2012 NICE publishes new ovarian cancer quality standard (UK OC incidence 6,500 deaths 4,500)

NICE publishes new ovarian cancer quality standard

The new quality standard is available on the NICE website from 00:01 hrs on Wednesday 23 May at: http://www.nice.org.uk/aboutnice/qualitystandards/qualitystandards.jsp


NICE has today (23 May) published a new quality standard for ovarian cancer, which states that an integrated approach to the diagnosis and management of the disease is fundamental to the delivery of high quality care to women.

Every year in the UK, there are around 6,500 women diagnosed with ovarian cancer, and about 4,400 deaths from the disease. It is more common in women over the age of 50ⁱ. Some of the symptoms of ovarian cancer are similar to those seen in more common conditions, like irritable bowel syndrome (IBS) so it can be hard to diagnose. Other symptoms include:

• Persistent pelvic or abdominal pain
• Increased abdominal size/persistent bloating
• Difficulty eating or feeling full quickly
• Needing to pass urine more urgently or more often than usual

The new quality standard for ovarian cancer consists of eight quality statements that describe high-quality, cost-effective care that should contribute to improving the effectiveness, safety and experience of care for women with ovarian cancer. The standard states that women aged 50 years or over reporting one or more symptoms occurring persistently or frequently suggesting ovarian cancer should be offered a CA125 testⁱⁱ. It also states that women with raised CA125 should have an ultrasound of their abdomen and pelvis within 2 weeks of receiving the CA125 test results. Women with a mass, growth or lump next to their uterus, which usually arises from the ovary or fallopian tube, (called an adnexal mass), and found by ultrasound should be offered magnetic resonance imaging (MRI) to help determine if the lesion is benign or malignant.

Dr Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE said: "We know that the poor survival rates of ovarian cancer may be linked to late diagnosis, which is often because of a lack of awareness of the early symptoms, which include abdominal bloating or pain and difficulty eating. The disease is more prevalent in women over 50, who often mistake its symptoms for the menopause. Therefore, it is important that there are clear, measureable standards that can help drive improvements in the diagnosis, care and treatment of this disease. Quality standards also help to achieve the goals set out in the NHS Outcomes Frameworkⁱⁱⁱ, as well as informing new Quality and Outcomes Framework (QOF)^iv indicators."

The new quality standard is available on the NICE website from 00:01 hrs on Wednesday 23 May at: http://www.nice.org.uk/aboutnice/qualitystandards/qualitystandards.jsp

UK media: 54% doctors support denying treatment to smokers and the obese until they quit or lose weight

54% doctors support denying treatment to smokers and the obese until they quit or lose weight

UK: Advanced Solid Tumours Clinical Trial: Phase I Study of AT13148, a Novel AGC Kinase Inhibitor [Conditions: Advanced Solid Tumours; Interventions: AT13148]

Advanced Solid Tumours Clinical Trial: Phase I Study of AT13148, a Novel AGC Kinase Inhibitor [Conditions: Advanced Solid Tumours; Interventions: AT13148]

Verified by: Cancer Research UK, April 2012

First Received: April 25, 2012 | Last Updated: April 25, 2012 | Phase: Phase 1 | Start Date: April 2012

Overall Status: Not yet recruiting | Estimated Enrollment: 40

The purpose of this first clinical study of the noval multiple AGC kinase inhibitor, AT13148, is to identify the recommended dose for future studies in cancer patients by exploring the safety and maximum tolerated dose and biological effects in patients with advanced solid tumours...

Brief Summary

Official Title: “A Cancer Research UK Phase I First in Man Study of the Novel AGC Kinase Inhibitor AT13148 Given Orally in Patients With Advanced Solid Tumours.”

The purpose of this first clinical study of the noval multiple AGC kinase inhibitor, AT13148, is to identify the recommended dose for future studies in cancer patients by exploring the safety and maximum tolerated dose and biological effects in patients with advanced solid tumours.

