Block 32 Flashcards
What did the EUROCARE report compare?
Compared 5 year survival in patients across Europe.
What did the EUROCARE report show?
That the UK was performing less well than other European countries.
The UK had a lower average than Europe for colorectal cancer mortality.
Give 4 potential causes of the UKs poor performance in the EUROCARE report.
1) Differences in data collection.
2) Age differences.
3) Differences in pt. stage at presentation, social class and access to treatment.
4) Greater delays in pathways to diagnosis.
What happened as a result of the EUROCARE-II report?
The expert advisory group to the CMO generated the ‘Calman-Hine’ report.
Give 4 recommendations of the Calman-Hine report.
1) All patients should have access to a uniformly high quality of care.
2) Give public and professional education to allow recognition of early symptoms.
3) Give clear information to patients, carers and families about treatment options and outcomes.
4) Cancer services should be patient centred.
5) Primary care should be central to cancer care.
6) Recognise the psychosocial needs of patients and carers.
7) It is essential to register and monitor outcomes.
What were the 3 levels of care suggested to be a solution to inequalities in cancer care in the Calman-Hine report?
1) Primary care.
2) Cancer units serving DGHs.
3) Specialist cancer centres serving populations >1 million.
**The Calman-Hine report also recognised the ongoing importance of palliative care.
1) Describe the roles of cancer units which serve district general hospitals.
2) Describe the roles of specialist cancer centres.
1) Treat common cancers, perform diagnostic procedures, perform common surgeries, give non-complex chemotherapy treatment.
2) Diagnose and treat rare cancers, give complex chemotherapy, perform complex surgeries, give deep X-ray therapy.
Why was the Calman-Hine solution of creating 3 levels of care organised in such a way?
1) Unite commissioners, providers, local authorities and the voluntary sector.
2) Integrate care and deliver holistic care.
3) Target resources to where they are most needed.
4) To promote alliance between providers.
Why is there an emphasis on use of MDTs in cancer treatment?
Modern management involves many disciplines and the skills of different HCPs.
MDTs streamline and coordinate care so that it is not fragmented across different sites.
MDTs provide better outcomes.
1) Which HCPs are involved in the core MDT in cancer care?
2) Which HCPs are involved in the extended MDT in cancer care?
1) Physicians, oncologists, radiologists, histologists, specialist nurses and an MDT coordinator.
2) Physiotherapists, dieticians, palliative care teams and chaplains.
Give 3 roles of MDTS within cancer care.
1) Discuss all new diagnoses within the centre.
2) Decide on case management and inform primary care of updates.
3) Designate a specialist nurse to patients.
4) Audit cancer care processes.
5) Develop guidelines for the management of cancer care.
Give 2 benefits of concentrating specialist cancer care into cancer centres.
1) Better case management of lesser seen cancers due to high quality of expertise.
2) Services often only needed in complex cases, so more efficient than having these resources in all tertiary centres.
Give 2 disadvantages to concentrating specialist cancer care into cancer centres.
1) May mean that fewer services are available in smaller, local hospitals.
2) Geographical inequalities in services provided as it would be challenging to provide easily accessible services to more geographically isolated areas.
Describe the structure and role of cancer networks in the UK.
34 cancer networks and 12 strategic clinical networks in the UK.
Cancer networks produce local treatment guidelines.
Strategic clinical networks deal with cancer, CVD and dementia.
What is the aim of cancer networks?
To decrease inequalities in the care received by patients with cancer.
** Networks ensure that commissioners, provider, local authorities and the voluntary sector work together to deliver high quality care.
What are cancer registries?
A service responsible for registering all cancers that occur within their geographical area. There are 4 in the UK.
Describe 4 roles of the UK cancer registries.
1) Establish incidence and survival between different demographic and social groups.
2) Track efficacy of screening and primary prevention programmes.
3) Compare and evaluate quality of care between regions.
4) Evaluate the impact of social and environmental factors between areas.
What is meant by the term ‘cancer survival’?
The % of the study population who are alive for a given period of time following diagnosis (usually 5 years).
1) What is relative survival?
2) What is observed survival?
1) An estimate of the number of patients expected to survive compared with national mortality date.
2) Actual number of patients still alive after a specified length of time post-diagnosis.
1) What is net cancer specific survival?
2) What is crude probability of death?
1) The probability of surviving cancer in the absence of an other illness.
2) The probability of death from cancer in the presence of other causes of death.
**CPOD: determined by using LE tables and COD information.
What is meant by the following with regards to cancer care:
1) Structure
2) Process
3) Outcome
1) Facilities, resources and organisation of resources (clinics, consultants, nurses, mammogram scanners, GPs).
2) How the system works and how healthcare is provided (the % patients diagnosed at an early stage).
3) Results, changes in health status and PROMS (mortality rate and patient satisfaction).
1) What is the national cancer research network?
2) What does the national cancer research network do?
3) What is the national cancer research institute?
1) An institute established by the DoH in 2001 due to a need for the integration of research and cancer care.
2) It supports prospective cancer trials and trials performed by charity.
3) An institution developed in 2001 to develop common plans for cancer research and to avoid unnecessary duplication or studies/ effort.
State 3 roles of the national cancer research institute.
1) Invest in facilities and resources for research.
2) Maintain a cancer research database and analyse new research.
3) Develop research initiatives.
4) Coordinate clinical trials for new drugs.
Describe the aims of the national cancer research network.
To increase speed quality and integration of research to improve patient care.