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Female lung cancer cases top 20,000

Cases of lung cancer in women have reached 20,000 a year in the UK for the first time since records began.

Female lung cancer cases top 20,000The figure for 2012 represents a rise from 14,000 in 1993, according to the data compiled by Cancer Research UK.

It means the rate of lung cancer in the female population has risen by 22% to 65 cases per 100,000 people.

The trend is the opposite of what is happening with men and is linked to smoking-  which peaked in men in the 1940s but in women peaked in the 1970s.

About 24,000 men are diagnosed with lung cancer each year, which means it is the second most common cancer for both sexes.

Prof Caroline Dive, from Cancer Research UK, said: “It really is devastating to see that the number of women diagnosed with lung cancer continues to climb.”

“We also know survival remains poor and one of the problems is that lung cancer tends to be diagnosed at a late stage when it has already spread.”

That makes it hard to treat and as a result lung cancer claims the lives of 35,000 people each year.

Just 10% of people live for five years after diagnosis – compared with more than 80% for breast and prostate cancer.

Prof Dive said efforts were being made to tackle this with lung cancer one of its key priorities of its research strategy.

The work focuses on a new technique to carry out a biopsy using magnets to capture rogue cancer cells in the blood of patients – potentially providing vital information on the biology of the disease, which could help improve treatment.

But as well as investing in new treatment techniques, Nell Barrie, senior science communication manager at Cancer Research UK, said: “It’s vital that we keep on fighting against lung cancer.”

“It’s the biggest cancer killer in the UK so the government and health service must work to help smokers quit by providing more stop smoking services to help people give up this deadly addiction.”

Health Direct laments the sad increase in female lung cancers as these deaths are wholly preventable.

New drug may delay Alzheimer’s decline

New research of how a new drug could slow the pace of brain decline for patients with early stage Alzheimer’s disease have emerged.

New research of how a new drug could slow the pace of brain decline for patients with early stage Alzheimer's diseaseData from pharmaceutical company Eli Lilly suggests its Solanezumab drug can cut the rate of the dementia’s progression by about a third.

The results, presented to a US conference, are being met with cautious optimism. A new trial is due to report next year and should provide definitive evidence.

The death of brain cells in Alzheimer’s is currently unstoppable. Solanezumab may be able to keep them alive.

Current medication, such as Aricept, can manage only the symptoms of dementia by helping the dying brain cells function.

But solanezumab attacks the deformed proteins, called amyloid, that build up in the brain during Alzheimer’s.

It is thought the formation of sticky plaques of amyloid between nerve cells leads to damage and eventually brain cell death.

Solanezumab has long been the great hope of dementia research, yet an 18-month trial of the drug seemingly ended in failure in 2012.

But when Eli Lilly looked more closely at the data, there were hints it could be working for patients in the earliest stages of the disease. It appeared to slow progression by around 34% during the study.

So the company asked just over 1,000 of the patients in the original trial with mild Alzheimer’s to take the drug for another two years.

And positive results from this extension of the original trial have now been presented at the Alzheimer’s Association International Conference.

They show those taking the drugs the longest had the most benefit.

Dr Eric Siemers, from the Lilly Research Laboratories, in Indiana, said “It’s another piece of evidence that solanezumab does have an effect on the underlying disease pathology. We think there is a chance that solanezumab will be the first disease-modifying medication to be available.”

The company also started a completely separate trial in mild patients in 2012, and these results could prove to be the definitive moment for the drug.

At the moment there is no medication that can slow down dementia. If such a drug was developed it could transform how the disease is managed.

People would still get worse, but they would spend more time in the milder phase of the degenerative disease rather than needing constant care.

In a field that has been plagued by repeated disappointment, even a hint of such a drug is an exciting moment.

Next year, when further trial results are due, we will know for certain whether solanezumab is the breakthrough everyone hopes it could be.

