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MONKSPATH PATIENT PARTICIPATION GROUP MEETING 14th JUNE 2016 The meeting began at 7.00pm. The Chairman Tony Green welcomed the 20 Attendees and advised them of the evening’s agenda: Administration matters Presentation on Cancer by Paul Litchfield, QE Hospital Birmingham AGM: Steering Group Report, Election of Steering Group, Election of Delegates to Solihull’s PPG Network AOB, Thanks and Close Administration matters Apologies for absence received from: Eddie Ankrett, Sandra White, Carole Robertson, Clive Raybould, Katarine Mann, Tony Mann and P Priestley. The Minutes of the meeting held on 12th April 2016 were proposed by Vic Lloyd, seconded by Michael Evans and duly passed as an accurate account. There were no matters arising Cancer Talk: Paul Litchfield, Manager of Cancer Information and Support Services What is cancer? Cancer comes from within us. It is a part of the tissue which becomes out of sync with that around it, can be solid or in the blood and grows rapidly. Who gets Cancer? Presently statistics show that 1 in 3 will get cancer in their lifetime. By 2020 it is possible it will be 1 in 2. A percentage of the population will get more than one primary cancer in their life. Different groups of the world population will get certain types of cancer How do we deal with it? In the past there used to be no real cure – there was a policy of ‘Treat gently and leave’. Now there are various options open to us today in relation to cancer. It very much depends on the cancer and also the individual’s health and co-morbidities. It also depends on what stage the cancer is presenting. Radical (getting as close to a cure as is possible) or palliative (symptom control and quality of life) options are looked at as well as looking at how to help long term treatment by supporting other vital parts of the body such as heart and kidneys. Treatment Modalities Surgery This is the oldest method of treatment but nowadays is one of the most modern with the introduction of robots. Most people think this is the option of choice but there are many things to consider i.e. the position of the tumour, the possibility of disability and the possible decrease in quality of life. Radiotherapy A relatively new science in the history of medicine, around fifty years old. There are various options available: Photons, Protons, Electrons and Brachytherapy (using Iridium). Different cancer types can require a different particle, and the treatment can range from specific high doses of x-rays (Protons) to a dose equivalent to that of a microwave (Electrons) which is used to treat skin tissue and scars. Chemotherapy A young science. The very first chemo was actually developed from Mustard Gas. There are various ways to give chemo: tablet, injection into the body, via a pump, or intrathecally (via the spine) Immunotherapy There is a lot of research going on with this at the moment, looking at compounds that inter-relate with cancers and in so doing stop the cancer development. It is a type of treatment designed to boost the body's natural defences to fight the cancer. It uses substances either made by the body or in a laboratory to improve or restore immune system function Hormone Therapy This is used in hormone related disease such as breast and prostate cancer and works on Oestrogen/Progesterone balance. The most well-known of these is Tamoxifen. It may potentially be used for bowel cancer. Radioactive Isotopes Used mainly in liquid form these days for thyroid cancers and also lung cancers. They can be given by injection, inhalation or orally Active Surveillance This is where the disease is present but not causing severe issues. The patient can be monitored and when activity changes the disease can be treated straight away. It is very common in prostate cancer. Clinical Trials There is a myth that if you are in a trial there is nothing more that can be done. This is not the case. Trials look at new drugs or combination of drugs, toxicity issues and can be comparative. They also look at quality of life issues such as nail or hair-loss and help find which drug people are best able to tolerate. Combination Therapy This is the most common form of treatment for patients. Each patient and their disease is reviewed by a MDT (multidisciplinary team) to review the best ways of treating a cancer to ensure its treatment is the best quality and ensures the patient has best chance of being cured or given a good quality for the time they have left. Treatment protocols • Breast cancer In the ‘olden days’, up until the 80s and 90s, the whole breast was removed, followed by full chemo and radiotherapy treatment. Nowadays, quality of life is considered. First chemo is used to shrink the disease which means in some cases less surgery may be required, resulting in a better recovery and improved scars. Then a course of radiotherapy treatment. • Prostate cancer Nowadays a biopsy is done and then usually active surveillance. There is also the possibility of keyhole surgery or brachytherapy (a type of radiotherapy). • Bowel cancer This can be a major problem for the over 50s. In the past there used to be surgery followed by having a colostomy bag fitted. Nowadays five days of high dose chemotherapy is then followed by radiotherapy as they try to shrink the disease – this may avoid having a colostomy bag. • Liver cancer Treatment is chemotherapy into the centre of the liver. Liver surgery can also be done as the liver can regenerate if only one third is removed. Another possibility is a liver transplant. • Testicular There are two main types of testicular cancer, seminomas and nonseminomas. Depending on the type and stage of the cancer and other factors, treatment options for testicular cancer can include: surgery, three lots of four-day chemo sessions, one shot of chemo then active surveillance for seven years. Most at risk of testicular cancer are teenagers and the over 40s. Q: Is Pancreatic cancer treatable? A: Within reason, yes. Results are a lot better than years ago and survival is a bit longer – but still short. It can often depend on the mentality of the patient. Results are getting better, but it is still a disease the medical world is struggling with. Q: Has no-one found the part of the cell that kicks off the abnormal growth? A: No, research continues but there are too many different types. AGM 1. Steering Group Report Please see attached report 2. Election of Steering Group The PPG constitution states that the Steering Committee should consist of ten members with the option to co-opt any further members if necessary. All current members of the Steering Group stood again for re-election, with a new volunteer, Alistair McLachlan. Jim McMullan proposed that they all be elected for this year and the motion was carried by a majority show of hands. The elected Steering Group for 2016/2017 are: Tony Green, Vic Lloyd, Martin Tolman, Jean Thomas, Ginny Lassam-Jones, Mike Evans, Dave Perry, Eddie Ankrett and Alistair McLachlan. 3. Election of Delegates to Solihull PPG Network This PPG can send three delegates to take part in the bi-monthly PPG Network Meetings. With four members willing to attend these meetings it was suggested that this would ensure we always had at least three delegates available and it would be amicably agreed as to who attended when. Any Other Business Q: Due to the announcement that Heartlands A&E had been closed today due to flooding, where should people go instead? A: Your local Accident and Emergency or Walk-In Centre Q: Is everyone aware of the Patient Services Website? What percentage of patients in this practice use it? A: At present it can only be used for booking appointments with Doctors and for repeat prescriptions. 10% are registered and 5% are actively using it. Tony asked the meeting if there were any particular health issues that they would want a speaker for. A number of suggestions were given and will be discussed by the Steering Group at their next meeting. A NOTE FOR YOUR DIARY: The next Open Meeting will be held at the surgery on Tuesday 9th August 2016 at 7.00pm