Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
THE ROLE OF GPS IN CANCER CARE Prevention GPs and other primary healthcare professionals are well placed to provide advice and support to help people reduce their risk of cancer. This includes helping individuals to understand the holistic impact of obesity, smoking, exercise and alcohol on their health and supporting interventions to encourage healthy behaviours. Even brief interventions such as those recommended by the National Institute of Health and Care Excellence (NICE) for smoking cessation i have been shown to be effective in encouraging lifestyle change. It is important that primary care services have access to the information and resources to support open discussion about risk factors for cancer and about evidence-based interventions that can reduce risk. Screening Primary care has a direct role in taking samples for cervical screening. There is also a role for primary care in breast and bowel screening programmes. A GP will often be the first port of call for patients with questions or concerns about screening. Screening tests, while saving lives through early detection, are not perfect. There are risks of false negatives and positives, with a risk that some lesions / changes may be investigated and treated when they would not have progressed to cancer. Some screening interventions themselves may also carry some risks (e.g. exposure to radiation from mammography). It is important that primary healthcare professionals are able to help patients make informed decisions and choose whether screening is right for them. Early diagnosis and referral Primary healthcare professionals have a critical role in early diagnosis of cancer through recognition and prompt referral of people with symptoms that could be cancer for further testing or specialist consultation. It is critical that primary healthcare professionals use clinical judgement in addition to following relevant guidance. Of course, early diagnosis is not simply the remit of primary care. Patient awareness, reporting of symptoms and speed of assessment and diagnosis in secondary care all contribute. However, whilst we can all play a role in increasing public awareness of symptoms, inevitably there will be patients who do not present early, or are not referred at the first contact. In these cases, effective safety netting and willingness to reconsider initial diagnoses are essential. Living with and beyond cancer It is essential that those working in primary care have a good understanding of the expected and the unexpected symptoms from cancer and its treatment so that they are able to reassure, support, treat, refer and signpost patients appropriately. Although most oncology emergencies cannot be managed in primary care, it is essential that primary healthcare professionals can recognise these conditions and manage or admit them appropriately. In the majority of cases, malignant spinal cord compression, hypercalcemia, neutropenic sepsis and superior vena cava obstruction, in the majority of cases need immediate admission although there are always some exceptions. It is also important to remember that patients who have had a cancer diagnosis have an increased lifetime risk of developing another cancer. GPs should be proactive in lifestyle advice in those living with or beyond cancer and be alert to symptoms of recurrence or second primary cancers. End of life care Proactive compassionate end of life care is a vital part of the cancer care pathway and information on this can be found in the Palliative and End of Life toolkit. i Smoking: brief interventions and referrals: NICE guidelines [PH1] Published date: March 2006