetiology, investigations and treatment options for CRC. Explanation of primary surgical options and the principles of adjuvant therapies are included to aid informed discussions with patients.

Bladder cancer

2019 ◽  
Vol 13 (6) ◽  
pp. 271-277
Author(s):  
Ian Peate
Keyword(s):  
Bladder Cancer ◽  
Treatment Options ◽  
Older Person ◽  
Multiple Choice Questions ◽  
Men And Women ◽  
Treatment Regimens ◽  
Common Cancer ◽  
The One ◽  
The Uk

This article is the one in the cancer series that discusses bladder cancer. Bladder cancer can occur in men and women; however, in the UK, there are more men with bladder cancer than women. It is also a disease of the older person. This article provides an introduction that discusses the condition. An overview of the anatomy of the bladder and ureters is provided. In 2015, bladder cancer was the 10th most common cancer in the UK and was responsible for 3% of all new cancer cases. Diagnosis and treatment options are discussed, with an emphasis on ensuring that the patient is key in any decisions that are made about treatment regimens. The importance of follow-up after treatment is also discussed. A glossary of terms is provided and five multiple-choice questions are included to enhance learning and application to practice.

Managing suspicious skin lesions on deployed operations

2018 ◽  
Vol 104 (2) ◽  
pp. 115-119
Author(s):  
T J Holland ◽  
S McIntosh ◽  
J J Smith
Keyword(s):  
Skin Cancer ◽  
Risk Stratification ◽  
Skin Lesions ◽  
Key Factors ◽  
Military Population ◽  
The Uk ◽  
The Military

AbstractThe incidence of skin cancer is rising year on year. The general risk in the military population is low, but a missed lesion may have severe consequences. This paper outlines the key factors to consider when assessing a lesion, risk stratification methods and the challenges of managing suspected malignancy when operating remote from the UK.

scholarly journals The experience of health and welfare workers in identifying and responding to domestic abuse among military personnel in the UK

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Katherine Sparrow ◽  
Filipa Alves-Costa ◽  
Ana Alves ◽  
Neil Greenberg ◽  
Louise M. Howard ◽  
...  
Keyword(s):  
Military Personnel ◽  
Emotional Abuse ◽  
Healthcare Providers ◽  
Training Needs ◽  
Military Population ◽  
Systematic Training ◽  
Private Matter ◽  
The Uk ◽  
Welfare Workers ◽  
The Military

Abstract Background Awareness of domestic violence and abuse (DVA) as a problem among military personnel (serving and veterans) has grown in recent years, and there is a need for research to inform improvements in the identification of and response to DVA in this population. This study aimed to explore the experience of health and welfare professionals in identifying and responding to DVA among the UK military population (serving personnel and veterans). Methods Thirty-five semi-structured telephone interviews were conducted with health and welfare staff who work with serving UK military personnel and veterans. Interviews were analysed using thematic analysis. Results Three superordinate themes were identified: i) patterns of DVA observed by health and welfare workers (perceived gender differences in DVA experiences and role of mental health and alcohol); (ii) barriers to identification of and response to DVA (attitudinal/knowledge-based barriers and practical barriers), and iii) resource issues (training needs and access to services). Participants discussed how factors such as a culture of hypermasculinity, under-reporting of DVA, the perception of DVA as a “private matter” among military personnel, and lack of knowledge and awareness of emotional abuse and coercive controlling behaviour as abuse constitute barriers to identification and management of DVA. Healthcare providers highlighted the need for more integrated working between civilian and military services, to increase access to support and provide effective care to both victims and perpetrators. Furthermore, healthcare and welfare staff reflected on their training needs in the screening and management of DVA to improve practice. Conclusions There is a need for increased awareness of DVA, particularly of non-physical forms of abuse, and of male victimisation in the military. Standardised protocols for DVA management and systematic training are required to promote a consistent and appropriate response to DVA. There is a particular training need among healthcare and first-line welfare staff, who are largely relied upon to identify cases of DVA in the military. Employing DVA advocates within military and civilian healthcare settings may be useful in improving DVA awareness, management and access to specialist support.

