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Published on 27th September 2018 by lauram

Cancer

Welcome to this week’s medical news round up! We will be bringing you the healthcare topics that have featured in the news this week, and will be making them relevant and useful to you as a medical school applicant.

Joining us this week: a new Cancer Research UK report, NHS vs pharmaceutical companies for cheaper ophthalmic treatments and the aftermath of hernia repair surgeries.

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The link between female cancers and obesity

Cancer Research UK predicts that obesity will be the biggest preventable cause of female cancer in 2043. Currently, obesity and being overweight link to 7% of cancers in women, which is just behind  the leading preventable cause, smoking (12% of cancers).

The number of women who smoke is continually falling as numbers who are obese are simultaneously rising, so in the near future a high BMI is likely to overtake smoking and become the leading preventable cause of cancer in women.

However, the same cannot be said for men, even though they are following the same smoking and weight trends. This is because obesity in females has a larger impact on the risk and development of cancer than it does in men.  

The focus now needs to be on  developing interventions for children, encouraging healthy lifestyles and preventing obesity in adulthood.

What can we learn from this?

Obesity is one of the biggest challenges the NHS faces, so med school interviews don’t shy away from testing your awareness on it! A common ethical debate to think about is whether the NHS should treat diseases that are caused by preventable behaviours, such as smoking and alcohol.

Another topic to think about is the role of public health interventions – make sure to research the recent public health interventions that are targeting obesity and smoking!

See what you could be asked about NHS Hot Topics in an interview>>


Why not try one of our quizzes?


NHS vs Pharmaceutical Companies for Wet AMD Patients

The ethical argument surrounding pharmaceutical companies is huge, but a landmark legal case that has been in the spotlight this week is a good example and gives a flavour of the issues that the NHS faces.  

What is wet AMD?

Wet Age – Related Macular Disease is an increasingly common eye condition that develops when blood vessels grow abnormally and lead to central vision loss. Treatments are the focus of this case and include injections into the eye to prevent the blood vessels forming.

What was the problem?

Avastin is typically a form of cancer treatment; however, it is also globally recognised and WHO recommended as a treatment for wet AMD. As Roche, the drug company who own Avastin, have never applied for a UK license to market it for wet AMD, the NHS have been unable to prescribe Avastin for this condition. Consequently, more costly licensed alternatives are used.

The alternatives are Lucentis and Eylea, which are drugs licensed for wet AMD treatment, manufactured by Novartis and Bayer respectively. Avastin is equally effective as both of these drugs; however, Lucentis and Eylea cost around £561/£800 per injection, compared to Avastin at £28 per injection. In addition, NICE declared Avastin as a safe and effective treatment for wet AMD in January 2018.

So what has happened now?

Novartis and Bayer brought the High Court Challenge against 12 NHS CCGs in northeast England, after they offered patients a choice of using Avastin. The high court ruled the NHS bodies were practicing lawfully and Avastin be offered as treatment on cost grounds. This could save the NHS hundreds of millions, with no cost to treatment quality.

What can we learn from this?

The world of pharmaceuticals can be a bit of a mine field, but it is useful to understand some key concepts.

  • A company needs a license to sell a drug. It states whom the drug is for and what its uses are. The Medicines and Healthcare products Regulatory Agency provides licenses.
  • It is legal to use licensed drugs in ways that are not specified in the license, this is called “off-label”.

With limited resources and funding, the NHS faces a struggle between resource availability and health care quality/demand. Consider the challenges that arise from this, including possible risk to patient safety and pressure on trusts to save money.

Read more NHS Hot Topics 2018-19>>

Complications of hernia surgery

As one in 10 with us will develop a hernia in our lives, the surgery to repair a hernia is fairly common. Put simply, the main technique is to push any tissue back into the body and cover it with surgical mesh for support.

The complication rate for this surgery is between 12% to 30%, meaning in the past six years 170,000 patients may have faced complications. Some patients are severely affected, being left with chronic pain, feeling suicidal, and unable to walk or work.

The Royal College of Surgeons and regulatory bodies support the use of mesh, but others argue that suturing is the best method. In addition, it is thought correcting complications (removing the mesh) costs £25, 000 per patient.

What can we learn from this?

Chronic pain is both difficult for patients to live with and for professionals to manage. The impact can be huge on a person’s life. As a medical student you’ll have to show empathy for those struggling with pain – think about how you’d do this.

Top tip: complaining about healthcare services and treatment is a common MMI station, it’s your job to deal with this in a calm way, showing empathy!

Read more about how to deal with different MMI stations>>

Words: Katie Burrell

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