Cancer Treatment News
Management of NHS cancer services ‘in need of reform’
Hospital admissions of cancer patients arriving at Accident and Emergency departments have doubled in the past decade, according to a report from the National Audit Office (NAO).
Although emergency admissions are supposed to be the exception, the report also shows that between 2000 and 2008 the number of emergency admissions for cancer patients (admitted as an emergency by a healthcare professional) increased from 231,000 to 300,000.
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Around 80% of these patients had already been diagnosed with cancer, raising concerns about the support available to them during and after treatment. Cancer patients may be admitted as an emergency case for a variety of reasons, including the side effects of treatment such as chemotherapy. The number of patients being given chemotherapy has tripled in the past decade.
The remaining 20% of those admitted as an emergency are diagnosed as a result of their admission. Survival rates are worse for this group, as highlighted by another report published this week.
Variation
The NAO’s report highlights significant variation in the amount spent on cancer across the country. This varies from £55 per person in some parts of England to £154 in other parts. Less than half of the extent of this variation can be explained.
In another illustration of variation, the rate of cancer patients referred for diagnosis as an urgent case by their GP varies almost fourfold across different parts of the country and by more than eightfold between GP practises. The findings may indicate significant variation in the extent to which GPs are following national guidance on which symptoms should prompt an urgent referral to a cancer specialist. Nationally, the volume of patients referred urgently has increased by 44% from 627,000 in 2006 to 904,000 in 2009.
GPs
The role of GPs in managing cancer services is set to grow in the next four years and the report raises concerns about whether they will have sufficient information to support them in the decisions they will have to make, warning that there are “key gaps and limitations” in the data collected.
Currently, cancer services are purchased by local NHS commissioners working in primary care trusts (PCTs). However from 2013 GPs will take over this job, with PCTs abolished. By this time the Government may have introduced a new national cancer strategy following a review of the existing strategy being conducted by the national cancer director. The NAO report warns that without better information about cancer care in England, including costs and activity, delivery of the strategy will falter.
According to the report only 22% of PCTs attempt to assess the value for money they get from cancer services. This is particularly worrying given the fact that the NHS is expected to make savings of £15 – £20bn by 2014. The report found that only 26% of NHS PCTs had carried out a cost benefit analysis comparing different ways of delivering cancer services. Private medical insurers use a variety of ways to control spend on cancer, including delivering more care such as chemotherapy in patients’ homes. However, the rising cost of cancer treatment remains a challenge for the private sector. Bupa has reported that over the last five years the cost of cancer treatment for its members has increased by 40%.
The NHS spent around £6.3bn on cancer services in 2008-09 and the report argues that “there are opportunities to deliver better outcomes for patients whilst saving money and freeing up resources to meet the increasing demand for services.”
It concludes: “Any improvements in cancer services will need to be delivered in the face of much tougher finances and an increase in the number of new cases each year from 255,000 to 300,000 by 2020.”
Breast Cancer Treatment Efficient If Risk Categories GetMammograms Under 50
Family risk of developing breast cancer even at a moderate rate should be a noteworthy sign to get a mammogram per year, according to a recent study.
Even though all U.S. women having the above stated family background undertake this diagnosing procedure as per national healthcare programs, Europe is not so rigorous in this sense, as no screening in order to identify breast cancer is a standard procedure across the old continent. A recent study ran by a group of British researchers have developed a supervision program for 6,710 female participants under 50 whose risk of developing breast cancer as per family history and personal medical record.
The researchers have established several selection criteria in order to establish the moderate risk category. Having a close relative who suffered from breast cancer or being diagnosed with breast cancer could be a relevant criterion for study participation.
The monitoring program lasted close to five years and every single year, each women got a mammogram per year. Based on results of previous studies where patients shared the same eligibility criteria but did not get a yearly mammogram, the British scientists estimated that a mammogram per year was very likely to reduce death risk caused by breast cancer by 20 percent.
The annual screening procedure allowed doctors to identify at a very early stage small size tumors. This advantage has implicitly made the breast cancer treatment more efficient, in contrast to cases when the tumor remained unidentified and expanded and put the patient’s life at risk.
Doctor defends radical cancer treatment
An Austrian doctor has defended his radical cancer treatment before a Perth coronial inquest into the deaths of five people who were prescribed chemical cocktails to fight the disease.
Dr Hellfried Sartori blamed poor treatment in hospitals and the lack of ongoing nutritional support for the 2005 deaths.
“If those people had been treated properly they would be here today,” he told reporters outside the inquest on Thursday.
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He said cancers were largely caused by acute shock experiences but could be eradicated through the controlled administration of certain vitamins and minerals.
Dr Sartori’s treatment involves administering cesium chloride and other chemicals, some of which are banned for medical use in Australia.
In May 2005, Sandra McCarty, 53, from Victoria, Pia Bosso, 68, from NSW, Perth woman Sandra Kokalis, 52, and Deborah Gruber, 42, from New York, underwent Dr Sartori’s treatment at the Perth home of local practitioner Dr Alexandra Boyd.
All four women, who had severe forms of cancer, died about two weeks after being rushed to hospital with various symptoms, including gastrointestinal bleeding and seizures.
A fifth patient, 29-year-old Perth man Carmelo Vinciullo, underwent Dr Sartori’s treatment in May 2005, but stopped after he felt unbearable pain and was told to “control the pain with his mind”.
Mr Vinciullo died on July 1 following respiratory failure.
The coronial inquest is examining whether the treatment given to the five contributed to their deaths.
Dr Sartori, who has spent three years in jail in the US for practising medicine without a licence, lived in Thailand when the five were being treated and liaised with a nurse in Perth about their courses of treatment.
Under questioning from counsel assisting the coroner, Dr Celia Kemp, Dr Sartori said Dr Boyd was a local doctor who was there only to ensure conventional treatment was available if there were complications.
He said the patients died after being rushed to hospitals and taken off his treatment.
“It would have been so much better if I had been there and my very sad lesson from that … is in future I would not allow this to happen,” Dr Sartori told the inquest.
He later told reporters that in two cases, blood transfusions were not given when they were needed.
“The problem had nothing to do with my treatment. There was mismanagement in the hospitals.”
Dr Sartori said his treatment required continuing nutritional support and none of the patients received it.
He said the majority of cancers were caused by “acute shock experiences” and when doctors told patients they had cancer, the shock of the news could cause the body to develop secondary cancers.
Under questioning, Dr Sartori confirmed he believed anti-cancer drugs were the major cause of death in cancer patients and he totally opposed chemotherapy.
“Nature wants to heal itself and you have to provide the proper conditions. This is the art here,” he said.