scholarly journals Straight-to-test for the two-week-wait colorectal cancer pathway under the updated NICE guidelines reduces time to cancer diagnosis and treatment

2019 ◽  
Vol 101 (5) ◽  
pp. 333-339 ◽  
Author(s):  
J Christopher ◽  
TR Flint ◽  
H Ahmed ◽  
N Dhir ◽  
R Li ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Median Time ◽  
Cancer Diagnosis ◽  
Gastrointestinal Cancer ◽  
Retrospective Cohort ◽  
Test Protocol ◽  
Nice Guidelines ◽  
Referral Criteria ◽  
The Impact ◽  
Considerable Resource

Introduction The 2015 National Institute for Health and Care Excellence guidelines widened the referral criteria for the two-week-wait pathway for suspected lower gastrointestinal cancer. We implemented a straight-to-test protocol to accommodate the anticipated increase in referrals. We evaluated the impact of these changes for relevant pathway metrics and clinical outcomes using a retrospective cohort study with historic controls. Materials and methods We analysed data from all patients referred to a teaching hospital via the two-week-wait pathway for suspected lower gastrointestinal cancer under the previous guidelines between 1 March and 31 August 2015 compared with the same period in 2016, when the updated guidelines and straight-to-test protocol had been implemented. Results In the 2015 cohort, there were 64 cancer diagnoses from 664 referrals (9.6% pick-up) compared with 58 cancer diagnoses from 954 referrals in the 2016 cohort (6.1% pick-up). Our straight-to-test protocol reduced the median time to cancer diagnosis by 12.5 days (P < 0.001) and reduced the median time to cancer treatment by 7.5 days (P < 0.05) An increased proportion of non-colorectal cancers were diagnosed in 2016 compared with 2015, (37.9% vs 17.2%, P < 0.05) and more adenomas were removed in 2016 compared with 2015 (377 vs 193). Discussion and conclusion Our straight-to-test protocol has resulted in a reduction in times to cancer diagnosis and cancer treatment, despite an increase in the number of referrals. The new referral criteria have considerable resource implications, but their implementation did not result in an increase in the total number of cancers diagnosed.

scholarly journals Understanding the Prevalence of Prediabetes and Diabetes in Patients With Cancer in Clinical Practice: A Real-World Cohort Study

2021 ◽  
Vol 19 (6) ◽  
pp. 709-718
Author(s):  
Dominik J. Ose ◽  
Richard Viskochil ◽  
Andreana N. Holowatyj ◽  
Mikaela Larson ◽  
Dalton Wilson ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cancer Treatment ◽  
Cancer Diagnosis ◽  
Interprofessional Collaboration ◽  
University Of Utah ◽  
Patients With Cancer ◽  
Care Protocol ◽  
Total Cancer ◽  
One Year ◽  
The Impact

Background: This study aimed to understand the prevalence of prediabetes (preDM) and diabetes mellitus (DM) in patients with cancer overall and by tumor site, cancer treatment, and time point in the cancer continuum. Methods: This cohort study was conducted at Huntsman Cancer Institute at the University of Utah. Patients with a first primary invasive cancer enrolled in the Total Cancer Care protocol between July 2016 and July 2018 were eligible. Prevalence of preDM and DM was based on ICD code, laboratory tests for hemoglobin A1c, fasting plasma glucose, nonfasting blood glucose, or insulin prescription. Results: The final cohort comprised 3,512 patients with cancer, with a mean age of 57.8 years at cancer diagnosis. Of all patients, 49.1% (n=1,724) were female. At cancer diagnosis, the prevalence of preDM and DM was 6.0% (95% CI, 5.3%–6.8%) and 12.2% (95% CI, 11.2%–13.3%), respectively. One year after diagnosis the prevalence was 16.6% (95% CI, 15.4%–17.9%) and 25.0% (95% CI, 23.6%–26.4%), respectively. At the end of the observation period, the prevalence of preDM and DM was 21.2% (95% CI, 19.9%–22.6%) and 32.6% (95% CI, 31.1%–34.2%), respectively. Patients with myeloma (39.2%; 95% CI, 32.6%–46.2%) had the highest prevalence of preDM, and those with pancreatic cancer had the highest prevalence of DM (65.1%; 95% CI, 57.0%–72.3%). Patients who underwent chemotherapy, radiotherapy, or immunotherapy had a higher prevalence of preDM and DM compared with those who did not undergo these therapies. Conclusions: Every second patient with cancer experiences preDM or DM. It is essential to foster interprofessional collaboration and to develop evidence-based practice guidelines. A better understanding of the impact of cancer treatment on the development of preDM and DM remains critical.

scholarly journals Persistent Unilateral Sore Throat: Should It Be Included in the 2-Week Wait Referral Criteria by NICE

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Ahmed Allam ◽  
Hazem Nijim
Keyword(s):  
Retrospective Study ◽  
Head And Neck ◽  
Sore Throat ◽  
Sensitivity And Specificity ◽  
Cancer Diagnosis ◽  
High Rate ◽  
Nice Guidelines ◽  
Referral Criteria ◽  
Sensitivity Specificity

