How to Find the Right Oncologist for You

After a cancer diagnosis, it’s one of the most important decisions you’ll make.

After a career as a golf professional in southeastern New Mexico, Doug Lyle, 76, decided he had somewhere better to be than on the course: spending time with his new grandchild. Then this summer, just as he was settling into retirement, he learned he had prostate cancer.

“When you’re first diagnosed, you immediately go to the internet, and you can be overwhelmed in short order,” he said. “The more you read about it, the more complicated it gets.”

One of the first and most important choices he had to make was who his oncologist would be. Many of the two million patients diagnosed with cancer in the United States each year get the news from a primary care doctor. Those patients might accept a referral to an oncologist without question. But research suggests that it’s worth considering the choice closely: It can shape the care you receive, your satisfaction with the treatment and your chances of survival.

Not everyone has a choice of oncologists. There are fewer providers in rural areas, and patients must travel farther to reach them. Insurers may only cover certain clinicians and hospitals. And patients from certain populations have less access to oncologists for a range of reasons, which may affect the care they receive. For example, research suggests that Black and Hispanic women with breast cancer are more likely than white women to experience delays in starting radiotherapy. And Black men with prostate cancer are less likely than white men to receive treatment that’s intended to cure their condition, even when they’re at similar stages of disease.

No matter your circumstances, you should feel empowered to have a say in who treats your cancer.

Ideally, experts said, you’d be able to easily compare doctors’ levels of experience and the outcomes of patients they’ve treated with your same diagnosis. But such apples-to-apples comparisons are not always easy to make. But “right now, there are no publicly available data to help a patient with cancer say, ‘Oh, this is where I want to go,’” said Dr. Nancy Keating, a physician and professor of health care policy and medicine at Harvard Medical School. (And even if there were, apples-to-apples comparisons are not always easy to make, since patient populations vary from one doctor to the next).

Still, there are some accreditations to look for. The National Cancer Institute has given a special designation to 72 cancer centers, which must show they treat patients in accordance with the latest evidence and also conduct research into new therapies. The American College of Surgeons Commission on Cancer has accredited over 1,500 programs that meet certain standards. And the American Society of Clinical Oncology has several certification programs, including a list of 300 practices recognized for their quality and safety.

There are resources to help you search for oncologists, too, including a U.S. News & World Report directory that lets you sort by location, patient reviews and accepted forms of insurance. The consumer research firm Castle Connolly also has a database of doctors who are nominated by their peers and then evaluated for their qualifications, interpersonal skills and more.

Look for an oncologist who frequently treats patients with diagnoses similar to yours. Research has long shown that when doctors perform certain procedures more often, their patients have better outcomes. One study found that patients of surgeons who removed more than 25 lung cancers a year spent less time in the hospital, had a lower risk of infection and were more likely to survive three years without recurrence of disease.

Dr. Timothy Pawlik, the chair of the surgery department at Ohio State University Wexner Medical Center, said he only treats a handful of cancers. “You want someone with depth, not breadth,” Dr. Pawlik said. That way, he explained, “the patient may have a rare cancer, but it’s not rare to that doctor.”

Additionally, everyone else on the care team including the anesthesiologists and nurses, will also be familiar with your particular cancer and treatment.

Your primary care provider may be able to find someone specializing in your diagnosis. Some physicians’ websites will identify sub-specialties, and you can also ask for guidance from patient advocacy groups focused on your type of cancer. When you reach out to a doctor, don’t be shy about asking how many patients with similar cancers they treat per year.

Mr. Lyle hesitated to get a second opinion for fear of offending the first doctor he’d seen. But he ultimately chose to do so, a step many experts recommend. “Medicine is an art, and there are sometimes differences of opinion,” said Karen Knudsen, the chief executive of the American Cancer Society. Weighing those differences can help you make a more informed choice.

