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Early diagnosis of bladder and kidney cancers: Are we making a difference?

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By creating a ‘one stop clinic’ for people concerned about possible cancer symptoms, Morecambe Bay Hospital aimed to address the fears preventing early detection. Richard Turner, urological clinical nurse specialist, explains.

We recently saw the launch of another Be Clear on Cancer campaign – it is the re-run of the ‘blood in pee’ adverts that first appeared on our TV screens back in 2013.

As a uro-oncology clinical nurse specialist, I was pleased to hear that the campaign was running once again.

We know only too well from some of the patients that come into our department that some people delay going to their GP, even with a red flag symptom such as with visible haematuria.

”We know only too well that some people delay going to their GP”

By the time they reach us, the treatment options can be significantly reduced. If bladder and kidney cancers are diagnosed at the earliest stage, one-year survival is as high as 91–96%. At a late stage, it drops to just 28–38%.

Bladder and kidney cancer are the 7th and 8th most common cancers in England, around 20 people a day will die from these types of cancer.

Yet we still get patients who have never heard of these tumour types. They have heard of lung and breast cancer and know that smoking is related to lung cancer – but very few patients are aware of the link between these two urological cancers and smoking. It is estimated that smoking will cause nearly 4 in 10 bladder cancer cases and 1 in 4 cases of kidney cancer.

”It is estimated that smoking will cause nearly 4 in 10 bladder cancer cases and 1 in 4 cases of kidney cancer”

If we are going to really change the outcomes for urological cancers in England, we have to raise awareness and try to shatter the perception that some people may have that ‘cancer is a death sentence’. Or worse still, that they fear the treatment more than a cancer death itself.

It is really important that we understand the needs and fears of our local population. By tackling the challenges head on, we really can make a positive difference.

A number of years ago, our trust took the brave decision to stop running diagnostics the way we had done for decades.

We have a local population that is spread out across a wide geography, they could be based in a town with easy access to public transport or many miles away in small rural settings where getting into hospital for diagnostic tests can be a real chore.

We wanted to introduce a one stop clinic, but to do so would mean a challenging period, where the old system stopped and the new one started.

We did it.

”Today, patients will have most or all of their tests done in one day”

Today, even though it may still be a chore to get in to hospital, the patient will have most or all of their tests done in one day, from blood tests to a cystoscopy, scans, ultrasounds or x-rays if needed. We have found that it really works for our patients and our DNA has dropped making it an easier system for us to manage too.

Just shows you that being brave and not just carrying on in the traditional route can really make a difference.

And, I guess that’s what the TV adverts are doing. Be Clear on Cancer is trying to tackle not only awareness of symptoms, but addressing some of those fears and barriers that may prevent some people from going to the GP.

Is it working?

Well early data looks promising. It is estimated that the first ‘blood in pee’ campaign led to an increase in early detection which has been equated to the prevention of around 70 bladder cancer deaths and about 25 kidney cancer deaths.

I hope the current campaign makes a difference to a few more people, so as nurses we don’t have to discuss palliative care options with them and instead we are helping them plan for the future.

Richard Turner, uro-oncology specialist nurse, Barrow in Furness

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