Oncology ‘too difficult’ for many medical students

Oncology has been rated as one of the most difficult specialities to master in a survey of Australian medical students and junior doctors.

When asked to rate eleven medical specialities based on their perceived difficulty, the 114 would-be specialists at Western Health, Melbourne, nominated oncology as among the most difficult, along with haematology, rheumatology and nephrology.

Neurology was rated as the most difficult speciality, based on the complexities of neuro-anatomy and the challenges of making a diagnosis based on uncertain symptoms. However, students’ rating of teaching quality was higher for neurology than for other specialities including oncology, according to the study, conducted by Dr Alex Yeung colleagues at  Western Health and Melbourne University.

Cancer diagnosis delayed during pandemic

Victoria’s pandemic restrictions in 2020 led to thousands of cancer diagnoses  being either delayed or missed, according to modelling  of observed vs expected cases released by the Victorian Cancer registry.

Published in the MJA, the analysis found that 54 609 cancers were predicted for the period of 1 April – 15 October 2020 in Victoria but only 49 163 were recorded. The 10%  difference of 690 cases translated into an estimated 2530 undiagnosed tumours, the researchers said. The  biggest reductions in notifications were for prostate (-26%), head and neck cancer (-15%) and melanoma (-13%).

“Planning for a possible surge in cancer diagnoses over the coming 6-12 months, and media campaigns encouraging people to not further delay seeking medical attention, may ameliorate any negative impact of delayed cancer diagnosis,” they wrote.

Catecholamines key to breast cancer spread

Beta blockers have the potential to reduce breast cancer progression because the sympathetic nervous system regulates  growth of primary mammary tumours via release of catecholamines, according to researchers at Monash University. Using experimental models they showed that carvedilol blocked the effects of sympathetic nervous system activation, reducing primary tumour growth and metastasis and prevented invasion by breast cancer cell lines. The hypothesis that beta blockers may have benefit in breast cancer was supported by a retrospective analysis showing that women using carvedilol at breast cancer diagnosis had reduced breast cancer-specific five-mortality compared with women who did not (3.1% versus 5.7%) they reported in the European Journal of Cancer.