104 research outputs found
Active surveillance for prostate cancer: an update
No full textThis is the author accepted manuscript. The final version is available from Wiley via the DOI in this record. An increasing number of men diagnosed with localised prostate cancer has been accompanied by more men being considered for active surveillance as a management option. Here the author provides an update on recent developments in active surveillance and changes to NICE guidance
Prostate cancer treatment choices: the GP’s role in shared decision-making
No full textThis is the author accepted manuscript. The final version is available from the Royal College of General Practitioners via the DOI in this recor
Lymphoma for GPs across the cancer continuum
No full textThis is the author accepted manuscript. The final version is available from SAGE Publications via the DOI in this recordLymphomas are a diverse and relatively common cancer type in the UK. Early diagnosis of
lymphoma is vital for improving patient outcomes. The majority of patients diagnosed with
lymphoma have a life expectancy of at least five years. Lymphoma treatments can have
long-term health consequences, and patients with a history of lymphoma have a higher risk
of subsequently developing other cancers. More robust evidence for the early diagnosis of
lymphoma in primary care has been published in recent years, and the classification of
lymphoma has recently been updated by the World Health Organization (WHO). This article
is focused on the diagnosis of lymphoma in adolescents and adults, and the on-going care
needs for all patients who are being treated for lymphoma or have survived a diagnosis of
lymphoma. Further information about lymphoma and other cancers in children can be
found in the InnovAiT article by Dr Jennifer Kelly from 2017
Active surveillance for prostate cancer: an update
No full textAn increasing number of men diagnosed with localised prostate cancer has been accompanied by more men being considered for active surveillance as a management option. Here the author provides an update on recent developments in active surveillance and changes to NICE guidance
Lymphoma for GPs across the cancer continuum
No full textLymphomas are a diverse and relatively common cancer type in the UK. Early diagnosis of
lymphoma is vital for improving patient outcomes. The majority of patients diagnosed with
lymphoma have a life expectancy of at least five years. Lymphoma treatments can have
long-term health consequences, and patients with a history of lymphoma have a higher risk
of subsequently developing other cancers. More robust evidence for the early diagnosis of
lymphoma in primary care has been published in recent years, and the classification of
lymphoma has recently been updated by the World Health Organization (WHO). This article
is focused on the diagnosis of lymphoma in adolescents and adults, and the on-going care
needs for all patients who are being treated for lymphoma or have survived a diagnosis of
lymphoma. Further information about lymphoma and other cancers in children can be
found in the InnovAiT article by Dr Jennifer Kelly from 2017
Routes to diagnosis of symptomatic cancer in sub-Saharan Africa: Systematic review
No full textThis is the final version. Available on open access from BMJ Publishing Group via the DOI in this recordData availability statement: Data sharing is not applicable as no datasets are generated and/or analysed for this study. No data are available. No additional data available.Background Most cancers in sub-Saharan Africa (SSA) are diagnosed at advanced stages, with limited treatment options and poor outcomes. Part of this may be linked to various events occurring in patients' journey to diagnosis. Using the model of pathways to treatment, we examined the evidence regarding the routes to cancer diagnosis in SSA. Design and settings A systematic review of available literature was performed. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Between 30 September and 30 November 2019, seven electronic databases were searched using terms relating to SSA countries, cancer and routes to diagnosis comprising the population, exposure and outcomes, respectively. Citation lists of included studies were manually searched to identify relevant studies. Furthermore, ProQuest Dissertations Theses Global was searched to identify appropriate grey literature on the subject. Results 18 of 5083 references identified met the inclusion criteria: Eight focused on breast cancer; three focused on cervical cancer; two each focused on lymphoma, Kaposi's sarcoma and childhood cancers; and one focused on colorectal cancer. With the exception of Kaposi's sarcoma, definitive diagnoses were made in tertiary healthcare centres, including teaching and regional hospitals. The majority of participants initially consulted within primary care, although a considerable proportion first used complementary medicine before seeking conventional medical help. The quality of included studies was a major concern, but their findings provided important insight into the pathways to cancer diagnosis in the region. Conclusion The proportion of patients who initially use complementary medicine in their cancer journey may explain a fraction of advanced-stage diagnosis and poor survival of cancer in SSA. However, further research would be necessary to fully understand the exact role (or activities) of primary care and alternative care providers in patient cancer journeys.Cancer Research UK (CRUK)Can Test Collaborativ
Systemic anticancer therapies and the role of primary care
No full textCancer therapeutics are complex, constantly evolving, and aim to prolong the life of a patient with
cancer by cure, inducing remission, or by slowing disease progression. Cancer treatments can be
delivered locally directly against the tumour (i.e. surgery or radiotherapy) or systemically (i.e.
chemotherapy, hormone therapy). Systemic therapies have traditionally been administered
intravenously in a hospital or day unit setting; however many of the more recently discovered
systemic cancer therapies are taken as an oral medication. They also pose significant potential risks
to a patient’s health through side effects, immunosuppression, and later development of secondary
cancers.
This article focusses on systemic cancer therapies from a primary care perspective. Recent
developments and classifications of systemic therapies are briefly presented. Key considerations
around monitoring, potential treatment harms, and patient support are discussed to inform the
delivery of primary care for cancer patients receiving systemic therapies
Prostate cancer treatment choices: the GP’s role in shared decision-making
No full textNo description availabl
A Comparative Analysis of the Equity Outcomes in Three Sugarcane–Ethanol Systems
No full textThis article identifies equity outcomes associated with three biofuel systems in Brazil, Ethiopia, and Guatemala. Acknowledging that winners and losers are socially and politically generated, the article identifies some of the factors behind the distribution of winners and losers along different stages of three sugarcane–ethanol supply chains. Analyzing the outcomes for equity within each case study reveals an uneven distribution that, we argue, is related to the procedure and structure of the given sugarcane–ethanol system, and the recognition of the impacts on different actors within those structures. Increasing equity in sugarcane–ethanol systems will require greater openness in decision-making processes, in order that multiple voices are taken into account in the promotion, production, and consumption of biofuels—particularly those of smaller and less powerful actors
Significance of Shear Wave Dispersion Slope Values Before Versus After Biliary Drainage in Patients With Obstructive Jaundice
No full textThe shear wave dispersion (SWD) slope has become available in the clinical practice and is related to tissue viscosity. However, clinical evaluation using SWD was not yet performed for obstructive jaundice. We aimed to evaluate the change of SWD values between before and after biliary drainage in patients with obstructive jaundice. This prospective observational cohort study evaluated 20 patients with obstructive jaundice who underwent biliary drainage. The SWD and liver elasticity values were measured before versus after biliary drainage, comparing between days −5 and 0 (day 0), days 1 and 3 (day 2), and days 6 and 8 (day 7). The mean ± SD values of SWD measured at day 0, day 2, and day 7 were 15.3 ± 2.7, 14.2 ± 3.3, and 13.3 ± 2.4 m/s/kHz, respectively. Dispersion slope values were decreased significantly from day 0 to day 2, from day 2 to day 7, and from day 0 to day 7 (P < 0.05). Liver elasticity levels and serum hepatobiliary enzymes were additionally decreased significantly over time after biliary drainage. The correlations between SWD and liver elasticity values were strong (r = 0.91, P < 0.01). In conclusion, the SWD values decreased significantly over time after biliary drainage concomitant with liver elasticity
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