28 research outputs found
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
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
First Year Report by
No full textFirst Year Report, which comes before my proposal due to timing irregularities, initially, I present major findings from an eight month long project initiated, designed and co-led by myself with financial support from the industry which has led to my decision to focus on the analysis, measurement andmanagement of costs of complexity in networks as a PhD topic. I summarise work towards the design and proposal of my PhD Dissertation. A significant amount of time was spent on background research for my proposal, and this is presented as a detailed annotated bibliography at the end. FIRST YEAR REPORT..........................................................................................
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
Prostate Cancer in Primary Care
No full textProstate cancer is a common malignancy seen worldwide. The incidence has risen in recent decades, mainly fuelled by more widespread use of prostate-specific antigen (PSA) testing, although prostate cancer mortality rates have remained relatively static over that time period. A man's risk of prostate cancer is affected by his age and family history of the disease. Men with prostate cancer generally present symptomatically in primary care settings, although some diagnoses are made in asymptomatic men undergoing opportunistic PSA screening. Symptoms traditionally thought to correlate with prostate cancer include lower urinary tract symptoms (LUTS), such as nocturia and poor urinary stream, erectile dysfunction and visible haematuria. However, there is significant crossover in symptoms between prostate cancer and benign conditions affecting the prostate such as benign prostatic hypertrophy (BPH) and prostatitis, making it very challenging to distinguish between them on the basis of symptoms. The evidence for the performance of PSA in asymptomatic and symptomatic men for the diagnosis of prostate cancer is equivocal. PSA is subject to false positive and false negative results, affecting its clinical utility as a standalone test. Clinicians need to counsel men about the risks and benefits of PSA testing to inform their decision-making. Digital rectal examination (DRE) by primary care clinicians has some evidence to show discrimination between benign and malignant conditions affecting the prostate. Patients referred to secondary care for diagnostic testing for prostate cancer will typically undergo a transrectal or transperineal biopsy, where a number of samples are taken and sent for histological examination. These biopsies are invasive procedures with side effects and a risk of infection and sepsis, and alternative tests such as multiparametric magnetic resonance imaging (mpMRI) are currently being trialled for their accuracy and safety in diagnosing clinically significant prostate cancer
Routes to diagnosis of symptomatic cancer in sub-Saharan Africa: Systematic review
No full textBackground 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
Exploring the causes of death among patients with metastatic prostate cancer - A changing landscape
No full textNo description availabl
Systematic Review and Narrative Synthesis of Economic Evaluations of Prostate Cancer Diagnostic Pathways Incorporating Prebiopsy Magnetic Resonance Imaging
No full textCONTEXT: Prebiopsy magnetic resonance imaging (MRI) of the prostate has been shown to increase the accuracy of the diagnosis of clinically significant prostate cancer. However, evidence is still evolving about how best to integrate prebiopsy MRI into the diagnostic pathway and for which patients, and whether MRI-based pathways are cost effective. OBJECTIVE: This systematic review aimed to assess the evidence for the cost effectiveness of prebiopsy MRI-based prostate cancer diagnostic pathways. EVIDENCE ACQUISITION: INTERTASC search strategies were adapted and combined with terms for prostate cancer and MRI, and used to search a wide range of databases and registries covering medicine, allied health, clinical trials, and health economics. No limits were set on country, setting, or publication year. Included studies were full economic evaluations of prostate cancer diagnostic pathways with at least one strategy including prebiopsy MRI. Model-based studies were assessed using the Philips framework, and trial-based studies were assessed using the Critical Appraisal Skills Programme checklist. EVIDENCE SYNTHESIS: A total of 6593 records were screened after removing duplicates, and eight full-text papers, reporting on seven studies (two model based) were included in this review. Included studies were judged to have a low-to-moderate risk of bias. All studies reported cost-effectiveness analyses based in high-income countries but had significant heterogeneity in diagnostic strategies, patient populations, treatment strategies, and model characteristics. Prebiopsy MRI-based pathways were cost effective compared with pathways relying on ultrasound-guided biopsy in all eight studies. CONCLUSIONS: Incorporation of prebiopsy MRI into prostate cancer diagnostic pathways is likely to be more cost effective in than that into pathways relying on prostate-specific antigen and ultrasound-guided biopsy. The optimal prostate cancer diagnostic pathway design and method of integrating prebiopsy MRI are not yet known. Variations between health care systems and diagnostic approaches necessitate further evaluation for a particular country or setting to know how best to apply prebiopsy MRI. PATIENT SUMMARY: In this report, we looked at studies that measured the health care costs and benefits and harms to patients of using prostate magnetic resonance imaging (MRI), to decide whether men need a prostate biopsy for possible prostate cancer. We found that using prostate MRI before biopsy is likely to be less costly for health care services and probably has better outcomes for patients being investigated for prostate cancer. It is still unclear what the best way to use prostate MRI is
Развитие плазменных и ионно-пучковых технологий для материаловедения в НЦЯИ
No full textThe Plasma/Ion Beam Technology Division is one of several laboratories forming the Material Physics Department at the NCBJ in Świerk, Poland. Scientific activity of the Division concerns different aspects of research related to material engineering, surface engineering, functional properties characterization, as well as synthesis and modification of different materials.Plasma surface engineering methods like cathodic arc UHV deposition and pulsed magnetron sputtering methods as well as ion beam implantation methods are intensively exploited and developed in our laboratory.Відділення плазмових та іонно-пучкових технологій - одна з лабораторій відділу фізики матеріалів НЦЯД у Свєрці, Польща. Наукова діяльність відділення пов’язана з різними аспектами досліджень у галузі матеріалознавства, технології поверхні, визначення характеристик функціональних властивостей, а також синтезу й модифікації різних матеріалів. У лабораторії активно використовуються та розробляються методи плазмової обробки поверхні, такі як катодно-дугове осадження за надвисокого вакууму (UHV deposition), та методи імпульсного магнетронного розпилення, а також методи іонної імплантації.Отделение плазменных и ионно-пучковых технологий - одна из лабораторий отдела физики материалов НЦЯИ в Сверке, Польша. Научная деятельность отделения связана с различными аспектами исследований в области материаловедения, технологии поверхности, определения характеристик функциональных свойств, а также синтеза и модификации различных материалов. В лаборатории активно используются и разрабатываются методы плазменной обработки поверхности, такие как электронно-дуговое осаждение при сверхвысоком вакууме (UHV deposition), методы импульсного магнетронного распыления, а также методы ионной имплантации.Works conducted in the FM2 division were
supported by the National Science Centre within the
Projects 2014/15/B/ST8/01692, 2013/09/B/HS3/03289,
2016/23/N/HS3/03160, 301719/2016-2019, the National
Centre for Research and Development within the
Projects PBS2/A5/34/2013, PBS3/B6/24/2015 and the
Polish Ministry of Science and Higher Education from
the Science Found projects: 3418/SPIRIT/2015/0,
W46/SPIRIT/2017 and HZDR: 17000973-ST,
17001078-ST
