Last month we were delighted to support the 2018 National Colorectal Cancer Nurse Network (NCCNN) study day. We welcomed healthcare professionals from across the country to London for a varied and engaging day of updates on bowel cancer.
Professor Gary Middleton kicked off the day’s presentations with an overview of the value of genomics for bowel cancer. He emphasised that the types of mutation a cancer has can vastly impact treatment decisions and outcomes. And that there’s a real need to identify more mutations to test for to accelerate progress for patients, making this is a really exciting area of research.
A similar theme ran through Consultant Medical Oncologist, Kai Keen-Shiu’s presentation. Describing the results of various clinical trials, his talk demonstrated the range of responses patients can have to the same therapy based on their genes. Whilst much of the research focuses on patients with advanced disease, trials are now beginning to explore its potential in earlier stage bowel cancer too.
London Bowel Screening Hub Director, Natasha Djedovic, updated delegates on the bowel cancer screening programme. Looking ahead to the introduction of FIT – which is expected to be fully rolled out by April - she described the benefits and anticipated improvements in uptake. And there’s more to come in the future, including lowering the eligible age to 50 (something the government have already committed to), potentially varying screening intervals and cut offs for different groups and deciding the fate of bowel scope.
Keeping with the topic of screening, Sarah Marshall from St Mark’s Hospital, along with Dr Lesley McGregor and Dr Christian von Wagner from University College London teamed up to talk about initiatives to improve uptake. Interventions include staff training, community outreach, GP non-responder support services and reminder letters have demonstrated promising results. We learnt from Dr von Wagner that how you present information to people could influence behaviour and Dr McGregor concluded by focusing on patient navigation as a potential way of encouraging participation.
Dr Jane Winter gave an overview of the changing nature of clinical nurse specialists, highlighting the evolution of the role over time. She covered the wide-ranging benefits of the support worker role – from care planning and coordination to referrals, service improvement and emotional support. Dr Winter also underlined the importance of stratification - each patient has different needs so tailoring support is key.
Moving along the patient pathway, the afternoon sessions began with Lesley Smith from NHS England. The number of people living with cancer continues to rise year on year. But it’s clear the traditional ‘one size fits all’ approach to follow up isn’t an option going forward. Personalisation of care is crucial and this can be both professional and self-managed. ‘Quality of life and experience matter as much as survival’ was one of Lesley’s take home messages.
Jenny McDonald from the Royal Alexandra Hospital talked about the importance of prehabilitation – something which happens between being diagnosed and starting treatment to help improve recovery. Promoting physical activity before surgery has the potential to reduce post-op complications. But things like body image, lack of education and financial implications can all act as barriers. Involving the patient in decisions, setting achievable goals, signposting to classes for patients with cancer, educating the whole team and recommending free activities like walking can all help.
Professor Arthur Sun Myint talked us through Papillon - a groundbreaking type of radiotherapy that means surgery can be avoided in some patients who aren’t suitable or don’t want to have it. The technique is able to deliver radiotherapy directly to the tumour, limiting damage to the surrounding tissues. At the moment the treatment is only available at a few selected centres in England, for people with certain types of rectal cancer.
Clinical Nurse Specialist Vicki Pleavin-Evans presented on treatment for patients whose bowel cancer has spread to the peritoneum. A type of surgery called cytoreduction plus ‘HIPEC’ – a heated chemotherapy treatment delivered straight to the abdomen – are treatment options shown to greatly improve survival for some patients with this type of bowel cancer.
The day was brought to a close with our Gary Logue Colorectal Nurse Awards, marking the achievements of colorectal nurses who make a huge difference to both the lives of their patients and colleagues across the UK. Congratulations to everyone who won an award!