If a second physician agrees with your original treatment plan, it can give you more confidence in the approach. Research suggests a second opinion can also lead to clinically meaningful changes in treatment. One 2023 study of 120 cancer patients found that a for a third of patients, a second opinion led to treatment changes that yielded better outcomes. Many had received evidence-based care from their first doctor but decided after a second opinion to scale back treatments that might have been unnecessary and had harmful side effects.

Mr. Lyle said that during his first conversation with a physician, he didn’t know enough to ask the right questions about his diagnosis and newer treatment options. “The fine points, you’re not aware of yet. So you almost need a rehearsal,” he said. (For help with what to ask during an appointment, the National Comprehensive Cancer Network has detailed information about care for many cancers.)

When it is clinically appropriate, some cancer centers now offer second opinions through telehealth. You can call to see if it’s possible to submit your medical records and get a remote consultation.

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Ending financial discrimination for cancer survivors: embedding the Right to be Forgotten in legislation across Europe

A new study published today in The Lancet Oncology highlights that many of the current 20 million cancer survivors across Europe are being discriminated against in accessing financial services, including loans, mortgages, health and travel insurance.

The work indicated that on average, up to 25% of those living beyond their cancer may be having more difficulty accessing appropriate financial services.

A European-wide effort is currently attempting to fight this discrimination, by supporting the introduction of legislation that will permit successfully treated cancer patients to not declare a previously diagnosed cancer, so that their diagnosis is essentially “forgotten”.
In January 2016, France became the first country in the world to introduce the “Right To Be Forgotten”, specifying that long-term cancer survivors do not have to share medical information with a financial institution about their cancer diagnosis after a delay of five years without recurrence. Seven other European countries have since taken similar legal measures to counter financial discrimination against cancer survivors. Other European Member States have chosen to implement self-regulatory codes of conduct (Denmark, Finland, Greece, Ireland, Luxembourg), but these are not legally binding.

With over eight years of experience, evidence from France indicates no significant negative impact on insurance companies operating in the French jurisdiction.

Those who are living beyond their disease should not be penalised for a previous cancer diagnosis. Cancer patients across Europe who have been successfully treated should, by law, be able to avoid disclosing a previous diagnosis of cancer, so that they can access the financial services that they need.

Professor Lawler added: “This is not about compassion; this is about evidence and acting on that evidence. When a cancer professional says that you are cured and international benchmarking agrees, then why do the financial institutions say that you are not? Don’t make cancer patients pay twice. Ensure the Right To Be Forgotten is enshrined in law throughout Europe.”

Read the full study here: https://lnkd.in/e_PZHn_j

It’s never been more important to focus on cancer prevention

With an ageing population, cancer cases predicted to increase from 17 million to 30 million by 2040 and rising levels of overweight and obesity, it’s never been more important to focus on cancer prevention. Over 40% of cancers could be prevented if we all lived healthy lifestyles, including maintaining a healthy weight, being physically active and eating a healthy diet.

But what does this mean in practice? Every day we’re bombarded with information about what’s healthy and what isn’t. It can be confusing and seem contradictory: what’s missing is the context – how do all the disparate pieces fit together to make a coherent picture?

That’s where our Global Cancer Update Programme, formerly known as the Continuous Update Project, comes in. This huge undertaking pulls the puzzle pieces together to show how what we eat, what we weigh and how active we are all affect our risk of cancer. The Expert Paneloverseeing the process then use that information to develop Recommendations for Cancer Prevention.

A while back I wrote about how this work was moving into a new and exciting phase of development. This new phase has now started and the programme has changed in a number of ways. It’s more:

  • targeted – looking at specific research questions such as early life exposures and their impact on cancer risk later in life.
  • collaborative – to increase the reach and scope of the work a number of collaborations with leading international research groups will take place that focus on specific areas such as dietary patterns and the life course.
  • efficient – we are shifting from reviewing all risk factors for every cancer to systematically scanning the evidence to identify which topics are likely to be the most fruitful areas of detailed study. Integrating more automation into the review process will be central to this.
  • inclusive – in addition to looking at cancer prevention, the work will expand to encompass cancer survivors. With improved diagnosis and treatment the good news is that there is a growing population of people living with and beyond cancer. The Global Cancer Update Programme will help us to understand how diet, nutrition and physical activity can improve long-term health and prolong survival after a cancer diagnosis.

