Radiography Shortages Causing Breast Cancer Problems

Shortages of radiologists and radiographers are causing problems for women with potential breast cancer, according to healthcare experts.

In particular, it is asserted that the breast cancer screening programme in the NHS is on the verge of grinding to a halt.

Particularly troublesome will be the growing numbers of women who will require mammograms in coming years when the age of eligibility is extended from 50-70 to 43-73.

This will also be compounded by demographic trends which point to a greying population in the coming years.

The Royal College of Radiologists (RCR) believe that there is a “looming workforce crisis facing breast cancer screening and diagnostic services in the NHS”.

Already 8% of consultant posts in radiology are unfilled owing to staff shortages.

Dr Hilary Dobson, the chair of the British Society of Breast Radiology, believes that more must be invested in staff training and recruitment if the situation is to improve.

“The skill of breast radiologists in interpreting mammograms and other complex scans is vital to the early detection and diagnosis of breast cancer, as well as in the delivery of cancer screening programmes. Without more breast radiologists to tackle this increasing demand we cannot hope to achieve the best possible health outcomes for patients”.

An official report has also found that 15% of posts among radiographers in England who carry out mammograms are currently unpopulated.

Commenting on the issue, Danni Manzi, the head of policy and campaigns at Breast Cancer Care, indicated that British women were being short-changed by the existing situation.

“These findings suggest that in the future these staff shortages could risk more women experiencing a delayed diagnosis. Any delay in diagnosing breast cancer could affect how successful treatment is because the sooner treatment starts, the more effective it’s likely to be. It’s vital any wait is kept to a minimum.”

Yet the RCR claims that the NHS has too few clinical oncologists who deliver both radiotherapy and chemotherapy.

Six of the 21 vacant consultant posts in the specialism had been unfilled for at least a year and one in five clinical oncologists were due to retire by 2021, according to RCR data.

Delyth Morgan, the chief executive of Breast Cancer Now, is understandably concerned about the problems in this sector.

“These findings are of tremendous concern. This workforce is the backbone of the screening programme and is critical to our ability to diagnose and treat women with breast cancer in England, and must now be urgently reinforced. If we are to ensure the success of the screening programme and that all patients with symptoms of breast cancer have access to the timely investigation they need, this crucial workforce must be properly resourced and sufficiently supported.”

Responding to criticisms, the Department of Health claimed that it is working hard on recruitment in this area.

“We’re helping the NHS manage increased demand in cancer services by making staffing a priority, with 20% more clinical radiologists since 2010. The NHS in England had 20% more clinical radiologists, including 20% more consultants, and almost 10% more doctors in training, than in May 2010,” a spokesman commented.

About 2.1 million women requires breast cancer screening in England on an annual basis.

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Breast Cancer Drug to be Removed From Cancer Drugs Fund

A breast cancer drug will not be routinely offered on the NHS, despite considerable negotiation from the drug manufacturer.

Kadcyla has been shown to be effective in extending the lives of breast cancer patients.

NICE has indicated that the price tag per patient, at £90,000 per individual, is not tenable.

Manufacturer Roche claims that it offered a discount; the same one it used to cut a deal with the Cancer Drugs Fund.

And it will still be possible for females in England to acquire the drug from this fund for the time being.

Kadcyla can add about six months of life to those with incurable breast cancer.

It is also utilsed to treat people with HER2-positive breast cancer that has spread to other parts of the body and cannot be surgically removed.

An undisclosed price had been agreed between the manufacturer of the drug and NHS England, with the intention of ensuring that the medicine is not taking off the Cancer Drugs Fund.

However, with the fund due to be eliminated permanently in March 2016, it seems that this treatment is about to be permanently blackballed in the United Kingdom.

The government has no intention to create a replacement to the fund at the time of writing.

Although negotiations are ongoing, charities are concerned that more breast cancer patients could miss out on getting Kadcyla in the near future if no deal is reached between those holding the purse strings of the NHS and the drug manufacturer.

Roche claims that around 800 women every year benefit from the existing medication.

But NICE believes that the price of Kadcyla is simply too high to justify its general usage compared to the clinical merits derived from it.

NICE has stated that its decision on the subject is final, although it will review the guidance if any further research becomes available.

Roche has indicated that it would be willing to return to the negotiating table with NICE.

Sally Greenbrook, of the group Breast Cancer Now, suggested that patients would ultimately suffer as a result of this decision.

“Women in England who could benefit from Kadcyla are covered – for now – by the Cancer Drugs Fund, but with just months until the new Fund is introduced, we’re yet to be convinced that the proposals will improve the outlook for breast cancer patients. We’ll do all we can to ensure that reform of the Fund leads to positive change but given that the plans include using similar thresholds to those used by NICE, and no mention of pricing negotiations, we’re concerned that the new Fund will fail to improve on the existing one and may make matters worse.”

Kadcyla is not available on the NHS in Scotland.

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Two New Diet Studies Offer Obesity And Breast Cancer Hope

Two recent academic studies give valuable insight into diet that could have a significant impact on the obesity epidemic.

The first of the two studies was conducted at Cambridge University, and indicated that portion size and human perception could be having a significant impact on our collective weight.

Researchers from the esteemed university found that offering super-sized portions or serving food on a larger plate led to participants in the study eating significantly more.

Even those who were conscientious about the amount that they ate were susceptible to consume large amounts when bigger portions were offered, according to the Cambridge-authored research.

The conclusions from the Cambridge researchers would seem to be logical, considering the amount of time that it takes for the hypothalamus to register the fact that we no longer require food.

Research from Cambridge suggested that if the general public was exposed to smaller portions across all aspects of diet, it would be possible to cut food consumption by 16 per cent.

This would amount to approximately 1,900 calories per week, which would mean a potential loss in weight of a pound every fortnight.

Dr Gareth Hollands, of Cambridge’s Behaviour and Health Research Unit, who co-led the study, suggested that the results indicate that overeating may not merely be due to a lack of self-control.

“Helping people to avoid ‘overserving’ themselves or others with larger portions of food or drink by reducing their size, availability and appeal in shops, restaurants and in the home, is likely to be a good way of helping lots of people to reduce their risk of overeating,” Hollands stated.

Dr Alison Tedstone, chief nutritionist at Public Health England, commented that it is important for people to keep a keen eye on portion size considering the rather worrying statistics related to obesity.

“Given that almost two-thirds of adults are overweight or obese, it’s important to keep an eye on portion sizes when cooking, shopping and eating out to avoid overeating and help maintain a healthy weight,” Dr. Tedstone asserted.

The findings from the Cambridge study were published in the Cochrane Database of Systematic Reviews.

Additionally, a study assessing the so-called Mediterranean diet concluded that it has the potential to reduce the risk of breast cancer by two-thirds.

The Mediterranean diet is particularly characterised by olive oil, and is consumed by countries including Italy and Greece.

It also involves swapping butter for oils, and producing meat intake in favour of more fish. Increased proportions of fruit and vegetables are also central to this diet.

Researchers found that those who follow the Mediterranean diet had a 68% lower risk of malignant breast cancer than those who consumed a low-fat diet.

Commenting on the results, lead author, Miguel A Martínez-González, said: “The results of the trial suggest a beneficial effect of a Mediterranean diet supplemented with extra virgin olive oil in the primary prevention of breast cancer. Nevertheless, these results need confirmation by long-term studies with a higher number of incident cases.”

There were nearly 12,000 deaths from breast cancer in the UK in 2012.

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