Tag: cancer treatment

Speeding up cancer diagnoses in Scotland

Report shows impact of Scotland’s first fast-track cancer diagnostic services

More than one in ten patients seen by new cancer diagnostic services have been referred for cancer treatment, helping to speed up treatment and improve outcomes. Patients waited an average of 14 days from referral, to having cancer ruled in or out.

An evaluation report into Scotland’s first Rapid Cancer Diagnostic Services (RCDS), published by the University of Strathclyde and the Centre for Sustainable Delivery (CfSD), found 11.9% of patients seen over the two year period were diagnosed with cancer. Around 6% were given a pre-cancer diagnosis, meaning they require further monitoring in case a cancer develops, and the remainder were either given the all clear and referred back to primary care or diagnosed with other non-cancer conditions (41.1% and 40.7% respectively).

The Rapid Cancer Diagnostic Services, currently in place across five Health Board areas, were established to help speed up cancer diagnoses for patients with non-specific symptoms such as unexplained weight loss, persistent nausea or fatigue, where the GP has a concern of a malignancy. Over the two-year evaluation period the services saw 2,489 patients, with more than 96% of them giving the service a positive satisfaction rating of eight out of 10 or more.

The report highlighted that the model delivers a quality service at speed, is cost effective, compared to previous pathways, and highly valued by patients and staff. Positive patient experience is attributed to the speed of referral, reduction in waiting times for diagnostic tests, having a single point of contact and enhanced information and communication throughout the RCDS pathway.

Visiting NHS Lanarkshire’s RCDS at University Hospital Wishaw, Health Secretary Neil Gray said: “Improving cancer services is a priority for the Scottish Government, as set out in our 10-year strategy published last year.

“This positive evaluation of Scotland’s Rapid Cancer Diagnostic Service provides valuable insight into their role in achieving vital earlier cancer diagnoses and improving patient care.

“RCDSs reflect our commitment to enhancing equitable cancer services across NHS Scotland – this report has shown the pivotal role they can play in early cancer detection while delivering quality patient-centred care. As Scotland’s cancer care continues to evolve, RCDSs stand as an essential component in improving outcomes.”

Professor Robert van der Meer, Co-Lead Author of the RCDS Evaluation, University of Strathclyde: “Scotland’s Rapid Cancer Diagnostic Services (RCDS) are working well. They’re achieving what they set out to do – find cancer – while delivering a high standard of quality care at speed.

“RCDS patients are complex and the specialist input that the RCDS can offer them, and concerned primary care clinicians, marks a gear-change in how we diagnose cancer in Scotland. RCDSs should be used as an exemplar for cancer care with learning embedded across all pathways.”

Mr Martin Downey, NHS Lanarkshire Rapid Cancer Diagnostic Service Clinical Lead and Associate Medical Director for Access, said: “The Rapid Cancer Diagnostic Service offers a timely, often one-stop, environment for clinically complex patients with potentially serious non-specific symptoms suspicious of cancer, such as weight loss, fatigue, nausea and abdominal pain. 

“These patients typically did not meet the criteria for existing cancer pathways and the service makes a positive difference to these patients, providing rapid patient centred assessment, diagnosis and coordination of ongoing care.”

To see the full report, please follow this link.

Groundbreaking research could revolutionise bowel cancer treatment

New research led by a team of scientists from Queen’s University Belfast and the Cancer Research UK (CRUK) Scotland Institute in Glasgow have made a series of groundbreaking discoveries into tumour biology that may be used to deliver a more effective personalised medicine approach for patients with bowel (colorectal) cancer.

Bowel cancer is the fourth most common cancer in the UK, with around 42,900 new bowel cancer cases and around 16,600 bowel cancer deaths in the UK every year, a statistic that highlights the need for new ways to treat patients with this aggressive disease.

The new study, funded by Cancer Research UK and published today in the prestigious journal Nature Genetics, used a unique and innovative approach developed in Belfast, to identify a set of previously unseen molecular patterns in tumour tissue that provides new information related to treatment response and risk of disease progression.

These remarkable results mean that clinicians and scientists can now draw more information from a patient’s tumour tissue which may lead to better treatment options.

Previously, the most common approach for identifying groups of tumours based on their biological signalling, known as molecular subtyping, used information about how active individual genes are within tumour tissue.

The subtypes identified using this method have shaped understanding of cancer development, progression and response to therapy over the last decade and served as the basis for numerous clinical trials and pre-clinical studies.

