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84 Dealing with the impact of surgery for lung cancer on the patient & their family
Posters, 5th Annual BTOG Meeting, 2007 Conclusion: Improved Nurse/Patient relationship reiterated by an increase in communication via phone calls. A proactive rather than reactive approach has enabled services to be accessed to prevent crisis management. Patients/Relatives/Carers appear to appreciate the clinic, which we feel has improved the Quality of life and care for lung cancer patients within South Tees Hospital Trust. Whether survival for the few or palliative care for the most. 83 Thoracic surgical liaison in lung cancer: developing a role in the patient journey A. Cunningham, L. Vasey. Departments of Cardiothoracic Surgery, Western Infirmary and Royal Infirmary, Glasgow, UK Introduction: Previous research in our department highlighted the plight of patients post-discharge after surgery for lung cancer. Gaps existed in communication between primary & secondary care and with the patient. A Macmillan Thoracic Liaison Nurse was appointed in September 2006 with the aim of addressing these issues. The challenge has been to complement the existing care pathway while expediting treatment where possible and provide a source of emotional and social support to vulnerable patients and carers. Methods: Qualitative methods of data collection were used in unstructured interviews & feedback from patients, carers, oncologists & General Practitioners. Results: Preliminary results indicate that the Thoracic Surgical Liaison nurse has had some impact in increasing referrals from Respiratory Units, delivering investigations & surgery within a timely manner (increasingly within the 62 day target) & improving communication between the Thoracic Surgical unit & primary care. Conclusion: Early experience suggests that the skills of a Nurse Specialist dedicated to Thoracic Surgery improves the efficiency & quality of patient care. 84 Dealing with the impact of surgery for lung cancer on the patient & their family S. Devenay. Department of Cardiothoracic Surgery, Western Infirmary, Glasgow, UK Introduction: Personal observation suggested that the diagnosis of lung cancer is devastating. The effects of this on the individual may be exaggerated when an operation is involved. Time & patience are often required to deal with this. Unfortunately with the recently imposed political deadlines, some of the “softer” aspects of the patient’s management are being abandoned in favour of speeding up the delivery of treatment. Methods: A standard literature review was made using personal sources & the internet search engines Medline & Pubmed. Results: Literature review confirms that surgery is the form of treatment in lung cancer that is most often associated with cure. The maximum number of patients should be considered for surgery, through the auspices of the multidisciplinary team (MDT). All sources recommended that a named person from the MDT should be available for counselling & support and that this person should be a Nurse Specialist. Conclusions: Social support is vital if a patient is to accept the disease This support should be in the form of a Nurse Specialist in Lung Cancer Surgery More patient & carer groups are required Recorded consultations and more literature may be helpful Further research will be required when a Nurse Specialist in Lung Cancer Surgery has been appointed
S23 85 Demographic and prognostic look at lung cancer patients in South East Eire K.I. Quintyne, P. Calvert. Waterford Regional Hospital, Ireland Introduction: The crude incidence of lung cancer in the European Union is 52.5/100,000 per year, the mortality is 48.5/100,000 per year [1]. Lung cancer remains the commonest cause of cancer-related death with a median survival of 10 months despite treatment. Based on our catchment population of 425,000 we sought to document incidence, demographics, prognostic factors and uptake of cytotoxic therapy for patients with newly diagnosed lung cancer from our area. Method: Study period: 01/01/06 30/06/06. Data sources for our study included: (i) WRH Medical Oncology database, (ii) Attendance records from the region’s four chemotherapy day units, (iii) WRH department of pathology files, (iv) Bronchoscopy lists at Wexford General and SJH Dublin, (v) Individual patient case records, (vi) National Cancer Registry data. Results: 40 patients were identified, M:F (22:18). Mean age was 69 years (SD 9.2 years). Modal ECOG performance status at presentation was 1, and the most common stage of presentation was 4. The histological subtypes were NSCLC 75% (30/40), SCLC 22.5% (9/40), unknown 2.5% (1/40). 92% were smokers. 50% of patients received chemotherapy and 60% of these patients successfully completed their prescribed regimens. Conclusion: Retrieval of information for this cohort of patients was difficult and limited in our region. Greater resource investment is needed to facilitate service planning. Advanced age and tumour stage at presentation limit the suitability of patients with newly diagnosed lung cancer for chemotherapy; nonetheless 50% of patients in our region were suitable for cytotoxic therapy, with more than half completing their chemotherapy. Reference(s) [1] Anonymous. Ann Oncol 2005; 16(Suppl 1): 128 9.