• Study Type: Interventional
• Study Design: Masking: Open Label, Primary Purpose: Treatment
• Study Primary Completion Date: October 2015

Detailed Clinical Trial Description

AT13148 is a new drug which looks promising in laboratory studies. We now wish to find out if it will be useful in treating patients with cancer. AT13148 is a type of drug called a protein kinase inhibitor. It blocks several different chemical messengers (enzymes) called AGC kinase proteins. These chemical messengers are part of the signaling process within cells which can make cells produce chemicals that trigger and control cell growth and cell death. In some types of cancer these chemical messengers are 'switched on' or 'switched off' permanently due to changes in the genes of cells called "gene mutations" leading to uncontrolled cancer cell growth. AT13148 targets multiple protein kinases from three families of kinases unlike many of the other protein kinase inhibitors currently being tested which target just one or two kinases. This may mean that it will work better and in a wider group of cancer patients. Patients will not be selected to take part based on having these gene mutations for this first trial because we want to learn more about which mutations are most important but this would be the hope for future trials. The patient population anticipated to benefit from this drug includes certain types of breast, prostate and ovarian cancer which more commonly have these gene mutations.

Campaigners call for Scottish Government to act over needless ovarian cancer deaths - The Daily Record

Campaigners call for Scottish Government to act over needless ovarian cancer deaths - The Daily Record

"New research shows woeful symptom awareness among women in Scotland with only one per cent of those surveyed being very confident of noticing a symptom. Across the UK the figure was just three per cent.
And, of the GPs surveyed in Scotland, 86 per cent agreed that updates to Scottish clinical guidelines would support them to diagnose ovarian cancer more effectively.
Now campaigners have called on the Scottish Government top spearhead a national campaign to increase symptom awareness.
In April 2011, the National Institute for Health and Clinical Excellence (NICE) published the first official guidance to GPs in England and Wales about the symptoms, diagnosis and early treatments for ovarian cancer.
The Target Ovarian Cancer Pathfinder Study 2012 found 68 per cent of a UK-wide representative sample of 402 GPs was aware of the NICE guidance.
However, GPs in Scotland will have to wait until later this year for updated guidance from the Scottish Intercollegiate Guidelines Network......"

Target Ovarian Cancer can be found online at www.targetovariancancer.org.uk

phase 2/UK: The Activity of TroVax® Versus Placebo in Relapsed Asymptomatic Ovarian Cancer - Full Text View - ClinicalTrials.gov

The Activity of TroVax® Versus Placebo in Relapsed Asymptomatic Ovarian Cancer - Full Text View - ClinicalTrials.gov

The Activity of TroVax® Versus Placebo in Relapsed Asymptomatic Ovarian Cancer (TRIOC)

This study is not yet open for participant recruitment.

Verified March 2012 by University College, London

First Received on March 14, 2012.   Last Updated on March 27, 2012   History of Changes

Sponsor:	University College, London
Collaborators:	Oxford BioMedica Cancer Research UK
Information provided by (Responsible Party):	University College, London
ClinicalTrials.gov Identifier:	NCT01556841

  Purpose

The purpose of this trial is to assess the effectiveness of TroVax® compared to placebo in extending the time to progression in patients with asymptomatic relapsed platinum resistant ovarian, fallopian tube or primary peritoneal cancer.The trial will also look at overall survival times and quality of life.

UK: A Survivorship Care Plan for Gynaecological Cancer Patients - Full Text View - ClinicalTrials.gov

A Survivorship Care Plan for Gynaecological Cancer Patients - Full Text View - ClinicalTrials.gov

A Survivorship Care Plan for Gynaecological Cancer Patients

This study is currently recruiting participants.

Verified April 2012 by Royal Marsden NHS Foundation Trust

First Received on April 20, 2012.

Adenocarcinoma of the Gastroesophageal Junction
Cervical Cancer
Endometrial Cancer
Esophageal Cancer
Fallopian Tube Cancer
Gastric Cancer
Ovarian Cancer
Sarcoma
Vaginal Cancer
Vulvar Cancer

open access: What do surgical trainees think about patient safety culture, and is this different from their consultants?

What do surgical trainees think about patient safety culture, and is this different from their consultants?

Abstract

Introduction Little is known about the patient safety culture within surgical departments in UK hospitals. What has been done to date is to survey only permanent senior staff opinion of the safety culture in their institution. This study surveyed both consultant and trainee views on perceived patient safety and compared the results between these two groups. 

Material and methods The previously validated Team Work and Safety Climate Questionnaire was configured in Survey Monkey format and sent to all surgical trainees and consultant surgeons in the South West Strategic Health Authority. Two reminders were sent to achieve as high a return rate as possible. 

Results Two hundred and ninety-six replies were received. Forty-four percent of trainees and 30% of consultants responded to the survey. Consultants consistently rated a higher safety culture than surgical trainees. Only 2.9% of trainees believe their patient safety concerns would be acted upon by hospital management. There is notable variation in perceived patient safety culture between hospitals. 