Dr Philip Dunne, Reader in Molecular Pathology from the Patrick G Johnston Centre for Cancer Research at Queen’s University Belfast and senior author of the study, explains: “While looking at patterns across individual genes has revealed remarkable insights into cancer signalling, advances in laboratory research over the last decade have shown that assessing activity in groups of closely related genes in combination can provide new understanding that isn’t apparent when using the traditional single gene approaches.”

Given the potential value of this new pathway approach, researchers from Queen’s University Belfast, the CRUK Scotland Institute, University of Zurich, University of Oxford alongside a multinational collaborative group proposed a new data-driven method for reclassification of bowel cancer, which has been published in this new groundbreaking study.

By assembling genes into biological pathways prior to the development of molecular subtypes, the team rearranged tumours into a series of new groups, based on activity across a complex network of cancer-related signalling; all of which appears to be critical in predicting how well a tumour will respond to different treatments such as chemotherapy and radiotherapy.

To ensure that scientists and clinicians around the world can immediately access these data and test this new subtyping approach, the team have released a freely available classification tool that allows the Belfast-developed approach to be used on tumour samples in any research lab.

Dr Sudhir Malla, Postdoctoral Research Fellow from the Patrick G Johnston Centre for Cancer Research at Queen’s University Belfast and first author of the study commented: “By developing an unrestricted classification tool for the cancer research community, it means that researchers from around the world can reproduce our finding on data emerging from their own collections of tumour samples, to identify biological pathways that cancer cells switch on or off to control their movement, growth and response to their environment.”

Professor Owen Sansom, Director of the Cancer Research UK Scotland Institute in Glasgow, who co-authored the study said: “The research presented today in Nature Genetics exemplifies the value of collaborative research between scientists and clinicians.

“Studies such as this are essential to enable us to understand the complexities of a patient’s tumour and will be used in our pre-clinical laboratories to identify novel treatments specifically targeting the biological patterns we have identified.”

Dr Sam Godfrey, Research Information Lead at Cancer Research UK, said: “Cancer is perhaps the most complex disease we face, and no single treatment will ever beat it.

“Cancer Research UK is delighted to have funded this innovative research, an important step towards giving doctors the insight to see which therapy can best exploit an individual cancer’s weakness.

“Research like this could lead to better and more precise treatments for the thousands of people diagnosed with bowel cancer every year in Scotland.”

The team are now applying their new subtyping approach on tumour samples derived from clinical trials run in the UK, to build the essential clinical evidence needed before the new method can be used to make clinical decision about which treatments a patient should be offered.

Western General’s Cancer Navigation Hub is one year old

The Cancer Navigation Hub, based in Edinburgh Cancer Centre at the Western General Hospital, recently celebrated one year of the service launching.

The team helps patients and healthcare professionals to navigate cancer pathways, ensuring enquiries are directed to the appropriate care team in a timely and efficient way.

The team is made up of Cancer Pathway Coordinators and acts as a single point of contact for patients who’ve received a cancer diagnosis. Coordinators are also trained to assist healthcare professionals and helps to alleviate the pressure on clinical teams.

Katie Seville, Assistant Service Manager in Cancer Performance, said: “In just one year we’ve seen the hub make such a difference to the ease with which patients and staff can access the information and support they need.

“The team is in high demand and we’re looking to further expand and grow the service into new areas, providing more personalised and holistic support for patients throughout their diagnosis and treatment.”

The Cancer Navigation Hub initially served five tumour groups – lung, melanoma, head and neck, gynaecology, and urology. In April 2023, the hub expanded to cover the neuroendocrine tumour group followed by breast in August 2023.

During the first five months of the service (October 2022 to February 2023) the team handled on average over 1,100 calls per month, 38% of which were administrative queries or issues that could be resolved by the Cancer Pathway Coordinators.

In the month after incorporating the breast service, the team handled just over 1,900 calls across all tumour groups, with 44% of all calls being dealt with by the coordinators.

Since January 2023, the Cancer Navigation Hub has also been proactively calling newly diagnosed patients to introduce the hub and direct patients to support services.

In June 2023, during the launch of the new Cancer Strategy, the team was among those to meet Michael Matheson, Cabinet Secretary for NHS Recovery, Health and Social Care.

Congratulations to the team for a brilliant first year.

Cancer drug delivery evaluation shows “better quality of life”

Beatson drug delivery study shows patient benefits

A new service evaluation on the use of intrathecal drug delivery (ITDD) by the Interventional Cancer Pain team at the Beatson West of Scotland Cancer Centre has shown patients having a better quality of life by being able to spend more time being cared for in the community.  

