Avoiding a Late Cancer Diagnosis, Due to “Vague” Symptoms

If a patient visits their GP due to unexplained weight loss, abdominal pain, or loss of appetite, it can be difficult to pinpoint the cause of the problem. A patient might be referred for different tests or scans, which can be time-consuming and delay a possible cancer diagnosis.

To further complicate this issue, we now have a backlog of cancer diagnoses due to the pandemic. Many of these diagnoses will be from patients who are not displaying so-called ‘red flag symptoms’. Now more than ever, clinicians need a solution to help their patients receive a correct diagnosis, as quickly as possible.

Clearly, this has been near the top of the NHS ‘to-do list’ because new Rapid Diagnostic Centres (RDC) are currently being launched across England. The aim of the RDCs is to expedite a diagnosis for patients with suspicious or vague signs of cancer. This gives patients the opportunity to benefit from early detection and a timely referral for necessary treatments.

The newest centres have been launched by the Barking, Havering and Redbridge University Hospitals NHS Trust which will operate at both Queen’s and King George hospitals.

“The RDC is unique, as unlike site specific pathways where patients who are not found to have a diagnosis of cancer are referred back to their GP, patients are managed to a diagnostic outcome, with a referral onto the relevant specialist service.” Jo Johnson, an RDC Strategy and Operations Manager explained.

“By providing this service, we hope to reduce the burden on the site-specific pathways by reducing inappropriate referrals. This will mean we are able to reduce multiple hospital attendances and ensure they are given timely targeted treatment.” He added.

Waiting for a cancer diagnosis can also be anxiety inducing. A faster diagnosis will not only increase the likelihood of successful treatment but will also relieve patients of stressful and anxious thoughts.

Luigi De Michele, an RDC consultant, knows this first-hand: “Many of our patients are highly anxious and have a number of problems that are impacting their quality of life and wellbeing.

This has a specific focus on patient experience and the quality of care. Patients are contacted as soon as we receive the referral to be introduced to their care team, who explain the process, and ensure they have all the information and support they need to attend their appointments and tests.

We treat the whole person and support them throughout their diagnostic journey, keeping their GP fully informed at all times, which improves communication and enhances their support in the community.”

For a patient to be referred to an RDC, GPs are following these guidelines:

  • GP ‘gut feeling’ of cancer diagnosis – reasons to be clearly described at referral
  • New unexplained and unintentional weight loss
  • New unexplained constitutional symptoms of four weeks or more (less if very significant concern). Symptoms include loss of appetite, fatigue, nausea, malaise, bloating
  • New unexplained vague abdominal pain of four weeks or more (less if very significant concern)
  • Unexplained new or progressive pain including bone pain, of four weeks or more

 

Even before the pandemic, speeding up cancer diagnoses was a main part of the NHS Long Term Plan. The first RDC was launched in December 2016 at Guy’s Hospital, to achieve higher cancer survival rates. All patients referred to Guy’s RDC were evaluated from the opening date to June 2019 to assess the effectiveness of the service. Out of 1,341 patients, cancer was diagnosed in 7% of patients and serious non-cancer conditions were found in 36% – which justified the centre’s tailored approach of seeing patients with vague symptoms. Usually, the approach for early diagnosis is the Two-Week Wait (2WW) referral. However, this is based solely on ‘red flag symptoms’ which only half of cancer patients ever develop, and less than a quarter are diagnosed by these symptoms.

At RMDM, we are overjoyed that new RDCs are being launched and more people will benefit from early detection. But to successfully overcome the cancer backlog, we must continue to create the most effective path to detect as many early cancer cases as possible. Having the PanTum Detect test as a first point of information at an RDC or in a primary care setting would be a helpful step along that path. PanTum Detect is a simple blood draw which can detect all cancers with a sensitivity of 97.5% and can rule out healthy individuals with 99.05% specificity. This could allow healthcare workers at the RDC to easily know if a patient’s symptoms are cancer-related or due to a different condition.

The pandemic has forced the world of healthcare to step up and commit to improving the diagnostic infrastructure. Now is the time to invest in a cancer pathway which is innovative and effective. A pathway that not only benefits those affected by the pandemic, but also future generations.

If you would like to partner with RMDM or find out more about PanTum Detect, please get in touch via our contact form.

 

Resources:

https://www.bhrhospitals.nhs.uk/news/our-trust-launches-rapid-diagnostic-centre-to-speed-up-diagnosis-for-cancer-patients-3109

https://www.bbc.co.uk/news/health-57820336

https://www.southtees.nhs.uk/services/cancer/rapid-diagnostic-centre-rdc/referrals/

https://www.england.nhs.uk/cancer/early-diagnosis/

https://www.nature.com/articles/s41416-020-01207-7

https://rmdm.group/diagnostics/pantum-detect/whitepaper