PET/CT is valuable in deciding the management outcome in patients with metastatic or recurrent colorectal cancer. Unnecessary surgery might be avoided by careful use of PET/CT scanning in colorectal cancer patients. PET/CT might not be of value in patients with an unexplained rise in CEA.

Introduction CONTACT is a national multidisciplinary study assessing the impact of the COVID-19 pandemic upon diagnostic and treatment pathways among patients with pancreatic ductal adenocarcinoma (PDAC). Methods The treatment of consecutive patients with newly diagnosed PDAC from a pre-COVID-19 pandemic cohort (07/01/2019-03/03/2019) were compared to a cohort diagnosed during the first wave of the UK pandemic (‘COVID’ cohort, 16/03/2020-10/05/2020), with 12-month follow-up. Results Among 984 patients (pre-COVID: n = 483, COVID: n = 501), the COVID cohort was less likely to receive staging investigations other than CT scanning (29.5% vs. 37.2%, p = 0.010). Among patients treated with curative intent, there was a reduction in the proportion of patients recommended surgery (54.5% vs. 76.6%, p = 0.001) and increase in the proportion recommended upfront chemotherapy (45.5% vs. 23.4%, p = 0.002). Among patients on a non-curative pathway, fewer patients were recommended (47.4% vs. 57.3%, p = 0.004) or received palliative anti-cancer therapy (20.5% vs. 26.5%, p = 0.045). Ultimately, fewer patients in the COVID cohort underwent surgical resection (6.4% vs. 9.3%, p = 0.036), whilst more patients received no anti-cancer treatment (69.3% vs. 59.2% p = 0.009). Despite these differences, there was no difference in median overall survival between the COVID and pre-COVID cohorts, (3.5 (IQR 2.8–4.1) vs. 4.4 (IQR 3.6–5.2) months, p = 0.093). Conclusion Pathways for patients with PDAC were significantly disrupted during the first wave of the COVID-19 pandemic, with fewer patients receiving standard treatments. However, no significant impact on survival was discerned.

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Background: Surgical haemorrhoidectomy is recognised as an effective but often painful intervention for haemorrhoids. Performed in a district hospital setting, this survey studied the success rates of stapled haemorrhoidopexy (SH) technique according to reported symptoms and patient satisfaction, post operatively. Methods: A cohort of 108 patients admitted for circular stapled procedure at Inverclyde Royal Hospital between June 2006 and December 2011 gave their consent to be interviewed over the telephone after their procedure. 101 out of the 108 patients responded. Assessment of patient satisfaction was made on the basis of pre operative symptoms, postoperative results and complications. Results: Preoperatively, all patients had Grade lll or lV haemorrhoids complicated by haemorrhage. 33% of patients reported associated pain, and 25% complained of anal leakage. Mean follow up time was 23.8 months (7-38 months). Overall reported complication rate was 17%, with 9% reporting short term bleeding, 4% reporting shortlived post-operative pain and 3% with recurrence of prolapsed haemorrhoids. 88% of patients were happy with results, with 87% of patients happy to recommend the procedure to others. Conclusion: Stapled anopexy is a relatively new procedure. It has been found to be a successful and well-tolerated procedure for prolapsing haemorrhoids in this district general setting. It has a low recurrence rate, low incidence of post operative pain and a high level of patient satisfaction. However, there are associated complications and it has a steep training curve.

Background: Breast cancer is one of the commonest cancers in women in the UK and western countries [1]. Follow ups after breast cancer diagnosis is usual practice, but there is no agreed consensus among breast care providers on frequency or duration of follow up after diagnosis and adjuvant treatment. The aim of this study is to find out women's views on the period of the clinical follow up after breast cancer diagnosis. Method: This was a surveillance study in Greenock and Glasgow in the UK (Between September 2009 and December 2010). The study group comprised of 446 Women, 246 with the history of breast cancer diagnosed 1 -10 years, (median 4.2 years) were asked to complete a questionnaire about their views of preferred duration of follow up while they were waiting for the annual review at a breast clinic, the same questionnaire was completed by 200 women with no history of breast cancer. Results: Between September 2009 and December 2010, 246 patients were included in the study. 40% of patients were within the first three years of follow up, 27% between the 4th and 6th year and 33% were in follow-up for more than 6 years. 63% of cancer survivors think that, 10 years of follow up is necessary for reassurance, detection and treatment of any new, recurrent or spread of their breast cancer. 14% and 22% of women with a history of breast cancer preferred 3 and 5 years review by trained Radiologist/GP respectively. Women without a history of breast cancer were different in their thoughts about follow up after breast cancer: 10%, 25%, and 30% chosen 10, 5 and 3 years, 35% preferred don't know the answer. Conclusion: Follow up programs for breast cancer survivors need to be organized, evidence based, flexible and patient tailored. Patients' views should be taken into account when considering provision of follow-up care for breast cancer patients.