Evidence
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Intensive follow-up following curative bowel cancer surgery may detect recurrent cancers sooner but does not improve survival

Intensive follow-up of patients who have been successfully treated for bowel cancer does not improve survival outcomes compared to less intensive follow-up. This systematic review included 15 randomised controlled trials comparing different intensities of follow-up. Protocols varied in terms of the number of tests, appointments or their setting (e.g. GP or hospital) – none of …

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Enhanced patient education improves bowel preparation before colonoscopy

People who are given extra information about preparing for their colonoscopy are likely to have clearer bowels before the procedure, meaning it is more likely to be successful. About a quarter of people currently having colonoscopy are poorly prepared and this prevents a good view of the whole bowel. Better preparation allows more accurate diagnoses, …

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Delaying chemotherapy after breast cancer surgery may reduce survival chances

Delaying chemotherapy after breast cancer surgery may slightly decrease a woman’s chances of survival. A review found about a 5% increase in the relative risk of death. Many women are offered chemotherapy soon after breast cancer surgery, called adjuvant chemotherapy. Chemotherapy is usually started after the surgical wounds have healed but the effect of any delay to …

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Whole brain radiotherapy provides little benefit for lung cancer that has spread

Radiotherapy to the whole brain makes little difference to people with the commonest type of lung cancer that has spread to the brain and cannot be operated on. This mainly UK-based trial found no difference in overall survival and quality of life among people who had whole brain radiotherapy plus usual supportive care compared with …

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A scan may help decide if surgery is required as follow-on treatment for head and neck cancer

People with head and neck cancer in the UK usually receive chemotherapy and radiotherapy followed by surgery. Using a scan to assess cancer status after this first line chemoradiotherapy and only suggesting surgery to those with a clear indication led to similar survival rates, complications and fewer operations compared with planned cancer surgery for everyone. …

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Chemotherapy for people with recurrent stomach and oesophageal cancers can prolong survival by two to three months

This meta-analysis provides high quality evidence that second-line chemotherapy with supportive care can boost survival by about two months. In the three trials included, two types of chemotherapy were investigated for people with recurrent gastric cancers and compared to supportive care alone. Not all patients benefited from chemotherapy – over a third did not live …

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Blood tests alone are not sufficient for detecting recurrent bowel cancer

The carcinoembryonic antigen (CEA) blood test – part of the usual approach for monitoring for bowel cancer– is not sensitive or specific enough to depend on alone for detecting recurrence. This new Cochrane review added more detail to existing evidence about the low sensitivity and specificity of CEA, a test which has been available in …

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