Dr Eric Karran, the director of research at Alzheimer’s Research UK, said “If this gets replicated, then I think this is a real breakthrough in Alzheimer’s research. Then, for the first time, the medical community can say we can slow Alzheimer’s, which is an incredible step forward.”

“These data need replicating, this is not proof, but what you can say is it is entirely consistent with a disease-modifying effect. We’ve never ever had evidence that we can affect the disease process.”

Many NHS hospital patients complain of lack of dignity

A fifth of people in hospital in England are not always treated with respect and dignity according to new research.

A fifth of people in hospital in England are not always treated with respect and dignityAnalysis of the 2012 poll has found that poor care was more likely to be experienced by those aged over 80. It also found that more than a third of patients who need help at mealtimes did not receive enough assistance.

Age UK, which helped to advise the researchers, said there had been “remarkably little change” over time in the care experienced by older patients.

The report, carried out by the Centre for Analysis of Social Exclusion at the LSE, found that poor or inconsistent care was more likely to be experienced by women as well as the over-80s.

The risks were also higher for those with a long-standing illness or disability like deafness or blindness, with those in hospital for a long period, or who stayed in three or more wards, at an even greater risk.

The report was compiled using evidence from the Adult Inpatient Survey 2012, which covers people aged 16 or above who stayed in hospital for at least one night.

According to the report: “There was a widespread and systematic pattern of inconsistent or poor standards of care during hospital stays in England in 2012.”

“Patient experiences of inconsistent or poor standards of dignity and help with eating do not appear to be limited to isolated ‘outlier’ providers. Rather, this appears to be a significant general problem affecting the vast majority of NHS acute hospital trusts.”

The researchers found 23% of patients reported experiencing poor or inconsistent standards of dignity and respect, the equivalent to 2.8 million people a year, of whom a million would be aged 65 and over.

They also found that a quarter of all respondents said they needed help with eating during their hospital stay, amounting to just under 3.5 million patients a year.

Of those who needed help with eating, 38% said they only sometimes, or never, received enough help from staff – equivalent to 1.3 million people a year, and 640,000 aged 65 and over.

Age UK charity director Caroline Abrahams said: “It must be recognised that the data this research is based on is two years old now and that the newest figures suggest some welcome improvement, especially as regards older people’s experiences of dignity, but this sobering report certainly shows that hospitals need to redouble their efforts.”

“Above all it is really worrying, if perhaps not altogether surprising, that the more vulnerable an older person is, the greater their risk of not being treated as we would all wish for ourselves or our loved ones.”

“Turning this situation around ought to be a top priority and no hospital can afford to be complacent.”

NHS to show cost of missed appointments to patients

Patients who miss appointments will be shown how much they have cost the NHS.

Patients who miss appointments will be shown how much they have cost the NHS.The NHS estimates more than 12 million appointments are missed each year

Overall, missed GP and hospital appointments cost the health service in England nearly £1bn a year, Jeremy Hunt said in a speech this week.

He said he sympathised with the idea of charging patients for missing GP appointments, although there are no plans for this to happen.

But he said people would have to “take personal responsibility” for NHS funds.

In a measure announced in a speech to the Local Government Association on Wednesday, Mr Hunt said he planned to display the cost of prescription medicines on packets.

The figure and the words “funded by the UK taxpayer” will be added to all packs costing more than £20 in England.

The move is part of efforts to reduce the £300 million bill for “wasted” medication, which is prescribed but not used.

In the same speech, he said missed GP appointments cost the taxpayer £162 million and missed hospital appointments cost £750 million.

Mr Hunt told the Question Time programme that NHS resources were stretched already, adding there would be more than one million extra people aged over 70 by the end of the current parliament.

“If we’re going to square the circle and have a fantastic NHS, despite all those pressures, then we have to take personal responsibility for the way that we use NHS resources,” he said.

Mr Hunt told the audience in Essex he did not have a “problem in principle with the idea of charging people for missed appointments.”

