Transplant patients receive cancerous kidneys

 The NHS transplant service has apologised to two patients after they contracted cancer from donated kidneys.

Robert Law, 59, from Wirral, and Gillian Smart, 46, from St Helens, were both given the transplants at the Royal Liverpool Hospital. The kidneys came from the same deceased female donor and medics only learned after the transplant surgery had taken place that the woman had intravascular B-cell lymphoma, a cancer which affects the immune system.

Both Mr Law and Mrs Smart subsequently had to endure six sessions of chemotherapy after a biopsy of the transplanted kidneys revealed the same lymphoma. Mrs Smart said: “I felt devastated to learn that I had received a kidney infected with cancer. The result has been psychologically and physically draining.”

Mrs Smart’s sessions of chemotherapy have now been completed and tests show she is cancer-free, but she said the fear of a return of the disease remains. Mr Law, who is also in remission, said the full details of how and why it happened should be revealed.

Mr Law said he was assured that the donor kidney was healthy but 12 days later he was told that an autopsy had been performed on the donor and it confirmed she had lymphoma.

Mr Law said: “Revealing how this was allowed to happen would ensure that medical professionals throughout the UK can learn from the mistakes made and ensure better care in the future.

“I also feel strongly that the NHS trusts involved should publish a comprehensive report stating what measures have been taken to minimise the risk of a tragic recurrence.”

Lynda Hamlyn, chief executive of NHS Blood and Transplant, said: “On behalf of NHSBT, I offer our sincere and unreserved apologies to the patients for the fact that each received a donated kidney that would have been rejected by their surgeon if he had been aware of the complete donor information.”

This is a shocking story, and whilst an apology has been made, I agree with Mr Law that this is hardly sufficient to explain how this happened and to reassure the public that changes have been made to ensure that this will not happen again.

 suzannetrask@boltburdonkemp.co.uk

Online tool developed to aid GPs in early ovarian cancer diagnosis

The lives of hundreds of women could be saved every year, thanks to a simple online calculator that could help GPs identify women most at risk of having ovarian cancer at a much earlier stage.

Academics from The University of Nottingham and ClinRisk Ltd have developed a new QCancer algorithm using the UK QResearch database. The new algorithm assesses a combination of patients’ symptoms and risk factors to red flag those most likely to have ovarian cancer and enable them to be referred for further investigation or treatment at a much earlier stage.

A study into the effectiveness of the algorithm, published online this week at BMJ.com, has shown that it was successful in predicting almost two-thirds of ovarian cancers in the 10 per cent of women who were most at risk of having the disease over a two year period.

Leading the research, Professor Julia Hippisley-Cox, said: “Ovarian cancer is notoriously difficult to spot and we hope that this new tool will help GPs identify patients most at risk of having ovarian cancer for early referral and investigations.”

Ovarian cancer is the seventh most common cancer in women worldwide and affects around 6,700 women in the UK every year, one of the highest rates in Europe. Most women are diagnosed when the disease is already at an advanced stage, meaning that in many cases their chances of surviving for five years after diagnosis can be as low as six per cent.

Less than one-third of women are diagnosed in the first stages of the disease but of those 90 per cent will survive to five years, showing that earlier diagnosis and treatment can have a dramatic impact on the patient’s chances of survival.

However, making a correct diagnosis as early as possible can be difficult for a disease which has few established risk factors and a range of non-specific symptoms such as loss of appetite, weight loss and abdominal pain which could also point to a number of less serious and more common conditions.

In addition to detecting cancer at an earlier stage, the tool could help GPs to direct their resources such as ultrasonography, MRI scans and blood tests, to the patients more urgently in need of further investigation.

It is in line with current Government policy and the National Awareness and Early Diagnosis Initiative (NAEDI) — a public/third sector partnership between the Department of Health, National Cancer Action Team and Cancer Research UK.

The simple web-based calculator — http://www.qcancer.org/ovary — is designed for doctors but a simpler version could also be made available on the internet to raise awareness among the general public and to prompt women with risk factors or symptoms to seek advice from their doctor. It could also be integrated into GP clinical computer systems for use during the consultation or for identifying patients with combinations of symptoms needing further assessment.

Similar scores using QResearch® have already proven effective in previous research in identifying patients at most risk of developing lung cancer, gastro-oesophageal cancer, bowel cancer, pancreatic cancer, heart disease, type 2 diabetes, fractures, kidney disease and serious blood clots.