As well as this, the pump devices mean patients are on a lower dose of opioid painkillers, which reduces cognitive impairment.  

Dr Alison Mitchell led the work which has been published in the journal Palliative Medicine.  

The ITDD service offered by the Beatson WoSCC is the only one in Scotland and it is hoped the findings of this study will support the use of ITDD further afield.  

Dr Mitchell, Consultant in Palliative Medicine, said: “We have been using ITDD since 2007 and this research confirms the benefits that it has for patients who have significant pain due to a variety of cancers.  

“It’s an appropriate method of pain relief for a small percentage of patients and makes a real difference to their quality of life.” 

The devices use an implanted catheter in the lumbar area of the spine which allows delivery of anaesthetic and painkilling medication from a pump which sits just below the ribcage.  

After the device is implanted, patients return every two weeks to have the medication reservoir refilled.  

Dr Mitchell explained: “As the medication is delivered directly to the spinal cord, the local anaesthetic administered by the device acts like a dental anaesthetic by numbing pain nerves directly and we try to ensure it does not impair motor function in the way a dental anaesthetic would affect your face muscles.  

“The morphine delivered by the pumps relieves the pain associated with cancers and means patients can reduce their oral morphine use and patients with pumps are on a much lower overall morphine dosage.  

“This means they are better able to spend quality time with their families as they don’t experience the cognitive impairment that morphine usage can cause.”  

Patients requiring pain relief in the lower half of the body are assessed by a multidisciplinary team made up of palliative medicine, physiotherapy and psychiatric specialists and a decision can be made on how appropriate this method of pain relief would be for them.  

Dr Mitchell added: “The team takes a holistic approach to how we help people manage pain in a palliative setting.  

“Patients put forward for this face a life that is limited by cancer but this allows them to have an added quality of life with less time spend in a clinical setting.” 

Skye’s the limit now for gentle Fort William donkey

Charities unite to provide life-saving surgery 

A donkey suffering from a form of cancer has received life-saving surgery, thanks to international animal welfare charities The Donkey Sanctuary and World Horse Welfare. 

The eight-year-old skewbald donkey called Skye, who was living on the grounds of a distillery in Fort William, in the Scottish Highlands, had a large growth on his chest that needed urgent veterinary attention.  

An independent vet examined the large growth on Skye’s chest, and diagnosed it as a sarcoid, a kind of skin cancer.  

The vet confirmed Skye would need specialist surgery and dedicated aftercare due to the severity of his sarcoid. It was suggested that the only option could be to put Skye to sleep. 

A local groom and volunteers looked after Skye and a pony he lived with, after their owner could no longer care for them.  

In a desperate effort to save Skye, Emma Norval, a local volunteer who helped look after him, contacted The Donkey Sanctuary to see if they could offer any support.  

The Donkey Sanctuary and World Horse Welfare worked together to explore other treatment options for Skye.  

Jenna Goldby, Donkey Welfare Adviser at The Donkey Sanctuary, said: “Due to the nature of Skye’s sarcoid, the only treatment option available was to remove it via laser treatment.

“It was not going to be possible to remove it on site, so World Horse Welfare transported him to the University of Glasgow, School of Veterinary Medicine for the operation.” 

John Burns, Field Officer at World Horse Welfare, said: “Because the sarcoid was on Skye’s chest the operation had to take place with him standing. Under the expert care of Professor David Sutton, the tumour was removed using laser treatment.  

“Everyone is really hopeful that Skye will continue to make a full recovery and go on to live in very good health.” 

Emma Norval said: “If it had not been for such a quick response from The Donkey Sanctuary I don’t think the lovely, gentle Skye would be here today. He is such a lovely boy.” 

Jenna added: “This is a great outcome for Skye and I hope he goes on to live a happy and enriched life. The Donkey Sanctuary has a team of Donkey Welfare Advisers around the country and we’re here to offer free support and advice to donkey owners.” 

Following surgery, Skye was moved to a holding base funded by The Donkey Sanctuary, where his health is continuing to improve. He has settled in well and is receiving the care that he deserves from his dedicated grooms.  

The Donkey Sanctuary is a global leader for equine welfare, research and veterinary care. The charity operates programmes worldwide for animals working in agriculture, industry and transportation. 

Cancer treatment plans should include tailored exercise prescriptions, says expert panel

A global panel of exercise oncology experts has published new guidance recommending the systematic use of an “exercise prescription” to help cancer patients cope with treatment side effects and lower the risk of developing certain cancers. Continue reading Cancer treatment plans should include tailored exercise prescriptions, says expert panel