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 am therefore doing a general summary. Types Endometrial Hyperplasia without atypia - fewer than 5% will progress to cancer…
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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 treatment in recent years, with cure rates of 95% in patients diagnosed with testicular cancer and 80% in those with…
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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 will be directed by what is on the referral form, so I have ignored those bits of the…
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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 summary including a useful 'infogram' for suspected childhood cancer. One to keep handy somewhere... The main points are: Abdominal mass /…
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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 recently. Last year, the London appraisal teams asked GPs to prioritise cancer in their choice of case study within appraisal. There were…
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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 have colorectal cancer and it can be difficult to determine who needs investigation. Focusing on colorectal cancer, survival is significantly better if detected early, but…
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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 to be involved in the PSA monitoring aspect - so that is worth having a look at. The second aspect is about managing some…
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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 myeloma in patients who present with: Bone disease or pain Impaired renal function Anaemia Hypercalcaemia Recurrent or…
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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't be screening, but a response to a concerned woman, or if there seems to be a significant history…
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