Steve Williamson, consultant cancer pharmacist at Northumbria NHS Trust & NHS England, talks about how pharmacy teams can help to improve early diagnosis of oesophagogastric cancer

Every year, around 12,900 people in England are diagnosed with either cancer of the oesophagus or stomach1, and it has been estimated that around 950 deaths from these cancers could be avoided if survival rates matched the best in Europe.2

Following successful local and regional pilots in 2012 and 2014, Public Health England is extending the Be Clear on Cancer campaign for oesophagogastric cancer to a national basis from 26 January to 22 February 2015. The key message will be: ‘Having heartburn, most days, for three weeks or more, could be a sign of cancer – tell your doctor’.

Pharmacists have an important role to play in supporting the campaign. The advertising may prompt people who have previously ignored their symptoms, or who have been managing their heartburn themselves, to come to you and ask for advice. We know that people delay going to see their GP for a number of reasons. They may not recognise that their symptoms are serious; they may worry about wasting a GP’s time; or, if they suspect cancer, they may fear diagnosis or treatment. Most people have quick and easy access to pharmacies and may be more willing to discuss their symptoms in a less formal setting. By talking face-to-face you can help people overcome any concerns.

You’ll be aware of people who have repeat prescriptions or those who frequently purchase OTC medicines for heartburn. Encourage these people to visit their GP, even if they say the medication is helping. The chances are it’s nothing serious, but persistent heartburn needs to be addressed and if it is cancer, the earlier it is diagnosed, the easier it is to treat.

Of course, having conversations about cancer with customers can be difficult. If you want to mention cancer as part of a review, talking about cancer in the same sentence as other serious illnesses such as heart disease or diabetes may make it easier. Or, if you are worried about someone who has repeatedly bought OTC medicine for heartburn, why not ask them what their doctor says about it. Pharmacy staff might want to discuss the best approach with their pharmacist.

The campaign will also promote another possible sign of oesophagogastric cancer – that of food feeling like it’s sticking in a person’s throat when they swallow. As a pharmacist, if you come across someone who has this symptom, advise them to make an appointment with their GP without delay.

Raise Awareness

Help promote awareness
Both oesophageal and stomach cancers affect men and women, but are more common in men. More than nine out of 10 people who get cancer of the oesophagus or stomach are over 50.3. For more information visit: www.naedi.org/beclearoncancer/oesophago-gastric

e-module for pharmacy
The North of England Cancer Network (NECN) was a pilot area for an oesophagogastric cancer symptom awareness raising campaign in 2012. As part of the campaign, Steve Williamson was involved in developing an e-learning training module for pharmacists and counter assistants. The e-module, which is free to all healthcare professionals, an be accessed by visiting www.bopalearning.com

References

  1. Incidence data supplied by West Midlands Knowledge and Intelligence Team based on National Cancer Registration Service data
  2. British Journal of Cancer (2009) 101, S115–S124. doi:10.1038/sj.bjc.6605401. Published online 3 December 2009
  3. Incidence data supplied by West Midlands Knowledge and Intelligence Team based on National Cancer Registration Service data.

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