Design and Setting. A retrospective study was conducted on all 2WW referrals made to our tertiary head and neck centre in a 12-month period. Methods. Sensitivity, specificity, and PPV of presenting complaints in H&N cancer diagnosis using Excel® and the statistical package SPSS®. Results. The sensitivity and specificity of 2005 NICE guidelines in detecting H&N cancers were 91.2% and 59%, respectively; their PPV was 9%. The sensitivity and specificity of 2015 NICE guidelines were 75.4% and 71%, respectively; their PPV was 10.3%. Eight out of 85 patients who presented with unilateral sore throat for more than 4 weeks, with or without otalgia and normal otoscopy, had H&N cancer (PPV 9.5%). Conclusions. Although the 2015 NICE guidelines have a high rate in detecting H&N cancers, consideration of reincluding unilateral sore throat in the referral criteria might be necessary.

scholarly journals Tackling Health System Delays for Cancer Patients in LMICs: An Innovative Multicomponent Programmatic Intervention in Botswana

2016 ◽  
Vol 2 (3_suppl) ◽  
pp. 41s-42s ◽  
Author(s):  
Neo M. Tapela ◽  
Malebogo Pusoentsi ◽  
Kerapetse Botebele ◽  
Michael Peluso ◽  
Isaac Nkele ◽  
...  
Keyword(s):  
Health System ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Median Time ◽  
Conflicts Of Interest ◽  
Local Health ◽  
Care Coordinator ◽  
Bayer Healthcare ◽  
The Impact

Abstract 67 Background: Health system delays are a major contributor to poor outcomes among cancer patients in low- and middle-income countries (LMICs). In Botswana, while median time from cancer-related symptom onset to first presentation at local health facility is 29 days, median time to initiation of cancer treatment is 401 days. Challenges to timely diagnosis and care include clinicians' lack of knowledge, limited diagnostic capacity, poor coordination between facilities, and socioeconomic barriers of patients that impede follow-up. We sought to develop an intervention to improve access to prompt cancer care. Methods: Participating facilities are all public health facilities (21 health posts, 14 clinics, 2 hospitals) in Botswana's Kweneng-East district as well as the national referral hospital. The five components of intervention are a) training of clinicians at primary facilities on evaluation of patients with suspected cancer, b) implementation of a standardized referral algorithm for cancer suspects, c) introduction of care-coordinator role to support patient and clinician navigation of the health system, d) use of SMS-based platform to support follow-up, e) provision of transport support for vulnerable patients. The primary endpoints are stage at cancer diagnosis and time from initial presentation to initiation of cancer treatment. Evaluation of the intervention's impact will include comparing endpoints following intervention with those at baseline and those among patients residing outside the Kweneng-East district. Results: Implementation of the above multi-component intervention will be presented, including a standardized algorithm to guide the evaluation, triage and referral of patients, an intensive one-day didactic training program that adapts curricula employed in the region, and the impact of training on knowledge. Conclusion: In conducting this study, we hope to identify effective program-based measures to reduce delays and improve cancer outcomes in Botswana. These measures may be scaled to other districts, and may be applicable to similar settings in the region. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: Neo M. Tapela No relationship to disclose Malebogo Pusoentsi No relationship to disclose Kerapetse Botebele No relationship to disclose Michael Peluso No relationship to disclose Isaac Nkele No relationship to disclose Jason Efstathiou Honoraria: Medivation/Astellas, Bayer Healthcare Pharmaceuticals Consulting or Advisory Role: Medivation/Astellas, Bayer Healthcare Pharmaceuticals Tomer Barak No relationship to disclose Scott Dryden-Peterson No relationship to disclose

Old Tyrosine Kinase Inhibitors and Newcomers in Gastrointestinal Cancer Treatment

2016 ◽  
Vol 16 (2) ◽  
pp. 175-185 ◽  
Author(s):  
Giordani Erika ◽  
Zoratto Federica ◽  
Strudel Martina ◽  
Papa Anselmo ◽  
Rossi Luigi ◽  
...  
Keyword(s):  
Tyrosine Kinase ◽  
Cancer Treatment ◽  
Tyrosine Kinase Inhibitors ◽  
Gastrointestinal Cancer ◽  
Kinase Inhibitors

Recent Advances of Silver Nanoparticles in Cancer Diagnosis and Treatment

2020 ◽  
Vol 20 (11) ◽  
pp. 1276-1287 ◽  
Author(s):  
Tran Q. Huy ◽  
Pham T.M. Huyen ◽  
Anh-Tuan Le ◽  
Matteo Tonezzer
Keyword(s):  
Silver Nanoparticles ◽  
Cancer Treatment ◽  
Cancer Diagnosis ◽  
Essential Role ◽  
Review Paper ◽  
Diagnosis And Treatment ◽  
Antimicrobial Material ◽  
Pathogenic Agents ◽  
New Generation ◽  
Carrier Systems

