MPS advises of need for better awareness of cauda equina red flag symptoms

MPS advises of need for better awareness of cauda equina red flag symptoms

May 9 2018 The Medical Protection Society is advising doctors of a revision to the NICE Clinical...

Anticholinergics linked to increased risk of dementia

Anticholinergics linked to increased risk of dementia

April 30 2018 Anticholinergic drugs used in helping control some involuntary muscle movement...

Women of childbearing potential must be on Pregnancy Prevention Programme if taking valproate

Women of childbearing potential must be on Pregnancy Prevention Programme if taking valproate

April 27 2018 Women and girls of childbearing potential must no longer take valproate medicines...

Buprenorphine may be safer than methadone in opioid substitute therapy, study suggests

Buprenorphine may be safer than methadone in opioid substitute therapy, study suggests

April 23 2018 Buprenorphine has been found to have lower rates of overdose death than methadone...

Class of diabetes drug linked to increased risk of irritable bowel disease

Class of diabetes drug linked to increased risk of irritable bowel disease

March 29 2018 A study has shown that dipeptidylpeptidase-4 inhibitors may increase the risk of...

  • MPS advises of need for better awareness of cauda equina red flag symptoms

    MPS advises of need for better awareness of cauda equina red flag symptoms

    Wednesday, 09 May 2018 16:01
  • Anticholinergics linked to increased risk of dementia

    Anticholinergics linked to increased risk of dementia

    Monday, 30 April 2018 12:20
  • Women of childbearing potential must be on Pregnancy Prevention Programme if taking valproate

    Women of childbearing potential must be on Pregnancy Prevention Programme if taking valproate

    Friday, 27 April 2018 12:12
  • Buprenorphine may be safer than methadone in opioid substitute therapy, study suggests

    Buprenorphine may be safer than methadone in opioid substitute therapy, study suggests

    Monday, 23 April 2018 16:59
  • Class of diabetes drug linked to increased risk of irritable bowel disease

    Class of diabetes drug linked to increased risk of irritable bowel disease

    Thursday, 29 March 2018 11:49

a woman coughing imageFebruary 20 2018

New British Thoracic Society guidelines on pleural mesothelioma include some key recommendations for primary care.

The BTS guideline give recommendations and good practice points around predicating the presence of mesothelioma. Specifically, it says:

  • do not rule out a diagnosis of malignant pleural mesothelioma (MPM) on the basis of symptoms and examination findings alone;
  • offer an urgent chest X-ray to patients with symptoms and signs as outlined in the NICE guideline NG12;
  • refer all patients with a chest X-ray suggestive of MPM urgently (via the 2-week wait suspected cancer pathway in England and Wales);
  • consider referral for further investigation in patients with persistent symptoms and history of asbestos exposure despite normal chest X-ray;
  • a thorough occupational history should be taken to cover all occupations throughout life, and also consider para-exposure by exploring details of relative and/or partner occupations.

The new guideline on the investigation and management of malignant pleural mesothelioma has been published by the BMJ journal, Thorax.

Highlighting the guideline, the Primary Care Respiratory Society has endorsed the recommendations on symptom recognition, management and follow-up.

“The use of products containing asbestos was banned in the UK in 1999 but mesothelioma takes a long time to develop (often 30-40 years after exposure) and symptoms can be non-specific, especially breathlessness, cough and chest pain,” said the PCRS. There were approximately 2,250 cases of mesothelioma in the UK in 2014, 97% of which were pleural, and 3% were peritoneal.

Dr Steve Holmes, who represented PCRS-UK on the BTS guideline development group, added: “Primary care clinicians should carefully read the recommendations in this guideline on symptom recognition, management and follow-up of these patients.

“The symptoms of MPM can be non-specific so primary care clinicians should always be asking themselves when assessing patients complaining of breathlessness, cough and chest pain, ‘What else could it be?’.”

Links
BTS Guideline for the Investigation and Management of Pleural Mesothelioma  
I Woolhouse et al. BTS guideline. ‘British Thoracic Society Guideline for the investigation and management of malignant pleural mesothelioma’. Thorax. 2018; 73: i1-i30.       
PCRS statement           
NICE guideline NG12 ‘Suspected cancer: recognition and referral’         

Clinical News

June 22 2018 A review into the scheduling of cannabis for medicinal purposes will look for “significant medical and therapeutic benefits” before a decision is made.
June 6 2018 The Royal College of General Practitioners has called for visa regulations to be reviewed to allow more doctors to work as GPs in the NHS. Home Secretary Sajit Javid announced on Sunday...