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News - May 2011

Contents

NICE updates recommendations on management of lung cancer

Each year in the UK, there are over 39,000 new diagnoses of lung cancer, with more than 35,000 deaths as a result of this disease; it is the most common cause of cancer-related death. The NICE guideline Lung cancer: the diagnosis and treatment of cancer has been updated in response to new evidence regarding diagnosis and treatment.

The updated guideline covers topics such as:

  • the importance of early diagnosis
  • communication
  • diagnosis and staging of the disease
  • treatment for non-small-cell lung cancer:
    • surgery with curative intent
    • radiotherapy with curative intent
    • combination therapy
  • assessment of individuals with small-cell lung cancer (SCLC)
  • management of endobronchial obstruction
  • follow up and patient perspectives.

New recommendations include:

  • ensuring the availability of a lung cancer clinical nurse to support patients and carers
  • performing investigations that provide the maximum amount of information about diagnosis and staging with minimum patient risk. Careful thought should be given before performing a test that only offers diagnostic pathology when information on staging is also needed to direct management
  • offering a lobectomy as the first-line therapy to patients with SCLC who are medically fit and appropriate for treatment with curative intent. For patients who have borderline fitness and smaller tumours, consider lung parenchymal-sparing surgery if a complete resection can be realised
  • offering all patients with lung cancer an initial specialist follow-up appointment to discuss ongoing care within 6 weeks of finishing treatment. Regular appointments should subsequently be offered, rather than depending on patients to ask for appointments when they have symptoms.

www.nice.org.uk

NICE releases advice on management of ovarian cancer

Ovarian cancer is the fifth most common cancer in women, with around 6800 women being diagnosed every year in the UK. While chemotherapy and surgery can be effective treatments, women have a greater chance of survival if the disease is identified earlier on. In some cases ovarian cancer can be confused at first presentation with other conditions, such as irritable bowel disease. This can lead to women being referred to inappropriate care pathways or only being correctly diagnosed when the cancer is already at an advanced stage. The new NICE guideline, Ovarian cancer: the recognition and initial management of ovarian cancer, calls for more initial investigations, such as blood tests, to be offered in primary care for an earlier, faster diagnosis.

The recommendations in the guideline cover:

  • detection in primary care
  • establishing the diagnosis in secondary care
  • management of suspected early (stage I) ovarian cancer
  • management of advanced (stage II–IV) ovarian cancer
  • support needs of women with newly diagnosed ovarian cancer.

The guideline does not cover the entire care pathway for ovarian cancer. It focuses instead on areas where there is wide variation or uncertainty in clinical practice. It also updates and replaces recommendation 1.7.4 in Clinical Guideline 27 Referral guidelines for suspected cancer.

www.nice.org.uk

GPC publishes guide on leadership in commissioning consortia

The General Practitioners Committee (GPC) has released, Leadership in clinically-led commissioning consortia. It outlines how current arrangements would need to change to make clinical leadership in clinically-led commissioning consortia (CCC) work.

The GPC believes clinical leadership will be key in the success of CCCs, but they will need support from local GPs to meet their objectives and encourage all clinicians to take ownership of the commissioning agenda.

The guide should be read alongside the GPC document, Shadow and pathfinder consortia: developing and electing a transitional leadership.

www.bma.org.uk

Tobacco control plan for England published by DH

Healthy lives, healthy people: a tobacco control plan for England describes how the Government will support attempts to reduce tobacco use over the next 5 years, within the context of the new public health system. The Tobacco control plan sets out key actions across six strands:

  • ending tobacco promotion
  • making tobacco less affordable
  • effective regulation of tobacco products
  • supporting people who use tobacco to quit
  • lowering exposure to second-hand smoke
  • effective communications for tobacco control.

www.dh.gov.uk

'More for less' report updated by the Audit Commission

The report More for less 2009/10: are efficiency and productivity improving in the NHS? has been published by the Audit Commission. It reviews primary care trust expenditure, alterations in trust income, and how successful the NHS has been in transferring care from hospitals to more cost-effective settings.

This yearly update concludes that there appear to be no identifiable changes in past trends and little sign of progress in achieving the target saving of £15–20 billion by 2014.

www.audit-commission.gov.uk

NICE has released Technology Appraisal 222, Trabectedin for the treatment of relapsed ovarian cancer

Trabectedin in combination with pegylated liposomal doxorubicin hydrochloride is not recommended for the treatment of women with relapsed platinum-sensitive ovarian cancer.

www.nice.org.uk

Guidance on the treatment of chronic immune (idiopathic) thrombocytopenic purpura has been published by NICE

It recommends romiplostim if the patient's condition meets the criteria outlined in the guidance and if romiplostim is supplied with the discount agreed in the patient access scheme.

www.nice.org.uk

NICE does not recommend everolimus for the second-line treatment of advanced renal cell carcinoma

Individuals who are already receiving everolimus for this purpose should have the option to continue treatment until they and their clinician consider it appropriate to stop.

www.nice.org.uk

New appraisal guidance for the revalidation process has been released by the General Medical Council

It describes how doctors can demonstrate that they are fulfilling the professional standards on which good medical practice is founded.

www.gmc-uk.org

Guidance on the use of golimumab for the treatment of active and progressive psoriatic arthritis has been published by NICE

Golimumab is recommended as a treatment option for patients with this condition only if the criteria in Technology Appraisal 220 are fulfilled.

www.nice.org.uk

The Royal College of Nursing has published new standards on the care of children

Six themes are reflected in these standards including working with children and their families, preventing hospital admission, and education of the children's nursing workforce.

www.rcn.org.uk

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