NICE publishes recommendations on lung cancer
Lung cancer: early diagnosis important |
A clinical guideline covering the diagnosis
and treatment of lung cancer has been published by the National Institute for Clinical Excellence.
The areas identified as priorities for implementation cover access to
services, including the need for urgent referrals, and access to appropriate
techniques for classifying the stage of the cancer, along with detailed
information on the treatment of non-small-cell lung cancer.
In particular, the guideline recommends that chemotherapy should be offered
to patients with stage III or IV non-small-cell lung cancer who are otherwise
well.
Chemotherapy, intended to improve survival, disease control and quality of life,
should be a combination of a third generation drug (docetaxel, gemcitabine, paclitaxel
or vinorelbine) plus a platinum drug (carboplatin or cisplatin). Patients who
cannot tolerate a platinum combination can be offered a third generation drug
as monotherapy. The guideline also states that docetaxel monotherapy should be
considered as second-line treatment in advanced disease when relapse has occurred
after previous chemotherapy.
Jesme Baird, director of patient care at the Roy Castle Lung Cancer Foundation,
and chairman of the guideline development group, highlighted the importance of
early diagnosis. “The general public needs to be aware that unexplained,
new or changing symptoms, such as cough and breathlessness, need to be investigated,” Dr
Baird said.
The guideline was developed by the National
Collaborating Centre for Acute Care on behalf of NICE. It is the first guideline
to be produced in collaboration with the Scottish Intercollegiate Guidelines
Network.
The guideline, along with a version for the public and quick reference guides
for health care professionals, is available here.
Violent behaviour Recommendations on the short-term
management of disturbed or violent behaviour have also been issued by NICE this
week. The guideline emphasises that rapid tranquillisation, physical
intervention and seclusion should only be considered once de-escalation
and other strategies have failed. Such interventions should be reasonable
and proportionate to the risk posed as well as to clinical need.
Where possible, advance directives should be taken into account when
determining which interventions to use.
|
|
The
Pharmaceutical Journal
Acrobat
Reader