But he added: “I think in practical terms it could be difficult to do, but I’ve taken a step towards that this week by announcing that when people do miss an appointment they will be told how much that’s cost the NHS.”

NHS medical legal costs- excessive should be capped

The UK government plans to limit excessive fees some lawyers claim in medical negligence cases against the NHS.

UK government plans to limits "excessive fees" some lawyers claim in medical negligence cases against the NHSOfficials want a defined limit on legal costs in cases where the claims are below £100,000, saying that some lawyers submit bills that charge more than patients receive in compensation.

But solicitors warn the move could deny patients access to justice. Figures show the NHS was charged £259 million in legal fees for claims in 2013-14.

The NHS did recoup £74 million by challenging some claims made in 2013-14, but the Department of Health says taking these cases to court is costly and time consuming and believes further savings could be made.

Officials say their proposals, which will be open to public consultation in the autumn, would ensure lawyer’s fees are more proportionate and reflect the amount of compensation patients receive

They give as an example once case where a patient received £11,800 in damages but the legal fees, which the NHS had to recompense, totalled £175,000.

Health Minister, Ben Gummer, said: “Safe, compassionate care is my upmost priority and to achieve this, the NHS must make sure every penny counts.

“Unscrupulously, some lawyers have used patient claims to load grossly excessive costs onto the NHS and charge far more than the patient receives in compensation.”

The Medical Defence Union, which offers doctors guidance on medico-legal issues, supported the move.

Dr Matthew Lee, professional services director for the MDU, said: “Patients often need to meet part or all of these costs themselves but the system must provide access to justice where patients have been negligently harmed.”

“Legal fees must, therefore, be affordable and proportionate.”

“If it was decided to introduce a well-thought-out, fixed-cost structure for legal costs in clinical negligence claims that could only be a good thing and should result in legal fees becoming more affordable and proportionate to the compensation claimed by the patient.”

New cancer strategy could save thousands of lives

About 5,000 lives could be saved each year in England if GPs follow new guidelines on cancer diagnosis.

About 5,000 lives could be saved each year in England if GPs follow new guidelines on cancer diagnosis.The health watchdog NICE say that a new approach is necessary to tackle England’s lagging cancer survival rates.

The guidelines suggest all GPs order certain tests directly, side-stepping referrals to specialists first, to speed up access to treatment.

Charities say they support the changes but warn that more funds are needed.

Doctors have long agreed that the sooner most cancers are diagnosed, the greater the chance of survival.

But according to experts from the National Institute of Health and Care Excellence (NICE), although the situation is improving, thousands of lives are lost each year because tumours are being diagnosed too late.

The new guidelines make wide-ranging changes to previous recommendations, to encourage GPs to think of cancer sooner and lower the threshold at which people are given cancer tests.

For the first time the guidance focuses on key symptoms, rather than encouraging GPs to consider first which cancer a patient may have and then to cross check it with the symptoms.

The recommendations also say all GPs across England should be able to order some cancer tests directly, without waiting for an appointment with a specialist.

For example in certain cases, GPs will now be able to access CT scans and internal examinations such as endoscopies, without a specialist referral.

NICE hopes this will allow patients to get investigations more quickly and take the pressure off specialists’ time.

The committee has produced information to help patients spot the most common signs of cancer so they can seek medical advice quickly.

And the guidance encourages doctors to put “safety nets” in place to ensure difficult cases are not missed.

Patients whose symptoms are worrying but do not currently suggest cancer, for example, should be given follow-up appointments or advice on when to come back.

The Royal College of GPs welcomed the guidance but warned that there might not be enough capacity to do the extra scans and checks, which could cause a backlog and longer wait times for patients.

“It would be regrettable if something that was so well-intentioned resulted in patients being worse off,” said Dr Maureen Baker, chair of the RCGP.

