CANCER

http://www.macmillan.org.uk Booklets detailing all available trreatments

http://cancerhelp.cancerresearchuk.org Includes current trials in progress

http://www.cruk.org is Cancer Research UK

 http://cancerhelp.cancerresearchuk.org/type/melanoma/treatment

http://www.factsoncancertreatment.org.uk  Includes Algorithm for Neutropenic Sepsis post chemotherapy

NEUTROPENIC SEPSIS

NICE SUSPECTED CANCER REFERRAL http://www.nice.org.uk/nicemedia/live/10968/29813/29813.pdf

NICE SUSPECTED CANCER REFERRAL

NEW JUNE 2015 NICE CANCER REFERRAL http://www.nice.org.uk/guidance/NG12/chapter/1-recommendations

http://guidance.nice.org.uk/IP/1023  Index Page to Topics

http://www.nice.org.uk/guidance/index.jsp?action=byTopic&o=7165  Lists Cancers Includes All Sorts of Treatments Current

SIGN HAS A FEW GUIDELINES http://www.sign.ac.uk/guidelines/published/index.html

http://cancerlancashire.org.uk/GP-zone/gp-resources.php

NAEDI FAST TRACK REFERRAL FOR CANCER

Patient.co.uk also has up to date information on each cancer

KNOW FOR SURE LEAFLET ABOUT SYMPTOMS TO WATCH FOR http://www.nhs.uk/cancer-symptoms/Pages/generic-cancer-signs.aspx

www.cancerlancashire.org.uk  has various guides on services  e.g.EastLancsCancerInfoGuide2011

www.csnlc.nhs.uk

LUNG CANCER MASTERCLASS  17 Sept 2013

American Cancer Society  http://www.cancer.org

NCCN GUIDELINES FOR PATIENTS http://www.nccn.org/patients/guidelines/cancers.aspx

CANCER DECISION SUPPORT PROGRAMME http://www.macmillan.org.uk/Aboutus/Healthandsocialcareprofessionals/Macmillansprogrammesandservices/Earlydiagnosisprogramme.aspx

CANCER SCREENING GUIDE 2013

MORE CANCER REFERRAL SUGGESTIONS FRON CCG JUNE 2015

Lung

·         Clinically pneumonia do repeat CXR at 6 rather than immediate 2ww referral

·         Suspected TB send to TB clinic not 2ww.

·         Pleural effusion usually unilateral which is more likely to be sinister as compared to bilateral effusion with history of CCF- add clinical details and patient can go straight to pleural list.

·         If patient has got high suspicion of having lung cancer and even if CxR is reported as normal please still refer the patient to 2 week rule clinic.

 

Urology

·         Haematuria- always check for infection. MSSU positive treat the infection

·         Referral with an elevated PSA checked during a UTI or symptoms suggestive of a UTI as this will often give an abnormal result. The only exception would be if the Prostate feels obviously malignant but both of these factors need to be specified in the referral. Check the urine, treat any infection or suspicion of infection appropriately and leave for at least one month after treatment before testing the PSA.

 

·         Referral with a single, slightly elevated age specific PSA test with a normal feeling Prostate. The level of PSA can fluctuate and if a second test is normal and the Prostate feels normal then urgent investigation is probably not required. In this situation, repeat the PSA test in 1-3 months and only refer if the level remains elevated or is rising.

·         Consider value in referral with a slightly elevated PSA level in men over 75 years of age or with significant co-morbidities meaning their overall life expectancy is probably less than 10 years. The exception is where patients have symptoms suggestive of locally advanced or metastatic disease and have a frankly malignant feeling gland.

 

Lower GI

·         Rectal bleeding with anal symptoms or patient less than 40 without family history --straight to flexible sigmoidoscopy

·         Decreased defaecation and harder stools Routine referral if usual treatments for constipation fail

·         Abdominal pain without evidence of obstruction or mass- routine referral

 

Hepatic/pancreatic/biliary

·         Not to refer none malignant problems as 2ww (e.g. incidental findings found on a scan). Can use options other than 2ww: routine referral; urgent referral or telephone advice.

 

Head and Neck

·         Small round simple mouth ulcers in young non-smoking patients are very common and very unlikely to be cancer; routine management/check for anaemia

·         Recognize common benign neck lumps e.g. sebaceous cysts.

 

 

REDUCE CANCER RISK LEAFLET

 

MACMILLAN CANCER FILES

 

http://www.healthcareimprovementscotland.org/our_work/cancer_care_improvement/programme_resources/scottish_referral_guidelines.aspx

 

http://www.macmillan.org.uk/Aboutus/Healthandsocialcareprofessionals/Macmillansprogrammesandservices/Earlydiagnosisprogramme/Earlydiagnosisprogramme.aspx

http://www.guidelines.co.uk/malignant_disease_macmillian_cancer_referral_toolkit#.Vkug9xKdFlw

 

http://www.nice.org.uk/guidance/ng12

http://www.macmillan.org.uk/Documents/AboutUs/Health_professionals/EarlyDiagnosis/Rapidreferralguidelines.pdf

http://www.macmillan.org.uk/Documents/AboutUs/Health_professionals/EarlyDiagnosis/Rapidreferraltoolkitmobile.pdf

http://www.macmillan.org.uk/Documents/AboutUs/Health_professionals/EarlyDiagnosis/RapidReferralToolkittablet.pdf

http://www.elmmb.nhs.uk/search/?q=syringe+driver

NICE CANCER REFERRAL SHEET

Notes from END OF LIFE at Dunkenhalsh 19 11 15

 

Hospice Helpline 07730 639 399 24H

 

Referral Forms www.eastlancshospice.org.uk

 

GMC has Treatment and Care Towards the End of Life

Getting It Right Every Time booklet

One Chance To Get It Right [DOH]

 

 www.cqc.org.uk  End of Life Care

 www.nhsiq.nhs.uk

Hospice UK CLIP Programme

 

Anticipatory Rx

Pain

Nausea

Agitation

Dyspnoea

Respiratory Secretions

ELMMB Guidance on Syringe Drivers and Symptom Control

 

Morphine Midazolam Cyclizine Hyoscione Hydrobromide

Do not use saline with Cyclizine

Do not mix Cyclizine with Oxycodone

Max capacity of syringe driver is 22 ml

 

 

OPIATES IN SG

Halve the oral dose

Oxycodone = twice potency of Morphine

Fentanyl 75mg= 180 mg oral or 90 mg S/C Morphine   also takes up to 3 days to come on or go off so don’t stop just add morphine  as S/C

PRN   S/C Morphine = 1/6 of the 24 hour dose

 END OF LIFE PRESCRIBING 2015

NICE CANCER GUIDELINES 2015  http://www.cancerresearchuk.org/health-professional/learning-and-development-tools/nice-cancer-referral-guidelines