There are four major themes to the work:

1. Cancer incidence

Looking at how a wide range of factors relating to diet, nutrition and physical activity as well as patterns of diet and lifestyle can affect cancer risk – either through decreasing risk or increasing it.

2. Cancer survivors

Focusing on the impact of diet, nutrition and physical activity on long-term health (cancer and non-cancer related morbidity, mortality and quality of life) after a cancer diagnosis. As part of this, we will look to determine for the first time the impact of diet, nutrition and physical activity on childhood cancer survivors.

3. Cancer mechanisms

Understanding the biological processes that underpin the links between diet, nutrition and physical activity and cancer.

4. Obesity

Ensuring previous work in relation to overweight and obesity remains up to date, given its critical role in increasing the risk of many cancer types. In addition, we will explore whether more specific guidance can be made for preventing obesity in adulthood and early life.

This comprehensive programme of work will allow us to look more deeply at how diet, nutrition and physical activity affect cancer risk and survival. In the next few years, the Global Cancer Update Programme will enable a more sophisticated understanding, with a more personalised approach to cancer prevention and survival than ever before.

Find out more about our Global Cancer Update Programme

The evolution of customer care: AI and the Gen Z effect

With the coming of age of Gen Z—both as customers and new workforce entrants—customer demands are evolving. At the same time, generative AI (gen AI) is transforming how contact centers respond to these demands. Forward-thinking leaders must explore the latest trends, emphasize cohesive support strategies, and take actionable steps to enhance their customer care functions, addressing challenges such as service improvement, cost reduction, and sales function integration.

In this episode of McKinsey Talks Operations, host Daphne Luchtenberg sits down with McKinsey partners Brian Blackader and Eric Buesing. Listen in as they discuss the latest trends, the importance of a cohesive support strategy, and actionable steps contact center leaders can take to improve their customer care functions.

The following conversation has been edited for length and clarity. Dates and statistics correct at time of recording in May 2024.

Daphne Luchtenberg: Every time you buy a product or service, you start or build upon a relationship with the company that stands behind it. And when something goes wrong or you just need help, the ease with which you’re able to get the support you need can have a big impact on how you feel and whether you choose to continue the relationship. With the arrival of more communication channels than ever before and the onward march of gen AI, how should organizations be thinking about where to improve their customer care functions? Throw Gen Z into the mix—with perhaps surprising preferences about how they want to engage with companies today—and you’ve got a complex landscape to navigate.

I’m delighted to be joined today by two of the people behind our recent research, “Where is customer care in 2024?,” Eric Buesing is a partner in our Charlotte office, and Brian Blackader is a partner based in Düsseldorf.

Eric, what do contact centers look like at the moment, and what are the challenges that they are facing?

Eric Buesing: The customer care function of the contact center is currently in the spotlight more than ever before, discussed even at the board level. Contact center leaders face unprecedented pressure in various forms: operational pressure to be efficient and reduce costs, enhance the customer experience, manage employees in increasingly complex environments, and expand the contact center’s role to include more advisory or consultative selling to build loyalty.

Customer expectations aren’t getting easier. With more platforms available for sharing information, disgruntled customers can amplify their dissatisfaction more loudly and broadly.

Eric Buesing: I don’t know if there’s any one organization that gets it all right all the time. At its core, good service involves excelling in the moments that truly matter—those critical times when customers are most in need. In these moments, the goal is to delight them in a way that impresses, garners loyalty, and resolves their issues, while generally maintaining good service overall.

Good service is characterized by several key aspects: the ease of resolving issues, the accessibility of information, and the integration of communication channels so that every interaction contributes to a cohesive resolution process.