86 An audit of lung cancer referrals detected during CT pulmonary angiogram (CTPA) J. Evans, D. Ip, E. Sawicka. Princess Royal University Hospital, Farnborough, Kent, UK Introduction: The lung cancer service had noticed that an increasing number of patients were being referred with a possible diagnosis of lung cancer following CTPA, usually as a result of an emergency attendance to the hospital. An audit was carried out to investigate the reasons for this. Methods: We reviewed 639 CTPA reports from the radiology department during the period February 2004 August 2006, and recorded abnormalities suggestive of an underlying malignancy. We were able to access 88% of the chest radiographs (CXR) and 69% of the clinical records. From this, we were able to ascertain symptoms, presumed diagnosis and radiological findings which had prompted this line of investigation, and assess whether it was appropriate. Results: 159 (25%) patients with CTPA abnormalities leading to a new diagnosis of primary lung malignancy (17.5%), lymphoma, metastatic disease or tumour recurrence (7.4%) were identified. Of the former, 69% were documented as current or ex-smokers, 67% had one or more symptoms suggestive of lung cancer and 76% had CXR abnormalities suggestive of malignancy. In only 24% of patients (6% of all patients undergoing CTPA) should the diagnosis of malignancy have been unexpected and therefore diagnosed earlier through CTPA. In only 3 cases were there coexisting lung malignancy and pulmonary embolism. Conclusion: The increased number of CTPAs requested by clinicians, appears to reflect fear of missing pulmonary emboli. It is worrying that this seems to take priority over assessment of clinical history, physical signs and CXR abnormalities of patients with potential malignancy. This results in inappropriate imaging,
S23 85 Demographic and prognostic look at lung cancer patients in South East Eire K.I. Quintyne, P. Calvert. Waterford Regional Hospital, Ireland Introduction: The crude incidence of lung cancer in the European Union is 52.5/100,000 per year, the mortality is 48.5/100,000 per year [1]. Lung cancer remains the commonest cause of cancer-related death with a median survival of 10 months despite treatment. Based on our catchment population of 425,000 we sought to document incidence, demographics, prognostic factors and uptake of cytotoxic therapy for patients with newly diagnosed lung cancer from our area. Method: Study period: 01/01/06 30/06/06. Data sources for our study included: (i) WRH Medical Oncology database, (ii) Attendance records from the region’s four chemotherapy day units, (iii) WRH department of pathology files, (iv) Bronchoscopy lists at Wexford General and SJH Dublin, (v) Individual patient case records, (vi) National Cancer Registry data. Results: 40 patients were identified, M:F (22:18). Mean age was 69 years (SD 9.2 years). Modal ECOG performance status at presentation was 1, and the most common stage of presentation was 4. The histological subtypes were NSCLC 75% (30/40), SCLC 22.5% (9/40), unknown 2.5% (1/40). 92% were smokers. 50% of patients received chemotherapy and 60% of these patients successfully completed their prescribed regimens. Conclusion: Retrieval of information for this cohort of patients was difficult and limited in our region. Greater resource investment is needed to facilitate service planning. Advanced age and tumour stage at presentation limit the suitability of patients with newly diagnosed lung cancer for chemotherapy; nonetheless 50% of patients in our region were suitable for cytotoxic therapy, with more than half completing their chemotherapy. Reference(s) [1] Anonymous. Ann Oncol 2005; 16(Suppl 1): 128 9.
86 An audit of lung cancer referrals detected during CT pulmonary angiogram (CTPA) J. Evans, D. Ip, E. Sawicka. Princess Royal University Hospital, Farnborough, Kent, UK Introduction: The lung cancer service had noticed that an increasing number of patients were being referred with a possible diagnosis of lung cancer following CTPA, usually as a result of an emergency attendance to the hospital. An audit was carried out to investigate the reasons for this. Methods: We reviewed 639 CTPA reports from the radiology department during the period February 2004 August 2006, and recorded abnormalities suggestive of an underlying malignancy. We were able to access 88% of the chest radiographs (CXR) and 69% of the clinical records. From this, we were able to ascertain symptoms, presumed diagnosis and radiological findings which had prompted this line of investigation, and assess whether it was appropriate. Results: 159 (25%) patients with CTPA abnormalities leading to a new diagnosis of primary lung malignancy (17.5%), lymphoma, metastatic disease or tumour recurrence (7.4%) were identified. Of the former, 69% were documented as current or ex-smokers, 67% had one or more symptoms suggestive of lung cancer and 76% had CXR abnormalities suggestive of malignancy. In only 24% of patients (6% of all patients undergoing CTPA) should the diagnosis of malignancy have been unexpected and therefore diagnosed earlier through CTPA. In only 3 cases were there coexisting lung malignancy and pulmonary embolism. Conclusion: The increased number of CTPAs requested by clinicians, appears to reflect fear of missing pulmonary emboli. It is worrying that this seems to take priority over assessment of clinical history, physical signs and CXR abnormalities of patients with potential malignancy. This results in inappropriate imaging,