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Forgotten Voices of Welfare Reform

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Dr Nicola Cunningham, University of Stirling

The policy voice of welfare reform is evident on a daily basis, from coverage of the current Northern Ireland impasse to senior government ministers advising they ‘could live on £53 a week’.  Since 2010, welfare reform has been rapidly drawing in previously unaffected sickness and disability benefits and claimants from the welfare periphery. People experiencing sickness and disability are more vulnerable to poverty, particularly those of working age. This may also impact on the ability to retain independence, contribute to society and be valued; reinforcing existing barriers to equality. Never before have frontline advice and support services across all sectors been more stretched – and under-resourced.

The often forgotten voices of welfare reform are those health, social care and welfare professionals supporting people affected by disability and ill-health. In current climates, advising and supporting people affected by disability and ill-health can be stressful and testing. Taking time for reflection can prove difficult.

While reflective practice is not a simple cure-all for social and welfare ills, networking and learning helps front line professionals share and exchange skills and knowledge, removing sometimes unhelpful boundary demarcations between staff and service sectors.

The outcome? Professional experience and support is improved; likewise, support for patients, claimants, their families, partners and carers is improved.

Within my work as Macmillan Lecturer I encounter a range of health, social care and welfare professionals sharing and reflecting on their learning and practice online, establishing connections and networks across health and social care sectors. This is one space where health, welfare and social care professionals can join together, share their concerns and make their voices louder.

Dr Nicola Cunningham
Macmillan Lecturer
Twitter:  @NCunningham6

For most work-related cancers, you have a 1% chance of state compensation

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Professor Andrew Watterson

Prof Andrew Watterson writes in The Conversation:
For most work-related cancers, you have a 1% chance of state compensation

Cancer Care Pathways – A Directorate for cancer patients and their families

Danika Marmara

Danika Marmara

In Malta the number of cancer incidence as well as experiences and feedback from patients and relatives has motivated the new Cancer Care Pathways Directorate to plan models of care to achieve a more positive impact across cancer services.

Around 2000 new cases of cancer are registered yearly in the Maltese Islands. The average number of male cancer cases per year is 944, while 964 females are diagnosed yearly with cancer. On average, the most common cancer sites by incidence for males include the prostate, lung, colorectum and urinary bladder, while those cancer sites ranked highest by incidence for females are namely breast, colorectal, uterus and lung cancers.

The Director of Cancer Care Pathways Directorate, Ms. Danika Marmara,is reading for a PhD in Health and Cancer Care at the University of Stirling. She leads this innovative Cancer Care Pathways Directorate and is working on aspects of care to offer support, guide and help increase access to care for cancer patients. As part of its pathway, aspects of patient needs must be continuously explored as cancer has several implications towards family life, social life and consequently society in general.

Aim of the Cancer Care Pathways Directorate

Cancer Care spans the whole patient pathway from screening or initial referral for a symptom to cancer diagnosis to cancer treatment followed by survivorship, palliative care or end-of-life to improve patient experiences and outcomes across the patient journey. On an organisational level, it aims to illustrate patient flows through the different phases of the cancer care pathways for various cancer patients with the aim of identifying the strengths and weaknesses of the current service provision and improve cancer pathways.

In this regard, this directorate has commenced work on the following aspects:

  • Identifying gaps in services and improve care coordination for cancer patients and their families to improve quality and timely care;
  • Improving communication and networking between various organisations/hospitals/entities such as Primary Care, Screening programme, Mater Dei Hospital, Oncology services and NGOs;
  • Research audits have commenced to provide evidence regarding cancer pathways and timelines for breast and colorectal pathways to provide direction for implementing carecoordination and other service improvements to achieve a better and optimised cancerjourney experience;
  • Improving coordination of Palliative patients;
  • Improving patient information in the treatment stage and any other information gaps in cancer services;
  • Identifying survivorship issues through patient needs post-treatment. This research work and patient feedback shall provide a basis for the vision of the New National Cancer Plan starting 2016;
  • Identifying barriers to screening programmes to increase uptake rates.

Ms. Danika Marmara has recently spearheaded a working group entitled ‘Tailored Information in Cancer Care’ (TICC). This working group has developed cancer treatment booklets for breast, colorectal, early prostate and primary lung cancers. These booklets are the first set of written resources involving a multidisciplinary team approach in the treatment stage of the cancer journey, a stage where previously local tailored information was lacking for different cancer types. From feedback received from the healthcare professionals and patients alike, these booklets have been identified as offering clear, well-written and patient-friendly information that will be used to complement verbal information by the patient’s medical team. More work is in progress in Malta to develop resources where patient needs are being identified.

Ms Marmara can be contacted by email:

The importance of talking about Smoking in the context of Cancer

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Professor Mary Wells

Our recent research highlights the importance of understanding the multiple factors which influence continued smoking in people affected by cancer.  It also shows that engaging patients and families in discussion about smoking within the context of a cancer diagnosis is acceptable, but that an individualised and integrated approach to smoking cessation across the whole cancer journey is needed.

Research evidence illustrates the value of cessation for patients’ treatment outcomes, survival and future health.  Last month we held two public engagement sessions in Dundee as part of the NMAHP Research Unit’s CSO-funded ‘Cancer & Smoking Cessation Study’.  Over the past 18 months this has been exploring key factors likely to increase uptake of smoking cessation services among families, within the context of a recent cancer diagnosis.  Researchers Tricia Aitchison and Fiona Harris have conducted more than 65 in-depth interviews with patients, relatives and health professionals in Tayside and Forth Valley.

The ‘Talking about smoking and cancer: Help us design better services’ sessions brought together a range of people.  Participants included consultant oncologists, cancer nurse specialists, radiographers, smoking cessation advisors, charity representatives and health promotion staff – as well as a small number of patients and family members who had taken part in interviews for the study.  An advert had also been placed in the local Courier newspaper to invite members of the public to attend.

The aim of the public engagement sessions was not only to present key findings from the study but also to provide opportunity for participants to suggest, discuss and evaluate ideas for future interventions.  Three short, 10-minute presentations on study findings were followed by small group discussions facilitated by members of the study Steering Group.

The presentations were:

  • Talking About Smoking: What patients, family members and health professionals bring to conversations about smoking in the context of cancer;
  • Moving from talking about smoking to doing something about it: What happens next? and
  • What opportunities are there for intervention and what might these look like?

They certainly seemed to stimulate lots of talking and interaction within the groups!

Our study findings highlight that potential opportunities for talking to patients and families about smoking may often be missed by healthcare professionals.  There was consensus among the participants at our event that barriers to discussing and addressing smoking need to be overcome so that patients are given effective cessation advice and support throughout their care journey.

Professor Mary Wells, University of Stirling, School of Health Sciences
4 February 2015