Spa medical expert helps highlight bowel cancer symptoms

A MEDICAL expert in Droitwich Spa is calling on people to recognise the symptoms of bowel cancer.

It is the UK’s second biggest cancer killer claiming a life every 30 minutes, yet bowel cancer spotted early can be successfully treated in over 90 per cent of cases.

As Bowel Cancer Awareness Month starts in April, medical experts throughout the country are calling on people to recognise the symptoms so they are able to act quickly if they spot anything out of the ordinary.

At BMI Droitwich Spa Hospital, consultant colorectal surgeon Simon Radley stressed that early treatment could mean the difference between life and death.

He said: “If you know what is normal you can then act if something out of the ordinary happens.

“A change in your bowel habit that lasts for three weeks or more, blood in your poo are warning signs that need acting upon as soon as possible.”

Figures provided by Cancer Research show that over 93 per cent of people diagnosed with bowel cancer at an early stage survive for at least five years compared with less than seven per cent of those diagnosed at a late stage.

Read More - http://www.worcesternews.co.uk/news/10320561.Spa_medical_expert_helps_highlight_bowel_cancer_symptoms/

Bowel screening identifies early cancers

Around 40 000 people are diagnosed each year in the UK with bowel cancer.

A bowel cancer population-screening program is now running throughout the UK using a simple stool test.

At the recent National Cancer Intelligence Network conference in Birmingham, researchers using data from the West Midlands Cancer Intelligence Unit presented a study looking at bowel cancers in the region between January 2006 and September 2011 in people aged 60-69. In total there were 5,633 cancers of which 904 were detected by screening.

Researchers compared the stage at diagnosis of bowel cancers picked up by screening and those identified from symptoms.

18.5% of bowel cancers detected by screening were at the earliest stage compared with 9.4% of the cancers detected in patients with symptoms.

Late stage (advanced) cancers were more commonly found in patients with symptoms than in the screened population.

When bowel cancer is diagnosed in its earliest stage more than 90% of patients will survive for at least 5 years

There are several studies, which show that bowel cancer screening does save lives. The West Midlands data show that bowel screening picks up cancers at an earlier stage where cure is more likely.

There remains concern about the low uptake of the bowel cancer screening by the population as a whole and particularly amongst men.

It is important that when that kit arrives, you complete test. The testing is not always diagnostic, if you have any unexplained bowel symptoms or bleeding you should always seek medical advice irrespective of the test result.

Simon Radley July 2012

BUPA to cut fees to consultants

I read an interesting article in the BMA news review regarding BUPA and the latest round of fee cuts.

Most consultants in private practice will have received BUPA’s new range of fees pertaining to their speciality. Procedure fees paid to consultants have been reduced in some cases by up to 50%.

Derek Machin chair of the BMJ private practice committee has commented “this is a reduction in benefits for patients. There has not been any increase by and large for these re-imbursements for 20 years, and they have now cut some of them by 50% leading to a shortfall for patients” he goes on to say that “the British Medical Association advice is for consultants to send their bills to the patients, not to the insurer, because it is the patients that they have the relationship with’

BUPA has said that they “benchmark procedures against other relevant procedures to establish its relative complexity, time and skill required”. It is interesting that where changes have taken place the vast majority are cuts to fees rather than increase. Whilst many would agree that medical fees do need regular review as procedures change both in terms of time, complexity and risk, there are many consultants left questioning this whole process, seeing it simply as a cost cutting exercise by BUPA that has little to do with proper reimbursement for high quality healthcare.

There has been no engagement with speciality organisations, most of whom have their own private practice sub-committees.

The BMA private practice committee has sought to meet with BUPA to discuss the issue, the company have refused.

As more consultants and specialities are drawn into this inevitably patients will become concerned that they are no longer able to see the consultant of their choice and the their medical insurance will not cover the costs of their private healthcare. The parallels with the BUPA/ BMI Healthcare dispute from earlier this year are becoming clearer with once again the patient stuck in the middle.

Simon Radley July 2012

Diverticular Disease and Fibre

Some years ago I wrote a short review article on fibre and diverticular disease so I read with interest a recent article in the British Medical Journal on treating diverticular symptoms with fibre.

Whilst we know that a low fibre intake is associated with an increased risk of developing diverticulosis, there isn’t any good evidence that treating symptomatic diverticular disease with fibre is of benefit.

The article highlights the lack of scientific evidence and points out that it is unlikely that there will ever be any industry lead trial of fibre supplementation, as fibre would not be patentable.

There is however, growing interest from companies in looking at other treatments that alter gut bacteria or immunology.

Trials are currently underway looking at an anti-inflammatory drug, mesalazine, in treating symptomatic diverticular disease and also for preventing acute diverticulitis as well as studies of Lactobacillus in uncomplicated diverticular disease. The results of these trials may lead to some new treatments for diverticular disease.

In the meantime, I agree with the conclusions of the authors.

It is always important to let patients understand the lack of evidence around treatments for diverticular disease and fibre in particular.

Fibre can be beneficial for patients, in particular relieving constipation but it is important to warn them that it can also increase flatulence and can sometimes exacerbate pain. If patients are already taking a high fibre diet it can be beneficial for them to reduce their fibre intake a little. This strategy certainly works well for irritable bowel sufferers already on a high fibre diet.

