Chapman S.,The Royal Marsden NHS Foundation Trust
Nursing standard (Royal College of Nursing (Great Britain) : 1987) | Year: 2012
Pain is a significant problem in patients with cancer. Understanding the causes and types of cancer pain, thorough pain assessment and use of individualised pain management strategies can help to improve quality of care and pain relief for patients with cancer This article provides an overview of cancer pain and the effects this may have on patients and their carers. The nurse's role in understanding pain and interventions that may help to minimise pain are discussed. Assessment and management of cancer pain will be explored in a subsequent article.
Cook G.J.,The Royal Marsden NHS Foundation Trust
Cancer imaging : the official publication of the International Cancer Imaging Society | Year: 2010
Bone scintigraphy augmented with radiographs or cross-sectional imaging, such as computed tomography (CT) or magnetic resonance imaging (MRI), has remained the commonest method to diagnose and follow up skeletal metastases. However, bone scintigraphy is associated with relatively poor spatial resolution, limited diagnostic specificity and reduced sensitivity for bone marrow disease. It also shows limited diagnostic accuracy in assessing response to therapy in a clinically useful time period. With the advent of hybrid positron emission tomography (PET)/CT scanners there has been an increasing interest in using various PET tracers to evaluate skeletal disease including [(18)F]fluoride (NaF) as a bone-specific tracer and [(18)F]fluorodeoxyglucose and [(18)F]choline as tumour-specific tracers. There is also early work exploring the receptor status of skeletal metastases with somatostatin receptor analogues. This review describes the potential utility of these tracers in the assessment of skeletal metastases.
Yim K.L.,The Royal Marsden NHS Foundation Trust
Recent results in cancer research. Fortschritte der Krebsforschung. Progrès dans les recherches sur le cancer | Year: 2011
With the progress of research in molecular biology and greater understanding of cell signalling systems emerge an increasing array of potential targets for the therapy of cancer. While traditional chemotherapy aims to elicit tumour cell death, it also produces undesirable side effects on physiologically proliferating cells. By isolating cell surface receptors which link specific intracellular secondary messenger pathways, researchers are increasingly able to define the biological network which drives cellular function. Of importance are routes involved in malignant transformation, proliferation, survival and angiogenesis. Thus targeted therapy is directed to specific differential growth processes particular to malignant tumours. The principle mode of action generally involves the "lock-and-key" mechanism and identifying the "Achilles' heel" for drug action. Various targeted agents have been studied and many have translated into significant clinical benefit. This chapter will describe some examples which illustrate the role of this approach in gastrointestinal cancers.
Fisher C.,The Royal Marsden NHS Foundation Trust
Diagnostic Histopathology | Year: 2011
Soft tissue sarcomas are rare but have numerous subtypes, and both benign and malignant soft tissue tumours can show considerable morphological variation. With increasing subspecialization, histopathologists become less skilled outside their areas of practice, and it can be difficult for an inexperienced pathologist to assess malignancy, subtype and grade of a sarcoma as required for management. In different clinicopathological settings, there is a consistent discrepancy rate between referring and expert diagnoses of approximately 25% for diagnosis and grading, with about a 5% malignant-benign change.Soft tissue tumour specimens should therefore be reported by specialist pathologists, within a multidisciplinary team. Furthermore, outcomes are better in specialized centres with dedicated multidisciplinary teams bringing together expertise in imaging, histopathology, surgery and oncology. This should include access to cytogenetic and molecular genetic diagnostic services. Ideally, patients with soft tissue masses suspected to be malignant should be referred to a specialist unit before biopsy. © 2011 Elsevier Ltd.
Chapman S.,The Royal Marsden NHS Foundation Trust
Nursing standard (Royal College of Nursing (Great Britain) : 1987) | Year: 2011
Advances in medical knowledge and treatment have resulted in improved five-year survival rates for some forms of cancer. However, pain syndromes resulting from chemotherapy, radiotherapy, surgery or interventional procedures continue to have a significant effect on cancer survivors' quality of life. Nurses are uniquely placed to assess pain in cancer survivors and ensure pain management strategies are initiated. This article focuses on chronic pain syndromes that can occur following cancer treatment, examining the effect of pain on patients' quality of life.