Nurse-led telephone outreach for a COVID-adapted suspected colorectal cancer pathway

2021 ◽  
Vol 19 (1) ◽  
pp. 22-26
Author(s):  
Sheila E Bell ◽  
Jill Crawford ◽  
Frances Gunn ◽  
Colin Noble ◽  
Janice Miller ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Patient Flow ◽  
Treatment Options ◽  
Ct Scanning ◽  
Healthcare Services ◽  
Flow Number ◽  
Phone Calls ◽  
Immunochemical Test ◽  
The Uk ◽  
Patient Concerns

Background: COVID-19 has brought about unprecedented challenges to healthcare services in the UK. The pandemic led to the cessation of colonoscopy and outpatient clinics. A bespoke COVID-adapted cancer pathway, using computed tomography (CT) scanning and the quantitative faecal immunochemical test (qFIT), was introduced to mitigate the risks of patients referred with potential colorectal cancer. Aims: This study aims to evaluate the workload of patient telephone calls undertaken by nurses and their impact on the operation of the pathway. Methods: Data were collected prospectively and analysed to assess the volume of patient flow, number of calls made and content of conversations. Findings: During a 2-month period, 975 patients (56.6% female, median age 63 years) were registered on the COVID-adapted cancer pathway. The 45.9% (n=448) of patients who did not return qFIT tests in a timely manner were contacted. Of these, 9.4% (n=42) requested to postpone or declined an appointment. Most were appreciative of the opportunity to clarify the rationale of the pathway and address any concerns. Conclusions: Phone calls made and received by nursing staff were helpful to discuss patient concerns and increase patients' understanding of the alternative treatment options available during the pandemic.

Service evaluation of faecal immunochemical testing introduced for use in North East London for patients at low risk of colorectal cancer

2020 ◽  
pp. jclinpath-2020-206632
Author(s):  
Ruth M Ayling ◽  
Michael Machesney
Keyword(s):  
Colorectal Cancer ◽  
Clinical Excellence ◽  
Service Evaluation ◽  
Patient Pathway ◽  
North East ◽  
Common Cancer ◽  
Nice Guidance ◽  
Education And Awareness ◽  
The Uk ◽  
Diagnostic Investigations

AimsColorectal cancer (CRC) is the fourth most common cancer in the UK. Following National Institute of Clinical Excellence (NICE) guidance for faecal immunochemical testing (FIT) (DG30), we introduced a service for the measurement of faecal haemoglobin (fHb) in symptomatic patients in line with the 2017 update of the NG12 guidance. The purpose of this study was to audit the use of FIT, focussing on the indication for request and referral for diagnostic tests as recommended in NICE guidance.MethodsTesting was rolled out after careful introduction with extensive education led by the local Cancer Alliance and reinforced by the laboratory. After 6 months, the outcomes of all patients tested were reviewed.Results1203 samples were received, of which 894 (74.3%) were suitable for analysis. Of these, 482 (53.9%) actually met the criteria for FIT analysis stipulated in our patient pathway. Eight patients were diagnosed with CRC; fHb was detectable in all and was ≥200 µg/g in seven and <10 µg/g in one. 217 patients underwent gastrointestinal investigations, and the sensitivity and specificity of FIT for CRC were found to be 87.5% (95% CI 46.6% to 99.7%) and 52.6% (95% CI 45.6% to 59.6%), respectively. Patients with anaemia were more likely to have fHb ≥10 µg/g.ConclusionsThese findings suggest benefits from the introduction of FIT in terms of more efficient use of diagnostic investigations, while revealing initial problems relating to familiarity with a new test. This merits further intervention with education and awareness programmes for Primary Care and further audit.

scholarly journals Do the UK public realise that colorectal cancer is a common cancer?

2011 ◽  
Vol 13 (2) ◽  
pp. 227-228 ◽  
Author(s):  
D. Juszczyk ◽  
A. E. Simon ◽  
J. Waller ◽  
A. J. Ramirez ◽  
J. Wardle
Keyword(s):  
Colorectal Cancer ◽  
Common Cancer ◽  
The Uk

An introduction to colonic polypectomy

2019 ◽  
Vol 17 (Sup8) ◽  
pp. S22-S27
Author(s):  
Jonathan Fawkes
Keyword(s):  
Colorectal Cancer ◽  
Screening Programme ◽  
Endoscopic Therapy ◽  
Colorectal Polyp ◽  
Bowel Cancer ◽  
Endoscopic Polypectomy ◽  
Common Cancer ◽  
Cancer Screening Programme ◽  
Bowel Cancer Screening ◽  
The Uk