Sara Hiom, from Cancer Research UK, said: “We know the strain the NHS is already under and the number of people diagnosed with cancer is increasing – further investment is essential in order to support this much needed shift in investigative testing. “

She added: “Research would indicate we do fewer diagnostic tests in this country than comparable countries, but there are a lack of workforce, perhaps a lack of kit, to do those tests, so patients may be missing out because there are delays, backlogs or bottlenecks and this really does need to be addressed.”

Health Direct agrees with Cancer Research that not enough diagnostic proceedures are taking place- but we warn that the resources to fund and undertake these extra processes are not in place.

New stroke treatment should be more available

Specialists are urging the NHS to make a new stroke treatment widely available.

New stroke treatment should be more availableStudies suggest the technique for removing blood clots in the brain doubles the chance of recovery for people who have suffered an ischaemic stroke.

The specially designed “Solitaire” stent is highly effective at catching and removing blood clots. However, it is currently only available at 28 specialist hospitals in the UK.

Stroke is one of the leading causes of disability in the UK, and the treatment could benefit a quarter of patients who have a particular type of blood clot in the brain.

Stents are normally used to hold open or strengthen damaged blood vessels, but experts realised this particular device was a very effective way to “catch” and remove blood clots.

The Solitaire stent is made of a nickel-titanium alloy and looks like a net.

The Solitaire stent is used more widely to treat strokes in nearly every other developed nation. In the UK, it is only being used in hospitals that specialise in interventional neuroradiology – and there are only 28 of those.

Anyone who has an ischaemic stroke needs to get to one of these centres within six hours to even have a chance of benefitting from it.

The health regulator for England and Wales, NICE, and Scotland’s regulator, SIGN, have yet to issue guidance.

The treatment has also won the backing of Chest Heart and Stroke Scotland, a group offering free advice and support to stroke survivors and their families.

Chief executive Mark O’Donnell said the Solitaire stent method was “far more effective than any other treatment available”.

He said: “This benefit is over and above that from clot busting alone and can sometimes be used even when patients cannot safely be given clot busting drugs.

“It is likely that 300 to 500 patients could potentially benefit from clot retrieval in Scotland each year. “If this could be delivered, then over 100 people would avoid serious disability and many others would achieve improved outcomes from their stroke.”

Elderly being trapped in hospital warns Age UK

Elderly people are being “trapped” in English hospitals in ever greater numbers as there is nowhere else for them to go.

Elderly people are being Age UK said it was bad for patients’ health, a waste of NHS resources and a huge cost to taxpayers. Its analysis shows patients spent a total of nearly 2.5 million days stuck in a hospital over the past five years.

Age UK says there is a crisis in social care ranging from a shortage of care home places to a lack of district nurses to help people in their own home.

It says the situation has got worse and the number of people being kept in hospital in 2014-15 increased by 19% on the previous year.

The charity’s analysis of NHS England data for the last financial year showed the days spent stuck in hospital included:

  • 174,000 waiting for a residential home place
  • 216,000 waiting for a nursing home place
  • 206,000 waiting for help from social care workers or district nurses to get people back into their own home
  • 41,400 waiting for ramps or stairlifts to be installed into patients’ homes.

Caroline Abrahams, from Age UK, said: “These figures show that year on year, older people are being trapped in hospital in ever greater numbers because of a delayed assessment, care home place, home care package or home adaptation.

“Without decent social care when discharged, whether to their own home or to a care home, hospital stays are often much longer than they need to be and older people are more likely to be readmitted because their recovery stalls.”

She said this was a waste of NHS resources because it cost nearly £2,000 per week for an NHS bed in comparison to around £560 per week in residential care.

“Everyone agrees the way to go is to integrate social care and health much more effectively, but unfortunately our report shows we’ve got a long way to go before really the reality lives up to the rhetoric,” she said .

“And if we can’t get it right for such an important group of people, older people stuck in hospital waiting to get out, really we have to redouble our efforts and do much better.”

