Abstract 4433
Background
Cancers presenting with ‘vague symptoms’ are difficult to diagnose. These non-specific but serious symptoms (weight loss, anorexia, pain, fatigue) have a number of causes including malignancy. The risk for each individual cancer may be low, but the total risk of cancer of any type is higher. Patients diagnosed with cancer as the result of an emergency presentation (EP) to secondary care have poorer survival, usually describe a long history of symptoms, and most have seen their general practitioner (GP) prior to presentation. Earlier diagnosis improves cancer outcomes. But investigating vague symptoms is challenging, requiring both oncology and general medical knowledge, while bespoke rapid-access oncology diagnostic clinics are needed to avoid EP.
Methods
The Acute Diagnostic Oncology Clinic was established at Chelsea & Westminster Hospital in 2016. It initially provided rapid access investigations for those too ill to wait for an urgent suspected cancer appointment, as an alternative to the Emergency Department (ED). In February 2018 the clinic expanded to, uniquely, include a GP with specialist interest in oncology and patients with ‘vague symptoms’.
Results
361 referrals were received, 65% were female. Weight loss was the commonest vague symptom (50%). Initially, 96% of patients were seen within 24 hours of referral, falling to 69% after expansion of the clinic remit in 2018. 34% of patients (from 2018, 21%) were diagnosed with cancer. Mean time from referral to diagnosis was 4 days, and to starting cancer treatment it was 20 days. A range of cancers were identified, lung the commonest, and advanced stage disease the most likely. A number of significant non-malignant conditions were diagnosed. One-third of patients provided feedback. Only 37% were told at referral that cancer was suspected. The service was rated Excellent or Very Good in all cases. 84% valued being seen urgently. Feedback was received from 40 GPs. 100% would use the service again. Alternate referral routes would have been routine cancer referral (60%) or ED (13%).
Conclusions
To our knowledge, this is the only GP-oncology led rapid access cancer diagnostic clinic. Combining general medical and oncology expertise is an effective approach for diagnosing patients with vague symptoms and tackling EP cancer.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
CW+ Healthcare Charity.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3117 - A modified Edmonton Symptom Assessment Scale for assessing symptoms in one day chemotherapy clinic
Presenter: Anjuleta Kampitsi
Session: Poster Display session 3
Resources:
Abstract
6058 - Level of physical activity and nutritional status in cancer patients with fatigue: an exploratory cross-sectional study
Presenter: Patrick Jahn
Session: Poster Display session 3
Resources:
Abstract
1980 - Catheter related necrotizing fascitiis in haematological patients. Case report and implications for nursing
Presenter: Arianna Rosich Soteras
Session: Poster Display session 3
Resources:
Abstract
3984 - Everyday life with Long-term Chemotherapy Induced Peripheral Neuropathy among Patient in Adjuvant Treatment for Colorectal Cancer – a Multi Methods Study
Presenter: Marlene Jensen
Session: Poster Display session 3
Resources:
Abstract
2202 - Scalp cooler is effective in reducing chemotherapy-induced alopecia among breast cancer patients : a single institution experience
Presenter: Emilia Gianotti
Session: Poster Display session 3
Resources:
Abstract
5942 - Nursing management of fatigue in cancer patients: mixed methods study
Presenter: Angela Tolotti
Session: Poster Display session 3
Resources:
Abstract
2930 - Awareness of Nursing Students about the Warning Signs of Cancer
Presenter: Hatice Yakar
Session: Poster Display session 3
Resources:
Abstract
2978 - Assessment of quality of life in patients with cancer and diabetes 2 in Northern Greece.
Presenter: STYLIANI MICHALOPOULOU
Session: Poster Display session 3
Resources:
Abstract
3400 - Radiation dose variables related to the causes of skin toxicities in women with breast cancer: a study proposal
Presenter: EULALIA PUJOL
Session: Poster Display session 3
Resources:
Abstract
2156 - How should the symptoms be managed after breast cancer surgery? An example of mobile app
Presenter: AYDANUR AYDIN
Session: Poster Display session 3
Resources:
Abstract