Background: Colorectal cancer is the fourth most common cancer in the UK. The vast majority of colorectal cancers develop from polyps. Polypectomy is an endoscopic therapy that interrupts the sequence by which a polyp develops into cancer. Methods: A review was conducted of the published literature and clinical guidelines relevant to colonic polypectomy, with an aim to introduce basic concepts of colorectal polyp assessment and management and to describe potential complications of polypectomy. Findings: Through optical lesion assessment, it is possible to identify polyps with malignant potential. A number of techniques can be used to attempt removal, the goal of which is complete histological eradication in the safest way possible. Conclusion: Endoscopic polypectomy is a relatively safe intervention that is protective against colorectal cancer. Increasingly, nurses in the UK are being trained to perform polypectomy, particularly within the Bowel Scope service, which is part of the Bowel Cancer Screening Programme aimed at early diagnosis and removal of pre-cancerous, distal colorectal lesions.

The management of renal colic

2014 ◽  
Vol 100 (2) ◽  
pp. 179-185
Author(s):  
M Leong ◽  
S Mackie
Keyword(s):  
Abdominal Pain ◽  
Occupational Health ◽  
Renal Colic ◽  
Treatment Options ◽  
Health Issues ◽  
Military Population ◽  
Hospital Environments ◽  
The Military

AbstractRenal colic can be a challenging cause of abdominal pain in the military population. This review highlights the management of renal colic in the Royal Navy’s operational setting. It provides an overview of the diagnosis, treatment options and occupational health issues in the deployed (Role 1) and hospital environments (Role 2 and 3).

Computational Analysis of miRNA and their Gene Targets Significantly Involved in Colorectal Cancer Progression

MicroRNA ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. 68-75 ◽  
Author(s):  
Jeyalakshmi Kandhavelu ◽  
Kumar Subramanian ◽  
Amber Khan ◽  
Aadilah Omar ◽  
Paul Ruff ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Cancer Progression ◽  
Target Prediction ◽  
Computational Prediction ◽  
Initial Step ◽  
Kegg Pathways ◽  
Candidate Mirnas ◽  
Common Cancer ◽  
Colon Cancer Progression

Background:Globally, colorectal cancer (CRC) is the third most common cancer in women and the fourth most common cancer in men. Dysregulation of small non-coding miRNAs have been correlated with colon cancer progression. Since there are increasing reports of candidate miRNAs as potential biomarkers for CRC, this makes it important to explore common miRNA biomarkers for colon cancer. As computational prediction of miRNA targets is a critical initial step in identifying miRNA: mRNA target interactions for validation, we aim here to construct a potential miRNA network and its gene targets for colon cancer from previously reported candidate miRNAs, inclusive of 10 up- and 9 down-regulated miRNAs from tissues; and 10 circulatory miRNAs. </P><P> Methods: The gene targets were predicted using DIANA-microT-CDS and TarBaseV7.0 databases. Each miRNA and its targets were analyzed further for colon cancer hotspot genes, whereupon DAVID analysis and mirPath were used for KEGG pathway analysis.Results:We have predicted 874 and 157 gene targets for tissue and serum specific miRNA candidates, respectively. The enrichment of miRNA revealed that particularly hsa-miR-424-5p, hsa-miR-96-5p, hsa-miR-1290, hsa-miR-224, hsa-miR-133a and has-miR-363-3p present possible targets for colon cancer hallmark genes, including BRAF, KRAS, EGFR, APC, amongst others. DAVID analysis of miRNA and associated gene targets revealed the KEGG pathways most related to cancer and colon cancer. Similar results were observed in mirPath analysis. A new insight gained in the colon cancer network pathway was the association of hsa-mir-133a and hsa-mir-96-5p with the PI3K-AKT signaling pathway. In the present study, target prediction shows that while hsa-mir-424-5p has an association with mostly 10 colon cancer hallmark genes, only their associations with MAP2 and CCND1 have been experimentally validated.These miRNAs and their targets require further evaluation for a better understanding of their associations, ultimately with the potential to develop novel therapeutic targets.

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