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Cancer World Newsletter - Cover Story, Roger Stupp: What's so ethical about strangling research? PDF Print E-mail
Patients are being let down by rules and legislation that claim to protect their interests says Roger Stupp, president of the EORTC. In this cover story he calls for academics to get back control, so that opportunities to find answers to important questions are not lost due to unnecessary costs and red tape.

What do you think?

  • Is it unethical that so many patients are being treated outside of trials, when there are so many questions that urgently need answers.
  • How can we better balance the ethical imperative to speed up progress in cancer treatment with the need to protect the interests of patients?
 You can read the article here. Press the comment button at the end and share your views.
 
Cancer World Newsletter - Editorial: 'Why me?' Helping patients find answers PDF Print E-mail
When your patients suffer severe anxiety, depression or stress, you can refer them to a psycho-oncologist or professional counsellor for help. But who can help them make sense of the knowledge that they have a disease that will ultimately kill them?

In this editorial, Roger Wilson, president of the patient advocacy group Sarcoma Euronet, says the traditional approach of leaving this aspect of care to ministers of religion is not the answer for most people. He offers some suggestions about how to meet the challenge of addressing patients’ needs for spiritual support, and calls for more attention to be given to this topic, which is widely recognised on paper, but largely neglected in practice.

What do you think?

  • How do you respond to your patients’ needs to make sense of why this had to happen to them and what will happen when they die?
  • Would you value being able to refer patients who want it to an accredited counselling service to help them try to find answers?
  • Have you suggestions about how such a service should provided, and by whom – or thoughts about what would not work?
 You can read the article here. Press the comment button at the end and share your views.
 
Cancer World Newsletter - e-Grandround Managing the sexual consequences of cancer and its treatment PDF Print E-mail
Sexual difficulties are not uncommon in the general population, and going through cancer and cancer treatments is known to increase the rate and severity of problems particularly in patients treated with pelvic radiotherapy. In this e-grandround, Isabel White, from the Royal Marsden Hospital in London, looks at how well oncologists screen for and address potential sexual problems, and offers some practical advice.

What do you think?

  • Do you invite patients to raise any sexual concerns they may have as a routine part of follow-up consultations?
  • Are you equipped to respond to issues they may raise; if not, can you refer them to someone who is?
  • If you are a patient, do you feel sexual problems are often not reported or addressed because doctors fail to explicitly ask about them in consultations?
You can read the article here. Press the comment button at the end and share your views.
 
Health-EU newsletter 119 - Focus: European Antibiotic Awareness Day promotes prudent antibiotic use in over 40 countries PDF Print E-mail
By Marc Sprenger, Director of the European Centre for Disease Prevention and Control (ECDC)

Antibiotic-resistant infections are increasing at an alarming pace, posing a great threat to human health. I believe that improving antibiotic use practices is the most important action needed to slow the development and spread of antibiotic-resistant bacteria. Antibiotics are frequently used inappropriately or when they are not needed in both humans and animals.

The 2001 Council Recommendation on the prudent use of antimicrobial agents in human medicine stated that EU Member States should inform the general public of the importance of prudent use of antimicrobial agents. ECDC decided in 2008 to establish the European Antibiotic Awareness Day (EAAD) on 18 November as a platform for providing support to national campaigns across the region. For the 6th year, activities promoting prudent use of antibiotics have taken place in more than 40 countries across Europe.

The European Commission and WHO/Europe, together with numerous health-related and professional organisations, have partnered with ECDC in preparing communications materials and planning activities for EAAD. The EAAD website includes communications materials in all European Union languages targeting the general public, primary care prescribers and hospital prescribers. Social media is increasingly being used to convey EAAD messages, including through EAAD Twitter (@EAAD_EU) and Facebook (https://www.facebook.com/EAAD.EU) sites.

To reduce levels of antibiotic resistance in Europe, we recognise the need for global cooperation. ECDC is proud that antibiotic use campaigns in the US, Canada and Australia have been aligned to the week of 18 November in order to coincide with EAAD.

