What are the opportunities for nurses in early diagnosis/screening? Julie Forshaw Cancer Support Nurse Brownlow Health
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1 What are the opportunities for nurses in early diagnosis/screening? Julie Forshaw Cancer Support Nurse Brownlow Health Supported by an educational grant from
2 Why bother? Cancer as biggest killer: heart disease improved. and cancer left behind.. Screening/ Early diagnosis is key So what opportunities have we got in Practice??
3 Screening and Action Screening: bowel cervical breast Early signs: bowel, lung, ovary, GI Nurses have most contact with LTC patients e.g. diabetes, COPD, obesity
4 Its the.. BOGOF scenario!!!! While Im here can I just ask It s a bit embarrassing but I don t want to bother the Doctor. Im sure its nothing BUT
5 Focus on: Every Contact Counts to encourage screening Every practice member Awareness of Nice Cancer Referral Guidelines Nurse and GP s Awareness of Red Flags Nurse and Gp s??? Or ALL staff! Being supported to take action everyone in Practice!
6 Cancer risk factors Poverty/Deprivation- Do you know yours? Smoking: lung and 14 others! Including ovary Obesity: breast, bowel, endometrium, oesophagus, kidney, pancreas, gallbladder Diabetes: pancreatic, endometrium, liver, bowel, bladder, in breast increased up to 50%! COPD: particularly + smoking: lung cancer Family history. Do you ask people?
7 Scenarios Group Work : 10 minutes Identify : Opportunities for screening Opportunities for early diagnosis What you can offer in your practices Barriers
8 Screening Matters!
9 Scenario 1 Johns Story: 40 years old, Teacher, Married 16 year old son Fresh bleeding PR after defaecation for 6 weeks Vague IBS symptoms for a few years very stressful job No Weight Loss No relevant medical /family history Non smoker Drinks 30 units per week
10 Scenario Feedback 1 Opportunities for screening Under age for bowel screening Genetic screening for son Opportunities for early diagnosis Early referral red flag symptoms Health promotion materials in practice self awareness John s Story:
11 What you can offer in your practices Immunisations Health Checks Psychological / psychosexual support -referral Financial Support / advice Health Trainer Diet and exercise Alcohol education Barriers?????????????????????????????? John s Story:
12 Scenario 2 Marks Story: 64 years old, Unemployed Labourer Carer for elderly parents No other family Diagnosed prostate cancer had radiotherapy and prostatectomy and in remission PMH- Diabetes type 2, Hypertension Smokes 20/day Drinks -20 units per week
13 Opportunities for screening Don t forget other screening- bowel Opportunities for early diagnosis Patient history awareness of red flags Consider social effects smoking, alcohol Also consider occupation-? High risk? Asbestos Scenario Feedback 2 Mark s Story:
14 What you can offer in your practices LTC checks diabetes hypertension Immunisations Health Checks Psychological support Financial Support / advice - Social Worker- support as a carer Access to Radar Key for public toilets Continence support?? Health Trainer Diet and exercise Support Groups - Barriers?????????????????????????????? Mark s Story:
15 Scenario 3 Janet s Story: 51 years old, Self employed Taxi Driver, New Partner in last year has two daughters aged 20 and 22 Breast cancer diagnosed after routine mammogram Has had lumpectomy and radiotherapy 6 months ago and now under surveillance Her mother died from breast cancer aged 40 Smokes- 10/week Drinks- 14units per week BMI- 35
16 Opportunities for screening Encourage to participate in follow-up screening Don t forget other screening- cervical- bowel?genetic screening for daughtersdoesn t really fit referral guidelinesimportance of breast awareness for family Think ethnicity! Women with Jewish ancestry are around 5 10 times more likely to carry BRCA1 or BRCA2 mutations than women in non-jewish populations. Opportunities for early diagnosis Breast awareness Health promotion materials in practice self awareness Breast Screening Programme Scenario Feedback 3 Janet s Story:
17 What you can offer in your practices Immunisations Health Checks Psychological / psychosexual support referral Hope / Moving on courses- Macmillan Financial Support / advice Health Trainer Diet and exercise Alcohol and Smoking cessation support Barriers??????????????????????????????? Janet s Story:
18 Scenario 4 Chen s Story: 42 years old, University Researcher Moved from China 12 years ago Lives with her daughter who is a Doctor Husband died this year aged 49- stomach cancer Non smoker Does not drink alcohol Keeps very fit and does Tai Chi every day in the park Very healthy diet BMI- 22 Has had a cold and now has had a dry cough for 6 weeks no haemoptysis/dyspnoea
19 Opportunities for screening Don t forget other screeningcervical- bowel Opportunities for early diagnosis Patient history awareness of red flags Consider ethnicity and environmental factors in home country Scenario Feedback 4 Chen s Story:
20 What you can offer in your practices Immunisations Health Checks Psychological support including family-referral Financial Support / advice Health Trainer Diet and exercise Support Groups Barriers??????????????????????????????? Chen s Story:
21 Scenario 5 Bills Story: 55 years old, Hepatitis C positive Ex- IV drug user and alcohol abuse for 20 years Diagnosed Liver Cancer in June has had drug trial treatment and is now in remission. Smokes- 10/day Denies drinking alcohol or taking drugs for the last year Unemployed and lives in a one bedroom flat Has no family support has friends who are still drug users BMI- 18
22 Opportunities for screening Don t forget other screeningbowel Scenario Feedback 5 Bills Story: Opportunities for early diagnosis Patient history awareness of red flags Consider social effects poverty, deprivation, smoking, alcohol drug use
23 What you can offer in your practices Immunisations Health Checks Psychological support including drug and alcohol support Financial Support / advice Macmillan Grant Social Worker Health Trainer Diet and exercise- dietician Support Groups - Barriers??????????????????????????????? Bills Story:
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