Obesity has been associated with increased risk of symptoms from diverticular disease, a high fibre diet in the overweight patient may well help them lose weight as well as providing symptomatic relief.

It is likely that fibre supplementation will continue to be helpful for many, together with the promising new treatments currently being evaluated.

SimonRadley July 2012

A New service at BMI the Priory Hospital for the treatment of overactive bladder symptoms and faecal incontinence

I am very pleased to finally announce the introduction of a new service to the Priory Hospital.

Percutaneous Posterior Tibial Nerve Stimulation (PTNS) is a minimally invasive outpatient procedure for the treatment of overactive bladder symptoms (OAB) and faecal incontinence. PTNS involves inserting a fine needle into a nerve just above the ankle. A mild electric current is passed through the needle and carried to the nerves that control bowel and bladder function.

Overactive bladder syndrome

The symptoms of OAB syndrome include the need to urinate often and without much warning (frequency), and urge incontinence (the strong need to urinate followed by an inability to stop passing urine). It is caused by the bladder muscle contracting before the bladder is full. Initial treatments my involve bladder training and pelvic floor physiotherapy and anti-cholinergic medication. When these therapies fail the clinician may recommend PTNS.

Faecal incontinence

Faecal incontinence occurs when a person loses the ability to control their anal sphincter and bowel movements, resulting in leakage of faeces.

Initial treatments may involve dietary manipulation, drugs to thicken up and slow down bowel movements as well as physiotherapy or biofeedback. Where such measures fail surgery is sometimes required to repair damaged muscle. In most cases alternative therapies are required and PTNS is an effective out patient treatment for some patients.

To find out more about PTNS visit our website

http://www.birminghambowelclinic.co.uk/treatments-percutaneous-posterior-tibial-nerve-stimulation-for-treating-faecal-incontinence/

Or contact us on 0845 241 7762 and ask for information about our PTNS clinic

 

Are older cancer patients undertreated?

A report by Macmillan Cancer Support has highlighted the problems with cancer investigation diagnosis and treatment in the elderly. The report suggests that decisions regarding cancer investigations and treatment are often based upon age and may fail to take into consideration physical fitness, mental attitudes and social support networks. Some 70 year olds may have a very active lifestyle whereas others can be bed bound.

The report calls for treatment decisions to be made on overall health not just on date of birth.

As a population we are living longer. With the number of people diagnosed with cancer set to double to 4 million over the next 20 years and with half of those cancers being diagnosed in the over 70’s, the investigation and treatment of elderly cancer patients needs to be addressed.

Relative five year cancer survival rates for patients over the age of 75 across the UK currently lag behind those of Europe.

A multidisciplinary approach to diagnosis and treatment is required with input from patients, their families as well as surgeons oncologists and geriatricians.

Minimally invasive diagnostic techniques mean more elderly patients can be diagnosed. Furthermore, the advent of minimally invasive surgical techniques and other novel therapies means that many more treatment options are open to the elderly frailer patient.

www.macmillan.org.uk/ageoldexcuse

Simon Radley April 2012

Private Healthcare Is Referred to The Competition Commission

Finally the Office of Fair Trading has decided to refer the private healthcare sector to the Competition Commission for further investigation.

There are aspects of the private healthcare market that are badly in need of reform. Transparent fee structures for patients and doctors are required. Theoretically at least NHS patients through their GP’s have the choice of which specialist doctor they can be referred to. This is not necessarily so in the private sector. Insurers are potentially able to influence patient choice by dictating which doctors patients are allowed to see. By not recognising certain doctors, insurance companies influence patient choice in the market.

The chairman of the British Medical Association’s Private Practice Committee, Derek Machin, has welcomed the announcement “the BMA has for many years called for reform of the private healthcare market so that it can deliver a system that is fairer to patients and doctors” he too has called for a probe into what he describes as “the disproportionate power of large commercial insurers over doctors”

As a consultant colorectal surgeon I am currently recognised by all the major insurers. The recent and very public stand off between BUPA and BMI hospitals and recent fee structure changes recently introduced by one major insurer (without any consultation with doctors or their professional speciality bodies) have highlighted to me the need for proper investigation and reform of the private healthcare market.

Simon Radley April 2012

Link between oral bacteria and bowel cancer?

Bacteria associated with the most common cause of tooth loss in adults could be a pre-curser for the development of bowel cancer, according to a team of scientists.
The link comes as scientists at the Dana-Farber Cancer Institute and the Broad Institure in America found an abnormally large number of Fusobacterium, a bacterium associated with the development of gum diseas, in nine colorectal tumour samples, pointing to the possibility the two could be associated.
Bowel cancer, also known as colon cancer, is one of the top three deadly cancers in the UK. Around 35,000 people get diagnosed with bowel cancer every year and around half of them die.
Although lead author Matthew Meyerson, MD, PhD, co-director of the Center for Cancer Genome Discovery at Dana-Farber and a professor of pathology at Harvard Medical School believes further research is needed to discover the extent of the link, the research suggests the bacterium could be a factor in the development of cancer.
Dr Meyerson stated: “At this point, we don't know what the connection between Fusobacterium and colon cancer might be. It may be that the bacterium is essential for cancer growth, or that cancer simply provides a hospitable environment for the bacterium. Further research is needed to see what the link is.”

Read More - http://www.femalefirst.co.uk/health/dental+health-227829.html