Conclusion This study has suggested that the patient safety culture in hospitals, within a Strategic Health Authority, is variable and sub-optimal when viewed by surgical trainees and their consultants. This study also provides some evidence that the perception of patient safety in an organization varies according to clinical experience. As trainees deliver a great deal of clinical care, surveys of safety culture should include this group. As perceived patient safety culture is correlated to clinical outcomes, validated safety surveys might form part of the assessment of a hospital's performance, along with outcome and patient satisfaction.

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Introduction

Medical errors are a major cause of mortality and morbidity. The National Patient Safety Agency (NPSA) estimates that 10% of all hospital admissions suffer an adverse event defined as a medical error that results in harm to the patient. One percent of all admissions die as a result of an adverse event. In practice this means that in England and Wales 300,000 adverse events and 30,000 deaths are recorded every year. This figure of 30,000 deaths a year is a greater number of deaths than the combined annual mortality from colorectal, prostate and breast cancer.¹ Even these striking figures may be underestimating the extent of the problem because recent studies in the surgical literature² indicate the adverse event rate could even be as high as 20%...........

Commentary: Primary care and diagnosis of cancer : The Lancet Oncology

Primary care and diagnosis of cancer : The Lancet Oncology

"..........These findings raise several questions. Do modes of cancer presentation vary systematically between different groups of patients? Are general practitioners more reluctant to refer young or non-white patients for investigation of possible cancer? Are participants in these groups less willing to accept a referral to investigate possible cancer? Lyratzopoulos and colleagues' study will raise concerns for those involved in diagnosing and treating patients with cancer. This descriptive study suggests several hypotheses concerning pathways to accessing cancer care that deserve to be tested prospectively in future research."

John Crown: Move aside bureaucrats and let us take a lead

".....Professional managers have their place in any institution – but where they set the agenda it is likely to be serving political edicts to balance budgets and meet targets. “That often means the welfare of patients comes second, and also – and this may be an old-fashioned view – I do not think that doctors act solely in their own self-interests. We have higher ethical considerations than other professions.” ...........

John Crown: Move aside bureaucrats and let us take a lead:

Outspoken oncologists, willing to take on ‘the powers that be’, can often play a very helpful role in galvanising administrators and policy makers and pushing the priorities of clinicians higher up the agenda. There are notable such characters around Europe, but one oncologist has taken a bigger step into the realm of politics by becoming a senator in his parliament – from where he is able to directly challenge politicians and bureaucrats with the protection of parliamentary privilege.

Ovarian cancer survival 'lower than the rest of Europe' | Scotland | STV News

Ovarian cancer survival 'lower than the rest of Europe' | Scotland | STV News

UK - March is Ovarian Cancer Awareness Month

March is Ovarian Cancer Awareness Month

The Royal College of Physicians of London roars : The Lancet

The Royal College of Physicians of London roars : The Lancet

How long before CVac, a new treatment for ovarian cancer, is available in the UK? – Telegraph Blogs

"Since my blog post about the Stage 3 trial of CVac – a new treatment for ovarian cancer – I have been in contact with Dr Neil Frazer, who is heading this research for the Australian company Prima Biomed. He has answered my questions about the treatment, clarified the methodology and explained about Prima Biodmed's medical facility in Dubai where CVac will be supplied......

UK survey - young adults - : When do life crises strike? Help us find out (online 20 min survey)

 When do life crises strike? Help us find out

17:45 7 February 2012

Being Human

Health

Jessica Griggs, careers editor

Psychologist Dan Levinson once remarked that he had never met anyone who had not gone through at least one major crisis during their adult life.
While films, sports-car cliches and personal experience may back up his comment, the questions of when and for whom crises occur have received little academic attention. Well, not for much longer.

Last year, New Scientist reported on the phenomenon of the quarter-life crisis; the re-evaluation and dramatic change of direction that sometimes occurs during early adulthood.

This was based on research carried out by researchers at the University of Greenwich who interviewed 50 young people about their emotional experiences during this time. The work established that the quarter-life crisis exists (as corroborated by the comments on our news story) but the sample wasn't large enough to determine how common it is or when it occurs.

Now, the innermost secrets of the crisis are to be laid bare. The Greenwich team are conducting an online survey of British adults which will probe the link between crisis episodes, age and life stage across a diverse group of adults.

The researchers are looking for adult volunteers to participate in the study. You can take part here (and be in with the chance of winning a cash prize for your efforts).