Listed as an Associate to Watch In Chambers UK

I was very pleased to be named in Chambers & Partners UK 2012 as an ‘associate to watch’ in claimant clinical negligence. Chambers & Partners UK is a guide to the legal profession. The organisation conducts independent research on lawyers and provides rankings and references for those listed. It provides a reference tool for those looking for a lawyer, and also for those within the industry.

I am proud to say that Bolt Burdon Kemp has been ranked in band 3 for claimant clinical negligence in London. The head of our clinical negligence department was also mentioned as a key individual.

“Associate Suzanne Trask impresses sources with her winning combination of technical skill and great client care. Clients note that she is “always prepared to go the extra yard.”

It is fantastic for our team’s hard work to be recognised by Chambers UK, and we look forward to developing this even further in the year ahead!

http://www.boltburdonkemp.co.uk/sitecore/content/BBK/Global/Profiles/P-S/Suzanne%20Trask.aspx

Dispatches programme uses secret filming to highlight failings by GPs

GPs failed to act on ‘red flag’ symptoms for cancer

The Dispatches programme on Channel 4 this week showed some quite shocking secret footage of appointments with several GPs where ‘red flag’ symptoms were ignored, and worrying symptoms were repeatedly dismissed, without referral. Actors provided details of symptoms that should have pointed quite clearly towards very serious conditions including cancer, when a referral for urgent tests in hospital was necessary. On each occasion they were given advice and medication and sent away, even after repeat visits.

GPs were selected by the programme on the basis that they had previously had complaints about their conduct referred to the General Medical Council (GMC). Dispatches questioned the effectiveness of the GMC’s regulation of GPs, a system that was reviewed during the Shipman Inquiry. After the inquiry’s final report in 2005, a system of revalidation was recommended for GPs, so the public could be more assured about the standard of their treatment and on-going training. This has taken a very long time to come about, and currently the system of revalidation is due to start in late 2012. This will require each GP to renew their license every five years, be subject to a more vigorous annual appraisal and to undergo continuing training on a ‘credit system’. It is quite shocking to think that such a system is not already in place, bearing in mind the huge responsibility held by each and every GP, and that 800,000 people visit GP surgeries every day.

Whilst the standard of the medical treatment revealed by footage in the programme is very disappointing, and given the symptoms described to the GPs, the delay in providing appropriate referrals could have led to serious injury or indeed death, it is a sad situation that I am not surprised by this. I often hear very similar stories from people who have indeed suffered injury as a result of a delay in diagnosing their condition. No worse situation can arise than where there is a delay in diagnosing cancer, and as a result of the delay the condition has become terminal.

If you believe that there has been a delay in diagnosing your medical condition and would like to discuss the circumstances of your treatment, please contact me on 0207 288 4834 or suzannetrask@boltburdonkemp.co.uk   

UK among countries worst at tackling pancreatic cancer

Review suggests that more could be done

 Pancreatic cancer is difficult to diagnose in the early stages of the disease. The UK ranks as one of the worst countries in the world in terms of survival for patients with pancreatic cancer, largely because of inadequate care, say experts.

A review suggests that although a fifth of patients with this deadly cancer could receive potentially life-saving surgery, only 10% do. Many with symptoms see a doctor up to five times before receiving a diagnosis.

In Canada and Australia survival rates are twice that of the UK. Pancreatic cancer has the poorest five-year survival rate of any cancer in Britain, with just 3% of people alive five years after diagnosis.

Most people die within six months of discovering they have the cancer, and only 16% are alive at one year, says the charity Pancreatic Cancer UK, which carried out the review.

England’s cancer tsar Professor Sir Mike Richards said the review findings show that “We clearly have a long way to go before we can say with confidence that everyone diagnosed with pancreatic cancer has access to the best possible treatment and care available.”

He added: “Pancreatic cancer is a challenging cancer - but we need to take this information and the opportunity it presents to improve survival and quality of life for everyone.

“Pancreatic cancer must not be written off as a hopeless cause.”

Henry Scowcroft, of Cancer Research UK, said that this type of cancer was difficult to treat, but that was “no excuse” for patients in the UK faring worse than those in other countries. “We urgently need to improve the way we manage the disease in this country,” he said.

Pancreatic Cancer UK’s study sought the views and experiences of 1,000 stakeholders affected by pancreatic cancer, including patients and their carers, GPs, nurses, pancreatic cancer specialists and researchers.

Pancreatic cancer kills about 7,600 Britons a year. The most common signs of the disease are pain in the abdomen which may spread to the back, jaundice, and unexplained weight loss.

IUDs halve chance of cervical cancer

Reuters reports that, contrary to popular belief, intrauterine contraceptive devices might actually protect women against developing cervical cancer even though they don’t stop the infection that commonly leads to the disease, according to the results of an international study. 

