Better palliative care needed for cancer sufferers
pharmafile | June 19, 2008 | News story | |Â Â Â
A national audit of care received by people in England and Wales with oesophago-gastric cancer has concluded that care has improved, but palliative care services still need further improvement.
Oesophago-gastric cancer (OG) is the fifth most common type of cancer, and patients with the disease need specialised care.
The main problems that the audit, funded by the Healthcare Commission, found were:
* No palliative care clinicians routinely attended multi-disciplinary team meetings at approximately one in three PCTs
* 7% of PCTs had no nurse specialist
* 26% of specialist cancer centres had no dietician support for their surgical inpatients
The point about nutrition support is particularly significant because this type of cancer can make eating difficult.
The Health Commission's chief executive Anna Walker urged health professionals to listen to the audit's recommendations.
"While we can see there have been some improvements, there remains more to be done," she said. "It is particularly important that patients with this cancer have access to palliative care and dietitians."
David Cromwell of the Royal College of Surgeons Clinical Effectiveness Unit, agreed: "It is clear that services have improved considerably over recent years. However, there are some aspects of care that need prioritising."
Despite the problems, the survey found that care received by patients has improved overall:
* The proportion of patients with OG cancer who are alive one year after diagnosis has increased from 30% (1998) to 37% (2005)
* Cancer Networks are following recommendations to move curative surgery to specialist cancer centres to improve clinical care
* Clinicians do routinely work together in multi-disciplinary teams and nurse specialists provide a single point of contact for patients
* Patients had good access to the investigations required to establish the spread of the cancer – a significant help in deciding the appropriate treatment.
The audit throws light in particular on the work of Cancer Networks.
Stuart Riley, consultant gastroenterologist and member of the British Society of Gastroenterology, said: "Patients with OG cancer can have their quality of life severely affected if their symptoms are not well managed. It is important that Cancer Networks provide a full range of palliative therapies and that hospitals ensure their palliative care teams are involvement at an early stage of a patient's care."
Richard Hardwick, consultant surgeon and member of the Association of Upper GI Surgeons, said they should complete the centralisation of surgery "as soon as possible and ensure that there are sufficient surgeons in each cancer centre to provide comprehensive cover".
Around 13,500 people, mainly older patients, are diagnosed with either oesophageal or gastric cancer each year. Overall five-year survival rates are 7% (oesophageal) and 13% (gastric).