NHS failing to direct patients to dentists

NHS patients are still facing problems finding an NHS dentist in England, research suggests.

NHS patients are still facing problems finding an NHS dentist in EnglandA survey found some patients were confused by charges for dental treatment as access to dentistry within the NHS has been a long running problem.

To help patients navigate their way round the system, NHS Choices now provides details of which dentists accept new NHS patients.

But researchers from consumer group Which? found three in 10 advertising availability could not actually take on new patients.

There are 7,500 dental practices that provide NHS services, but only 4,500 of them were advertising as being able to see NHS patients.

Undercover Which? researchers contacted 500 of those, choosing them randomly across the country.

As well as some not having availability, 29% of those that could take on new NHS patients had waits of at least two weeks for an appointment – with one saying it would be eight to nine months before the patient could be seen.

Some practices also made people “jump through unnecessary hoops” such as visiting the surgery to fill out forms or asking patients to pay deposits.

The Which? report said the problems needed to be investigated.

Which? executive director Richard Lloyd said: “We found it frustratingly difficult to get an appointment with a dentist, as information about availability doesn’t reflect reality.

“This is a kick in the teeth for patients and yet more evidence of poor communication from the dental sector.

“We want the Competition and Markets Authority to step in and ensure that dentists put the existing rules into practice so that people can easily find out where they can get NHS dentistry.”

The research comes after an investigation by Which?, published in January, indicated half of patients who had visited a dentist in the past six months had not seen a price list and a fifth had been unsure about the costs ahead of treatment.

Cosmetic surgery cooling off period suggested

Doctors who carry out cosmetic procedures should give patients time to think before agreeing to go ahead.

Cosmetic surgery cooling off period suggestedThe General Medical Council (GMC) has produced the guidance to make surgical and non-surgical procedures, such as facelifts, breast implants, dermal fillers and Botox, safer.

It will now consult doctors and the public about the guidance, however plastic surgeons said they were already using a two week cooling off period.

In 2013, a report by NHS England’s medical director highlighted the risks associated with the cosmetic sector.

This followed safety concerns after nearly 50,000 women in the UK had PIP breast implants fitted.

The French implants were made from an unauthorised silicone filler and were found to have double the rupture rate of other implants.

In January, the Royal College of Surgeons published a consultation on proposals to improve standards in cosmetic surgery.

The GMC sets the standards that are expected of all UK doctors who carry out cosmetic procedures. It also tries to help patients understand what to expect from their doctor.

Some of the main points in the new guidance say that doctors should:

  • Be open and honest with patients and not trivialise the risks involved
  • Give patients enough time and information before they decide whether to have a cosmetic procedure, allowing them time to “cool off”
  • Ask patients to tell them how they have been affected by a cosmetic procedure, both physically and psychologically
  • Not target people under 18 through their marketing and seek additional advice from professionals who treat young people
  • Seek their patient’s consent themselves rather than delegate it
  • Not make unjustifiable claims about the results they can achieve and not give away procedures as prizes

Prof Terence Stephenson, the chairman of the General Medical Council, said some patients in this area were vulnerable and needed protecting.

“We are clear that doctors must not pressure patients to make rushed decisions they may end up regretting and they must give them enough information so they can make an informed choice.”

Rajiv Grover, consultant plastic surgeon and former President of the British Association of Aesthetic Plastic Surgeons (Baaps), welcomed the GMC’s guidance because he said some patients were psychologically unsuitable for cosmetic surgery.

“Cosmetic surgery has for too long been seen as a commodity but unfortunately once an operation is done – it can’t be taken back to the shop.”

He said Baaps had insisted on a two week cooling off period for many years and also encouraged a second consultation with a surgeon before a decision was made.

The association is looking into developing a screening tool to help identify patients who should not have surgery.

The final GMC guidance is expected to be published in early 2016.

Health Direct thinks the GMC initiative is a common sense approach to a growing issue as more people opt for cosmetic surgery.