Summary

Aims: Monitoring and reviewing patients during adjuvant radiotherapy for breast cancer is an integral component of care and was until recently a predominantly medical domain. Patients were often reviewed in busy routine breast clinics, for short consultations with a variety of medical staff and with little time to address questions or concerns. Non-medical treatment review clinics, staffed by senior nursing and senior therapy radiographers have been introduced to provide a dedicated, consistent treatment review. This survey was conducted to assess the effectiveness of the non-medical review of these patients. Materials and methods:This was a prospective survey of all patients attending for breast or chest wall radiotherapy, between 1st July 2003 and 30th June 2004. Patients were invited to complete and return a postal questionnaire related to their treatment and treatment review. Review staff collected data on demographic information, clinical history and treatment intent for these patients at first visit. At subsequent weekly review visits, data were recorded relating to patient assessment, interventions and referrals initiated. Skin reactions were graded using Radiation Therapy Oncology Group scoring tool.Results: One thousand and ninety-five patient questionnaires were distributed and 865 (79%) were returned. There were high satisfaction scores with the time spent with review staff (99.7%) and the ability to discuss all aspects of treatment and concerns (99.1%). One hundred and ninety-three patients were referred to non-medical staff for additional support. Five hundred and forty-four were referred to medical staff. The majority (437) were planned referrals to their clinical oncologist to prescribe a 'boost' or review endocrine treatment and 107 to their general practitioner for routine visits and employment certificates. Review staff data of 1,067 patients showed 342 referrals for treatment and non-treatment related physical problems, 80 referrals for additional information and emotional support. Majority of skin reactions were grade 1 or 2a. Conclusion:The successful identification of patients' supportive needs and high patient satisfaction with this service supports the use of this approach.

Volvulus of the transverse colon is rare. Seven cases, 6 acute, are presented. Early diagnosis and prompt surgical management prevented complications. At laparatomy, extended right hemicolectomy or end colostomy and distal mucous fistula are the procedures of choice. Non-resection was associated with recurrence in three cases.

No abstract

A case of postoperative rectal stricture treated using an autostapling device is reported.