Background: Silver nanoparticles (AgNPs) are well-known as a promising antimicrobial material; they have been widely used in many commercial products against pathogenic agents. Despite a growing concern regarding the cytotoxicity, AgNPs still have attracted considerable interest worldwide to develop a new generation of diagnostic tool and effective treatment solution for cancer cells. Objective: This paper aims to review the advances of AgNPs applied for cancer diagnosis and treatment. Methods: The database has been collected, screened and analysed through up-to-date scientific articles published from 2007 to May 2019 in peer-reviewed international journals. Results: The findings of the database have been analysed and divided into three parts of the text that deal with AgNPs in cancer diagnosis, their cytotoxicity, and the role as carrier systems for cancer treatment. Thanks to their optical properties, high conductivity and small size, AgNPs have been demonstrated to play an essential role in enhancing signals and sensitivity in various biosensing platforms. Furthermore, AgNPs also can be used directly or developed as a drug delivery system for cancer treatment. Conclusion: The review paper will help readers understand more clearly and systematically the role and advances of AgNPs in cancer diagnosis and treatment.

scholarly journals First Attempts of the Use of 195Pt NMR of Phenylbenzothiazole Complexes as Spectroscopic Technique for the Cancer Diagnosis

Molecules ◽  
2019 ◽  
Vol 24 (21) ◽  
pp. 3970 ◽  
Author(s):  
Bruna T. L. Pereira ◽  
Mateus A. Gonçalves ◽  
Daiana T. Mancini ◽  
Kamil Kuca ◽  
Teodorico C. Ramalho
Keyword(s):  
Cancer Treatment ◽  
Cancer Diagnosis ◽  
Density Functional ◽  
Chemical Shifts ◽  
Chloride Ion ◽  
Platinum Complexes ◽  
Dft Method ◽  
Ion Concentration ◽  
Implicit Solvent ◽  
Early Cancer Diagnosis

Platinum complexes have been studied for cancer treatment for several decades. Furthermore, another important platinum characteristic is related to its chemical shifts, in which some studies have shown that the 195Pt chemical shifts are very sensitive to the environment, coordination sphere, and oxidation state. Based on this relevant feature, Pt complexes can be proposed as potential probes for NMR spectroscopy, as the chemical shifts values will be different in different tissues (healthy and damaged) Therefore, in this paper, the main goal was to investigate the behavior of Pt chemical shifts in the different environments. Calculations were carried out in vacuum, implicit solvent, and inside the active site of P13K enzyme, which is related with breast cancer, using the density functional theory (DFT) method. Moreover, the investigation of platinum complexes with a selective moiety can contribute to early cancer diagnosis. Accordingly, the Pt complexes selected for this study presented a selective moiety, the 2-(4′aminophenyl)benzothiazole derivative. More specifically, two Pt complexes were used herein: One containing chlorine ligands and one containing water in place of chlorine. Some studies have shown that platinum complexes coordinated to chlorine atoms may suffer hydrolyses inside the cell due to the low chloride ion concentration. Thus, the same calculations were performed for both complexes. The results showed that both complexes presented different chemical shift values in the different proposed environments. Therefore, this paper shows that platinum complexes can be a potential probe in biological systems, and they should be studied not only for cancer treatment, but also for diagnosis.

scholarly journals The impact of lymphedema on health-related quality of life up to 10 years after breast cancer treatment

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mads G. Jørgensen ◽  
Navid M. Toyserkani ◽  
Frederik G. Hansen ◽  
Anette Bygum ◽  
Jens A. Sørensen
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Treatment ◽  
Breast Cancer Treatment ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Impact

AbstractThe impact of breast cancer-related lymphedema (BCRL) on long-term quality of life is unknown. The aim of this study was to investigate the impact of BCRL on health-related quality of life (HRQoL) up to 10 years after breast cancer treatment. This regional population-based study enrolled patients treated for breast cancer with axillary lymph node dissection between January 1st 2007 and December 31th 2017. Follow up and assessments of the included patients were conducted between January 2019 and May 2020. The study outcome was HRQoL, evaluated with the Lymphedema Functioning, Disability and Health Questionnaire, the Disabilities of the Arm, Shoulder and Hand Questionnaire and the Short Form (36) Health Survey Questionnaire. Multivariate linear logistic regression models adjusted for confounders provided mean score differences (MDs) with 95% confidence intervals in each HRQoL scale and item. This study enrolled 244 patients with BCRL and 823 patients without BCRL. Patients with BCRL had significantly poorer HRQoL than patients without BCRL in 16 out of 18 HRQoL subscales, for example, in physical function (MDs 27, 95%CI: 24; 30), mental health (MDs 24, 95%CI: 21; 27) and social role functioning (MDs 20, 95%CI: 17; 23). Age, BMI, BCRL severity, hand and dominant arm affection had only minor impact on HRQoL (MDs < 5), suggesting a high degree of inter-individual variation in coping with lymphedema. This study showed that BCRL is associated with long-term impairments in HRQoL, especially affecting the physical and psychosocial domains. Surprisingly, BCRL diagnosis rather than clinical severity drove the largest impairments in HRQoL.

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