Pastoral tutorials Flashcards
What are the advantages of the watch and wait approach?
Delays potential toxicities of chemotherapy or targeted therapies.
Maintains quality of life in asymptomatic patients.
Allows for new therapies to emerge, which may be more effective or have fewer side effects.
What is the DAWN clinic?
The DAWN (Diagnose, Assess, Watch, Notify) clinic is designed for patients with indolent haematological cancers, such as chronic lymphocytic leukaemia (CLL) or low-grade lymphomas. It follows a watch-and-wait approach, monitoring patients regularly through clinical reviews, blood tests, and imaging. Treatment is only initiated if disease progression occurs or symptoms worsen, helping to avoid unnecessary treatments and side effects in the early stages of these slow-progressing cancers.
Expressions that don’t sound false
- I’m sorry you are going through that
- That must be really tough
What do you need to provide before you gain consent for treatment?
- Time (At least 24 hours)
- Information
- Other treatments
- Risks vs benefits
Good practice to get the patient to repeat back treatment plan and specific side effects
Should you involve family in decisions about treatment?
Yes always best practice.
Power of attorney?- make sure you ask whether it is to do with finance or health
Ask for legal proof
Why do cancer patients experience anxiety about follow-up scans?
Fear of recurrence or progression.
Uncertainty about scan results (“scanxiety”).
Emotional toll of regular monitoring.
Impact on mental health and quality of life.
How does a cancer diagnosis affect access to travel and life insurance?
Higher premiums or exclusion of cancer-related coverage.
Difficulty obtaining insurance, particularly if actively undergoing treatment.
Limited options for high-risk patients.
What challenges are faced in balancing immunotherapy with its side effects?
Immune-related adverse events (e.g., pneumonitis, colitis).
Need for close monitoring and prompt management.
Balancing therapeutic benefits with quality of life.
Potential for long-term autoimmune complications.
Why do some cancer patients struggle with decision-making responsibility?
Feeling overwhelmed by complex medical information.
Fear of making the “wrong” choice.
Emotional burden of choosing between treatment options.
Prefer leaving decisions to their healthcare provider.
How is managing multiple specialties important in cancer treatment?
Coordinating care between oncology, haematology, radiology, and surgery.
Multidisciplinary team (MDT) approach for personalised treatment.
Ensures comprehensive care across different treatment modalities.
What role does NICE play in the pricing of haematological drugs?
National Institute for Health and Care Excellence (NICE) assesses cost-effectiveness.
Recommends which drugs are funded by the NHS.
Balances clinical benefit with economic considerations.
What is a specialised commissioning hospital and how is it funded?
A hospital designated for highly specialised care (e.g., complex cancer treatments).
Receives a set sum of money from NHS commissioners.
Responsible for managing the budget to deliver specialised services.
What is the difference between commercial and university-led clinical trials?
Commercial trials: Funded by pharmaceutical companies, often come with financial support for the hospital.
University-led trials: Typically do not provide additional funding, focus on scientific research rather than profit.
How do trials in London/Oxford offer access to newer cancer treatments?
Leading centres for clinical trials, often first to offer cutting-edge therapies.
Patients may access experimental treatments not yet widely available.
Opportunities for early use of novel drugs through clinical research
What challenges exist for cancer drugs that are still under patent?
Under patent protection, meaning they can only be purchased from the developing pharmaceutical company.
Limits affordability and accessibility until generic versions are available.
Expensive, creating challenges for widespread use in the NHS.