Read the full focus of this edition
 
Cancer World Newsletter - Patient Voice, Navigating uncharted waters: a guide to shared decision making PDF Print E-mail
Most oncology professionals don’t want to play God. But how can you help patients truly share in decisions about their own care if every option carries a level of uncertainty and they feel overwhelmed or unwilling to accept the stark choices on offer? In the Patient Voice, international experts give their advice.

What do you think?

  • Do you find it hard to engage patients in reaching decisions about their own care?
  • Do you feel you have had enough training and advice on this aspect of your job?
  • Have you any tips for others?
  • If you are a patient, have you any tips for the doctors?
 You can read the article here. Press the comment button at the end and share your views.

 
Cancer World Newsletter - Systems & Services: A coordinated approach to multidisciplinary guidelines PDF Print E-mail
Multidisciplinary guidelines for diagnosis, treatment and care can end up sidelined if they fail to command the trust of all disciplines involved or fall short of the quality criteria for guideline development that many health services now insist on. In this systems and services article, the chair of ECCO’s new Multidisciplinary Clinical Guidelines Forum explains a new initiative designed to help people get it right.

What do you think:

  • So long as the management of patients is discussed within a multidisciplinary setting, is it enough for each professional group to develop their own guidelines?  or is there value in taking a co-ordinated approach to guideline development?
 You can read the article here. Press the comment button at the end and share your views.
 
Cancer World Newsletter - Cover Story: David Cameron: what do we really know about the quality of care we provide? PDF Print E-mail
With health budgets under pressure from multiple directions, getting the best possible health outcomes for the available resources has never been more important. But it’s never going to happen, argues David Cameron in this Cover Story, until those in charge of health policy and health service delivery invest in gathering and collating the data and doing the sums. If we want to do better, we need to ask questions about the quality of healthcare we deliver, is his message.

What do you think?

  • How far are decisions about health policy and delivery of health service based on hard evidence about what delivers the best value in terms of outcomes?
  • How far are you aware of the costs and benefits associated with the interventions you deliver?
  • Should clinicians feel responsible for getting the best value from limited health budgets, or is that just a job for the accountants?
 You can read the article here. Press the comment button at the end and share your views.
 
Cancer World Newsletter - Editorial: We need to get serious about management PDF Print E-mail
Clinicians are being increasingly called on to assume hospital management roles. This could make sense if we are to believe the evidence that shows hospitals are run better when clinically qualified managers are in charge. But clinicians are rightly reluctant to take on responsibilities for which they have received no formal training. This Editorial looks at an initiative designed to address this need and asks whether professional societies need to introduce management skills into their CME programmes.

What do you think?

  • Does it makes sense for clinicians to become more involved in hospital management?
  • Would you consider taking on a management role?
  • Would you value access to training in basic management skills?
 You can read the article here. Press the comment button at the end and share your views.
 
Cancer World Newsletter - Refusing treatment PDF Print E-mail
Doctors want to do the best for all their patients. But what can they do if a patient says no to a treatment that could make a difference to their chances of being cured? This Focus article reflects on conversations with people often referred to as “difficult” or “non-compliant” patients. It argues that, hard though it is to accept a refusal to follow evidence-based medical advice where lives are at stake, doctors who make an effort to listen and understand what their patient is saying – and are willing to respect whatever decision they take – will be more likely to be given a fair hearing by patients.

What do you think?

  • Have you ever worked with a patient who refuses some or all or key treatment recommendations?
  • Do you find it hard to discuss treatment options with patients whose decisions are heavily influenced by factors outside of the medical evidence?
  • How do you handle these sorts of consultations?
 You can read the article here. Press the comment button at the end and share your views.
 
Cancer World Newsletter - New paradigms to explain metastasis PDF Print E-mail
New knowledge about the process of metastasis is calling into question treatment paradigms that focus purely on preventing cell division.

In this e-grandround, Elizabeth Comen, part of the Memorial Sloan-Kettering team led by Larry Norton that has been leading much of this ground-breaking work, gives an overview of developments in our understanding of metastasis and looks at the potential of immunotherapy and other treatments aimed at manipulating the tumour microenvironment for inhibiting seeding of circulating cancer cells.

What do you think?

  • Is the search for new therapies still focused too heavily on finding ways to shrink tumours rather than inhibiting their capacity to spread?
 You can read the article here. Press the comment button at the end and share your views.
 
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