While IUDs, also known as coils, are unlikely to be recommended as way of preventing cervical cancer — the second most common form of cancer in women worldwide — the research should reassure women and their doctors that using them carries no added risk of the disease.

Spanish researchers who studied 20,000 women found that those with a history of using IUDs were no less likely than women who don’t to contract the human papillomavirus (HPV) that causes cervical cancer, but they had only around half the risk of developing the cancer itself.

The scientists think possible explanations for the protective effect of IUDs could be that the process of inserting or removing them destroys pre-cancerous cells, or that it causes some kind of inflammation that prompts a long-lasting immune response and prevents the HPV from progressing.

“It was a little unexpected,” Xavier Castellsague of the Catalan Institute of Oncology in Barcelona said in a telephone interview. “The data (available) before we did this study were very inconsistent, so we didn’t expect to find such a strong association with this protective effect.”

Cancer of the cervix is the second most common cancer in women across the world, with about 500,000 new cases and 250,000 deaths each year, according to the World Health Organization.

Virtually all cervical cancer cases are linked to genital infection with HPV, which is the most common viral infection of the reproductive tract.

Drugmakers Merck and GlaxoSmithKline have vaccines that protect against HPV and many wealthy and some developing countries have started nationwide immunization programs for girls to prevent more cases of cervical cancer.

An IUD is a plastic and copper or hormone-containing contraceptive device that is placed in the uterus to prevent sperm from joining with an egg.

Previous studies have shown that using coils can protect women against another type of cancer called endometrial cancer, but until now it was not clear whether they could also have an effect on the risk of cervical cancer.

Castellsague’s team, whose study was published in the Lancet Oncology journal on Tuesday, analyzed data from 10 case-control studies of cervical cancer done in eight countries and 16 HPV prevalence surveys in women from four continents. The findings were adjusted for the number of sexual partners and other confounding factors.

The results show that coil use did not affect the risk of HPV infection, but was linked to a markedly lower risk of cervix cancer for both major types of the disease — reducing the likelihood of developing squamous-cell carcinoma by 44 percent and adenocarcinoma or adenosquamous carcinoma by 54 percent.

The length of time that women used an IUD did not significantly alter the risk, the researchers said. They found the risk was reduced by nearly half in the first year of use and the protective effect remained significant even after 10 years.

“IUDs are not inert devices,” Castellsague said. “Our speculation is that they act as a foreign body and stimulate inflammatory changes that prevent the HPV infection from persisting and progressing to more advanced stages.”

SOURCE: bit.ly/nvPJeC Lancet Oncology, online September 13, 2011.

Ovarian Cancer: how do we push for a faster diagnosis?

A charity has voiced concern over what it called “startling variations” in diagnosis and treatment outcomes in ovarian cancer. The charity, correctOvacome, pointed out that women were more likely to survive if ovarian cancer was detected early on, yet more than a quarter of patients had had to see their GP twice before being referred to hospital for diagnostic tests.

Ovacome is concerned that women with ovarian cancer get faster diagnosis and more successful treatment in some parts of Britain than in others. According to a national survey report by the National Cancer Intelligence Network, only 38.1% of gynaecological cancer patients connected to St George’s Healthcare NHS trust, south-west London, thought they were seen by doctors as soon as necessary. This compared with 90.5% of similar patients being treated at the Central Manchester University Hospitals NHS foundation.

Bowel cancer rates on the rise, research charity warns

The Guardian reports that Cancer Research UK says one man in about 15 is diagnosed with disease, up from one in 29 during mid-70s.

The chances of a man getting bowel cancer have doubled since the 1970s, according to the UK’s biggest cancer charity.

In 1975 one in about 29 men was diagnosed with bowel cancer, but by 2008 that figure had risen to almost one in 15. The rate among women has also risen, although not so steeply, from one in 26 to one in 19.

Cancer rates are generally rising because people are living longer. But bowel cancer is strongly linked to diet and many cases are preventable.

Cancer Research UK says the figures are more accurate than in the past and arrived at through a new methodology, revealed on Wednesday in the British Journal of Cancer, that takes account of people who might get a recurrence of cancer and who would, in the past, have been counted twice.

It also allows for the age when a cancer poses a particularly high risk – somebody, for example, who has not been diagnosed with bowel cancer by the age of 70 is much less likely to get the disease than someone who is 10 or 20 years younger. Many more people survive than did previously. Half of all patients diagnosed with bowel cancer now survive the disease for at least 10 years – double the number who would have done so in the early 70s (about 23%).

(Source: http)