Stay tuned as New Scientist will exclusively report the findings later this year.
                      ~~~~~~~~~~~~~~

What does it involve and how long does it take?

The online questionnaire will involve approximately 20 minutes of your time.

You will be asked for the following information:
-    Age, job, income, marital status and number of children.
-    Crisis episodes and turning points in your adult life (if you are currently aged 25 or above)
-    Your marital satisfaction (if you are married)
-    Your sense of happiness, life satisfaction and wellbeing
-    Your sense of empathy

Who can participate?
In order to participate, you must be age 20 or over, have lived in the UK for the majority of your life since the age of 15 and be able to read and write English fluently.

(UK) Minister denies (ovarian) cancer test pressure - GP online

Blogger's Note: assumption: the ovarian 'cancer test' refers to the CA-125

Avastin: New Ovarian Cancer Drug Approved By European Medicines Watchdog Gives New Hope To Sufferers | UK News + link to Cancer Drugs Fund in England/UK

"We are delighted that Avastin is now available to women across the country."
The National Institute for Health and Clinical Excellence has yet to consider the drugs for routine use by the NHS.
But it is available through the Cancer Drugs Fund in England. Doctors in other parts of the UK can make individual applications for funding.

Jan 15th: New Symptom Indices Offer No Gain in Ovarian Ca - in Oncology/Hematology, Ovarian Cancer from MedPage Today

Action Points  

---

• Explain that two new ovarian cancer symptom indices offered little advantage over the current Goff Index.



• Point out that for all three indices, sensitivity was lower for data obtained from the general practitioner's notes and highest for those interviewed over the telephone, ant that the specificity was largely unchanged

"The small differences between the three indices indicate that there is little to gain from deriving new symptom indices," the authors concluded.


"This sobering news follows hard on the heels of a large U.S. randomized trial finding no benefit, and indeed some harm, to women who were screened annually with a transvaginal ultrasound exam and a CA-125 blood test compared with a usual care control group," they wrote, referring to the NIH-sponsored Prostate, Lung, Colon, and Ovary (PLCO) screening program (JAMA 2011; 305:2295-2303).

They said one question the ovarian cancer community needs to answer is where it should focus its efforts: On the time between when a tumor is large enough to cause mild symptoms and when it is large enough to cause symptoms that prompt women to call a physician, or on a better understanding of disease etiology, leading to better prevention and therapy.

"These other research directions remain critical as the search continues for better ways to find ovarian cancer early," they said.

Primary source: Journal of the National Cancer Institute Source reference: Lim AWW, et al. "Predictive value of symptoms for ovarian cancer: Comparison of symptoms reported by questionnaire, interview, and general practitioner notes" J Natl Cancer Inst 2012; 104: 1-11. Additional source: Journal of the National Cancer Institute Source reference: Hartge P, Speyer JL. "Finding Ovarian Cancer" J Natl Cancer Inst 2012; DOI: 10.1093/jnci/drj518.

Related Article(s): ESGO: Ultrasound Allows Early Ovarian Cancer Diagnosis ESGO: Anti-CA125 Fails to Slow Ovarian Cancer SGO: Change in Antigen Predicts Ovarian Cancer Outcomes

The impact of patient and public involvement on UK NHS health care: a systematic review

Study selection UK studies from 1997 to 2009 which included service user involvement in NHS healthcare services.

Conclusion There is a need for significant development of the PPI (Patient Public Involvement) evidence base particularly around guidance for the reporting of user activity and impact. The evidence base needs to be significantly strengthened to ensure the full impact of involving service users in NHS healthcare services is fully understood.

UK - Ovarian cancer test news is misunderstood says gynaecological cancer charity The Eve Appeal | CA125/NICE guidelines

"In light of recent media coverage following the introduction of new NICE guidelines on ovarian cancer, The Eve Appeal and UCL Gynaecology Cancer Research Centre are concerned that women are misunderstanding the advice recently reported on CA125 blood tests. ..."

Welcome to ocam.org.uk, the central ovarian cancer charity information portal. | Cision Wire

"All four national ovarian cancer charities are working together for the first time during Ovarian Cancer Awareness Month (March 2012) to build awareness of signs and symptoms of ovarian cancer.

Target Ovarian Cancer, The Eve Appeal, Ovarian Cancer Action and Ovacome have come together to provide a collaborative web-based resource to ensure consistency and uniformity in the information provided...."