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Cancer incidence is increasing year on year; survivorship rates are also increasing, as is the use of novel agents and additional treatment lines. These factors, along with evidence that suggests people are struggling to cope with the long-term effects of their diagnosis and its treatment, suggest we need to transform our approach to care and make better use of primary care, community assets and self-management. Transforming Care After Treatment (TCAT) was launched in 2013. A partnership between the Scottish Government, Macmillan Cancer Support, NHS Scotland and local authorities, it is intended to support and enable cancer survivors to live as healthy a life as possible for as long as possible. NHS Ayrshire and Arran worked with local patients and other partners to develop an action plan to meet TCAT's aims. In 2014, the TCAT team began to introduce initiatives that would support holistic care throughout the extended cancer pathway. One such initiative was a treatment summary. The approach to its implementation and patients' and GPs' perspectives of its initial effect are outlined in this paper. [ABSTRACT FROM AUTHOR]

Background:The two-week wait referral system for suspected cancer was introduced in the National Health Service in 2000. This study aimed to identify areas for improvement to the two-week wait system by seeking the opinions of doctors working in primary and secondary care.Method:A questionnaire was distributed to general practitioners and head and neck surgeons within North West England with ethical consent.Results:Twenty-seven general practitioners and 15 head and neck surgeons responded. Of the general practitioners, 59.3 per cent declared that they never attend training on referrals in this specialty. Overall, 59.3 per cent of general practitioners and 86.7 per cent of head and neck surgeons felt that the two-week wait system could be improved.Conclusion:The main areas for further work are development of pre-referral communication between primary and secondary care along with development of practical educational measures for general practitioners. [ABSTRACT FROM PUBLISHER]

Objective:We aimed to investigate the diagnostic accuracy of contact endoscopy in evaluating oral and oropharyngeal mucosal lesions.Methods:Between January 2010 and December 2011, 34 patients with lesions of the oral and oropharyngeal mucosa were enrolled in the study. Comparison between initial contact endoscopy results and ‘gold standard’ tissue biopsy was undertaken.Results:Nine patients had histologically confirmed squamous cell carcinoma, 2 had carcinoma in situ, 3 had dysplastic lesions and 20 patients had various benign lesions. Contact endoscopy demonstrated sensitivity and specificity of 89 and 100 per cent respectively in the evaluation of malignant lesions. Benign lesions were correctly categorised in 50 per cent of cases (10/20). The video images from contact endoscopy could not be interpreted in six cases.Conclusions:Contact endoscopy demonstrates high sensitivity and specificity in the imaging of malignant lesions with reduced reliability in the evaluation of benign lesions. Significant shortcomings also exist in the design of current technology that we believe represent a significant barrier to the reliable collection of useful video data. [ABSTRACT FROM AUTHOR]

Aims:To determine (1) the accuracy of positron emission tomography – computed tomography in the diagnosis of head and neck cancer, (2) the learning curve involved, and (3) whether its use alters patient management.Materials and methods:A retrospective study including 80 patients with head and neck cancer who underwent positron emission tomography – computed tomography image fusion at Blackpool Victoria Hospital.Results:Fifty-three patients underwent positron emission tomography – computed tomography for staging (32 for detection of a primary tumour and 21 for detection of distant metastasis) and 27 for detection of loco-regional recurrence. Ten primary tumours and 20 recurrences were accurately diagnosed by this method. Eighteen patients had their tumour stage and management modified as a result of this method of imaging. The effect of the learning curve resulted in better true positive detection rates, one year after introduction (81 versus 61 per cent). The sensitivity and specificity of this method in detecting head and neck cancer were 70 and 42 per cent, respectively, whereas those of conventional imaging were 73 and 51 per cent, respectively.Conclusion:Compared with magnetic resonance imaging, the benefits of positron emission tomography – computed tomography may be limited to diagnosis of recurrence, as it is less hindered by tissue fibrosis, radiotherapy-related oedema, scarring and inflammation. [ABSTRACT FROM PUBLISHER]

The aim of the study was to compare standards for the process of care and 2-year survival between two cohorts of patients with head and neck cancer in the south and west of England. A total of 566 and 727 patients presented in 1996-97 and 1999-2000, respectively. The median number of cases treated per surgeon was 4 (1997, range 1-26) and 4 (2000, 1-23) and per radiotherapist was 10 (1-51) and 19 (1-70). For all 'nontemporal' standards, the overall standard increased, without reaching minimum high targets, while most 'waiting times' increased. Overall 2-year survival was 64.1% in 1997 and 65.1% in 2000. There was no difference in survival between networks (range 56-68, 1997, log-rank test 4.1, P=0.4; 62-69, 2000, log-rank test 1.26, P=0.69). Patients assessed by a multidisciplinary clinic exhibited improved survival (1997: P=0.1; 2000: hazard ratio 0.7, P=0.02), as did those with a pretreatment chest X-ray (hazard ratio 0.7, P=0.03). Despite an increased incidence, standards for the process of care for patients with head and neck cancer improved between 1996 and 2000, while waiting times increased and 2-year survival rates remained unaltered. Two out of five networks demonstrated centralisation of services between audits. Being seen in a multidisciplinary clinic correlated strongly with patient survival. [ABSTRACT FROM AUTHOR]