Running innovative programmes
Innovative new app to help cancer referrals
Your wonderful support has enabled our cancer genetics team to develop a new app for clinicians to use for consultations. The exciting new technology helps them to determine whether a patient or their family has an inherited susceptibility to cancer.
Cancer is usually caused by a combination of environmental factors, such as exposure to smoking or UV light, and genetic factors. Around 5-10% of cancers can be caused by an inherited genetic mutation. With 1 in 2 people now getting cancer in their lifetime, it’s vital to be able to identify and refer people who are at risk as quickly as possible, so that they and their family have access to preventative options.
36-year-old Kenisha McGregor was diagnosed with breast cancer in 2013 and was found to carry the BRCA1 gene mutation when she was referred to Guy’s Hospital. Carriers of BRCA1 are at high risk of developing breast and ovarian cancer.
‘I’d been told that I could have an elevated risk of cancer due to my family history after my first scare, but I wasn’t given a definitive answer,’ says Kenisha. ‘I was left wondering until I found a second lump in my armpit and was diagnosed.
‘The use of this app could save families from similar uncertainty and help them to receive specialist genetic testing if necessary. I have a son and a daughter, and although it may be difficult for me to accept the results, I’d encourage them both to go for testing when they are older so that together we can be either reassured, or make informed decisions about prevention if they do carry the gene.’
Ensuring accuracy and efficiency
The app can help clinicians reach a more accurate diagnosis more quickly. Users are asked questions about their patient, and navigate via a specially designed ‘decision tree’ function until they reach a conclusion.
When using the app, clinicians will know whether their patient should be referred to the cancer genetics team or whether their case should be handled by a GP or another department in the hospital. GPs are one group who will be able to use the app, helping them with a quicker, smoother risk assessment.
‘GPs are like the gatekeepers; they’re inundated with so many different conditions that they need to be thinking about,’ says Dr Anju Kulkarni, consultant in cancer and clinical genetics. ‘It can be hard for them to know exactly what questions they need to ask each patient and the red flags to look out for. So the app gives them a framework for that.’
The app is so user friendly that it can even be used during an appointment with the patient present, if required. As well as the risk assessment tool, it generates summary reports that can be sent over email.
It also includes a reference guide with information about different conditions and links to useful websites. This is updated by the cancer genetics team, ensuring relevant and up-to-date information is always at the clinicians’ fingertips.
Responding to a need for improvement, with the help of donations
In 2013, the actor Angelina Jolie announced that she’d had a preventative double mastectomy following the discovery that she carried the BRCA1 gene. The press coverage surrounding this resulted in a doubling of referrals to the cancer genetics department at Guy’s and St Thomas’ in a six month period.
With the need for a slicker and more reliable referral system highlighted, the idea for the app was formed.
‘We were getting some appropriate referrals, but also a lot of inappropriate referrals which is a waste of resources,’ says Anju. ‘The app will help manage that.
‘For example, let’s say a patient is worried because her mother was diagnosed with breast cancer when she was her age. The app will help the clinician determine whether the patient’s family history warrants her being referred to us in cancer genetics because she is at high risk. Or alternatively, can she just be referred for early breast screening? Or can the clinician reassure her and say, “There’s nothing to worry about, just modify lifestyle factors like diet, alcohol intake and smoking.”’
Striving for the best care nationally
The app was launched in March 2016 within Guy’s Regional Genetics Service’s catchment area. The department’s hope is for it to eventually be used nationally as a reference guide and educational tool, with the aim of encouraging consistency of patient support and care around the UK.
‘Receiving funding from donations was crucial to the project,’ says Anju. ‘Current financial constraints make it hard to make innovative ideas a reality, so it’s been so helpful. The app wouldn’t be here if it wasn’t for our supporters’ generosity.’
Support from our wonderful donors and fundraisers allows innovative projects like this app come to life. If you would like to support projects to help patients like Kenisha, find out more about the ways you can get involved.
Above right image: Dr Anju Kulkarni with Kenisha McGregor. Above main image: Dr Kulkarni demonstrating the app to a patient