Cancer

Medicinal cannabis is effective and safe, but the NSW Government remains unwilling to recognise this

Laurence E Mather PhD, FANZCA, FRCA · Evert R Rauwendaal BSW · Vivienne L Moxham-Hall BA, BSc, MHealthPol · Alex D Wodak AM, FRACP, FAChAM, FAFPHM

CorrectionIncorrect footnote: In “Australia is continuing to make progress against cancer, but the regional and remote disadvantage remains” in the 4 November 2013 issue of the Journal (Med J Aust 2013; 199: 605-608), there was an error in Box 2 (page 607). There should be two separate footnotes for Box 2A and Box 2B: the footnote to Box 2A should state “Based on age- and sex-specific rates for ...

Michael D Coory MB BS, PhD, FAFPHM · Tsun Ho BE(Hons), PhD · Susan J Jordan MB BS, PhD

There is room for improvement in the management of patients with lung cancer, which remains the leading cause of death from cancer in this country. Tissue diagnosis, active treatment for all patients, postsurgical adjuvant chemotherapy and case discussion at multidisciplinary meetings would all help, as would screening those at high risk to detect cancers earlier.

Paul L R Mitchell MB ChB, FRACP, MD · Vicky J Thursfield BSc, GradDipAppStat · David L Ball MD, FRANZCR · Gary E Richardson MB BS, FRACP · Louis B Irving MB BS, FRACP, FRACGP · Yvonne Torn-Broers BA(Hons) · Graham G Giles BSc, Msc, PhD · Gavin M Wright MB BS, FRACS

To the Editor: The United States National Lung Screening Trial demonstrated a 20% reduction in lung cancer deaths among smokers screened with three low-radiation-dose computed tomography scans at yearly intervals. Hew and colleagues recently outlined the challenges in implementing such a screening program in Australia.1 However, the potential for saving lives is enormous. Currently only 14.1% of lung cancer patients survive 5 years — a marginal improvement ...

Paul L R Mitchell · Thomas John

In reply: We welcome the opportunity to respond to correspondence from Marshall and colleagues and Mitchell and colleagues about the impact of the National Lung Screening Trial (NLST)1 on three distinct issues: (i) current medical practice; (ii) developing public health policy; and (iii) implementation of future screening. Current medical practice: We do not currently recommend community screening. In the absence of resourced, educated, and coordinated referral ...

Mark Hew · Robert G Stirling · Michael J Abramson

Objectives: To examine whether incidence of colorectal malignancy is increased in Australasian liver transplant recipients compared with the general population of Australia, and to assess the characteristics and outcomes of colorectal malignancy in this patient group.Design, setting and patients: Data on patients who underwent orthotopic liver transplantation (OLTx) and had a diagnosis of de-novo colorectal malignancy after transplantation during the period ...

Deborah J Verran MB ChB, FRACS · Marie H Mulhearn BAppSc (Nursing), GradDipHPEd · Pamela J Dilworth RN · Glenda A Balderson BSc · Stephen Munn MB ChB, FRACs · John W Chen MB BS, FRACS, PhD · Michael A Fink MB BS, FRACS · Michael D Crawford MB BS, FRACS, MMed · Geoffrey W McCaughan MB BS, PhD, FRACP

Summary Depression in patients with cancer can present a challenging clinical problem for both general practitioners and the oncology team. Detecting depression in a patient with cancer, who may be debilitated and in pain, can be difficult. Cancer treatments can complicate antidepressant choices. Community-based psychologists are an important resource for helping manage less complex and less severe psychological problems that can ...

Jeremy W Couper MB BS, MMed, FRANZCP · Annabel C Pollard PhD, MA(Psych), GradDipApplPsych · Dianne A Clifton MB BS, MPM, FRANZCP

Objective: To conduct a cost analysis of a telemedicine model for cancer care (teleoncology) in northern Queensland, Australia, compared with the usual model of care from the perspective of the Townsville and other participating hospital and health services.Design: Retrospective cost–savings analysis; and a one-way sensitivity analysis performed to test the robustness of findings in net savings.Participants and setting: Records of ...

Darshit A Thaker MB BS, FRACP, ClinDipPallMed · Richard Monypenny BIngAgr, PhD · Ian Olver MD, PhD · Sabe Sabesan BM BS, FRACP

First-line monoclonal antibody therapy to prevent bone loss in bone-metastatic breast and prostate cancers is delivered subcutaneously, often by general practitioners who need to be aware that this treatment in patients with low vitamin D levels, impaired renal function and poor calcium absorption (all often seen in older patients) can lead to serious hypocalcaemia.

Jennifer M McLachlan · Gavin M Marx · Margaret Bridgman