How to manage suspected cancer
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Transcript How to manage suspected cancer
How to manage
suspected cancer
Sarah Slater
Model of Care
Setting out 104 recommendations across 13 care pathways, the
Model of Care’s key recommendations were to:
Help diagnose cancer earlier : Late diagnosis of cancers with many
cancers diagnosed at a late stage when successful treatment is less
likely;
Improve patient care and reduce inequalities in access to and
uptake of services
Improve patient outcomes
Improve patient experience.
Hence development of fast track
referrals
Pathways
for Upper GI/ Urology/ Haem
Oncology/ Bone and Sarcoma/ Brain/
Ovary/ Lung/Skin/Breast
Some patients don’t fit into these
pathways.
What to do for suspected cancer
My
role=Lead for CUP
Peer review measure for Acute Oncology
Fast track pts with suspicious imaging:
lung nodules; bone lesions.
Lead on appropiate next steps
MUO
15%
cancer diagnoses present as
metastases
In 2/3, will find the primary.
For the rest (5%)=provisional CUP
Most common sites- pancreas and lung,
then
colon,stomach,oesophagus,ovary,prostate
,breast
Clinical management of patients presenting with CUPs.
Fizazi K et al. Ann Oncol 2011;22:vi64-vi68
Recommendation
• Offer the following investigations to patients with MUO, as
clinically appropriate, guided by the patient’s symptoms:
− comprehensive history and physical examination including
breast, nodal areas, skin, genital, rectal and pelvic
examination
− full blood count; urea, electrolytes and creatinine; liver
function tests; calcium; urinalysis; lactate dehydrogenase
Section 3 CLINICAL INFORMATION
THERE MUST BE IMAGING SUGGESTIVE
OF METASTATIC DISEASE BEFORE ANY
REFERRAL USING THIS FORM, AND
PLEASE SEND REPORT.
*If patient has a history of cancer please
consider whether this is more likely to be
a recurrence than a true unknown
primary cancer. Patients with suspected
recurrence should be referred back to the
site specific team.
[ ] USS: Specify site
___________________________
[ ] CT scan: Specify site
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[ ] MRI: Specify site
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Symptoms accompanying suspected
cancer imaging eg
[ ] Progressive unintentional weight loss
[ ] anorexia
[ ] Pain: Specify site
_______________________
[ ] other:
________________________________
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Examination findings and blood tests if the
latter performed.
Specify site:
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