Cancer

Pancreatic cancer in adults (when to offer surveillance)

This is a new guideline from NICE on pancreatic cancer. Most of this is aimed at specialists, but there was a useful bit on when to consider surveillance in people who are at higher risk. Hopefully mo...

RCOG | Endometrial hyperplasia

This is a new guideline from RCOG on diagnosing and managing endometrial hyperplasia. This is a very common condition, so highly relevant for us and I had no idea on some of the management options. I ...

Testicular cancer

testicular cancer

Aimee Lettis from GP Update on how the management of testicular cancer has come a long way in the last 50 years. Testicular cancer survival has been one of the real success stories in cancer tre...

Nice | Idelalisib for treating chronic lymphocytic leukaemia

This is a new guideline from NICE on idelalisib use in chronic lymphocytic leukaemia. Idelalisib is likely to be secondary care prescribed, but I felt it was worthwhile knowing about as it is a new ty...

Nice | Suspected cancer in adults

This is a huge guideline from NICE on diagnosing cancer, far too big to summarise easily in a blog. I have done a separate post for diagnosing cancer in children. In reality the 2 week wait referrals ...

Nice | Suspected cancer in children

Nice has published an updated guideline on suspected cancer, including cancer in children. It is a huge guideline, so I have done a separate blog for adult cancers. The BMJ has published an excellent ...

The power of professional clinical reflection

John Sanfey is the Revalidation Lead for NHS England, North West London Area Team and is the Chambers Lead Partner for Central South London, and instigated the cancer diagnosis and led it until recent...

Colorectal cancer

Aimee Lettis from the GP Update team gives us short, sharp nuggets of clinical information for sessional GPs. Diagnosing colorectal cancer can be hugely challenging. Many patients come worried they ha...

GP Update | Risk of cancer diagnosis after herpes zoster

We know that shingles occurs more commonly in cancer patients. It has been postulated that the risk of a cancer diagnosis after zoster may also be increased. This large UK-based primary care study has...

Nice | Prostate cancer

This updated guideline from Nice on prostate cancer has a couple of useful elements for us. The first is that they have standardised the protocol for 'active surveillance' and GPs are expected ...

BCSH | Myeloma

OK, so most of this guideline into myeloma is way over our level, but it is a useful reminder of when to think about myeloma as a possible diagnosis and what tests to do. Beware the possibility of mye...

Nice | Familial breast cancer

This familial breast cancer guideline doesn't change anything for us. Our role is to risk assess women and refer on to the genetics services if they may be at high risk. NICE do say that this shouldn'...

Nice | Opioids in palliative care

This guideline doesn’t really add to current practice. They advise using oral morphine as 1st line and then patches as 2nd line (or subcut if requirements are variable). Otherwise this doesn’t add to ...

Primary care cancer risk assessment tool – early diagnosis of cancer

OK, so this wasn't a guideline, but a really useful course I and a few other Pallanteers recently went on. You may have seen that the 2ww forms for colorectal cancer have changed. You are now asked to...

Sign | Colorectal cancer

Most of this guideline won’t change our management. The following points are helpful: Prevention of colorectal cancer Patients should be advised to lower their risk by following a healthy lifestyle (...

RCOG | Breast cancer and pregnancy

A lot of this is aimed at specialists. There are some useful bits about preconception counselling in a woman who’s had breast cancer and also advice about breast feeding. The most useful things are: N...

Nice | Ovarian cancer

This is well worth a read – it changes our way of investigating women with abdominal symptoms quite a lot. Using our current system, most women are diagnosed at a late stage, so we need to do somethin...

Sign | Management of testicular germ cell tumours

Most of this is not new for us, or is for secondary care. Worthwhile noting is: 2 week wait refer if epididymo-orchitis/orchitis is suspected but is not resolving in 2 to 3 weeks. Patients have an in...