Brian Blackader: Adding to that, what good looked like a few years ago, especially during the pandemic, has changed. Back then, simply being available was often enough. Now, we’ve returned to fundamental principles like solving problems effectively and knowing the customer across different touchpoints. Expectations have risen; customers now expect not just solutions, but also personalized understanding and engagement.

Eric Buesing: Absolutely, Brian. The principles of, “Know me, know my issue, and understand me,” are easily said and very difficult to achieve. The organizations that manage to do well in this area invest considerable effort in understanding how to meet these expectations. It’s not a game you win. It’s a game you play. You’re always trying to get better.

Daphne Luchtenberg: It’s interesting to see leaders turning to gen AI tools across various business operations, particularly in business services and customer care. Could you elaborate on the potential for adopting these tools in these areas and how they might enhance the services you described?

Eric Buesing: We’re about 16–17 months into the era of gen AI being available to the wider public. From my perspective, gen AI promises significant disruption, particularly in service functions. I believe that it could reduce current phone volumes by 50 percent within five years. However, the initial progress has been slower than expected. Many believed that gen AI would quickly reduce call volumes and transform customer interactions, but that hasn’t been the case yet. Few organizations have implemented gen AI at a scale where its impact can be effectively measured, and it’s crucial to understand why.

Despite the technological advances, the need for human interaction remains critical, especially for empathy and connection. I do see gen AI playing a significant role in efficiently resolving complex customer issues. We’re likely to see an increase in interactions with chatbots and virtual voice assistants, which will provide quicker, more accurate responses. However, the moments that truly matter will still require a human touch.

Additionally, foundational elements such as data connectivity, data quality, and the technical systems needed to deploy these AI capabilities are also vital. It’s important to recognize that it’s never just tech; early strategic planning and implementation are key to leveraging these tools effectively.

Daphne Luchtenberg: Eric, considering we’re recording this session, could you discuss the role of recording live conversations and how this might enhance intelligence and optimize the call center experience in the future?

Eric Buesing: First, the concept of speech-to-text isn’t new; organizations have been recording conversations for years. However, there’s been a shift in expectations regarding the quality of insights derived from these recordings, moving toward what’s now often referred to as conversational or voice intelligence. This advancement is crucial as it helps organizations explore the root causes of customer calls. Generative AI plays a significant role here, particularly with the concept of multi-intent. This means recognizing that customer calls are complex and cannot be simply categorized as, for example, a “billing call” or a “policy inquiry.” Conversational intelligence enables organizations to understand the multiple reasons behind a customer’s call, which in turn helps in resolving issues more effectively and proactively sharing information across the organization to prevent future frustrations.

There’s potential to use customer care data beyond traditional confines, such as for improving product design or service delivery to reduce customer friction. This approach involves leveraging voice data more strategically than just for compliance and quality assurance.

Brian Blackader: Adding to Eric’s point, while many discuss using these insights for training models, the reality is that many organizations still have a basic understanding of why customers call. Often, the primary reason logged is simply the first option an agent selects from a dropdown menu. It’s vital to understand not just the primary reason for a call but also the second-, third-, fourth-, or fifth-level intent. This understanding is crucial for two reasons: it helps address root causes throughout the organization and enables more targeted training for agents on specific recurring issues, rather than a general overview of a category like billing. We can really be specific on the issue that they’re struggling with.

Daphne Luchtenberg: With the technological advancements in customer care, there’s also a growing need for new skills. Brian, could you expand on the talent challenges that customer care leaders are currently facing?

Brian Blackader: There are two main challenges that care leaders face regarding talent. First, in countries like Germany where I am, or even in the US, there’s a general labor shortage. This makes it difficult to recruit people who can handle increasingly complex issues, especially as simpler tasks become automated. The challenge is not only to find frontline talent but also to enable them to address these complex queries effectively, all while striving to provide excellent customer service amid rising expectations.

Second, the traditional customer care path, where an agent progresses to a team leader, and then to a business unit manager, has been effective for developing people managers for the past 25–30 years. However, this pathway doesn’t necessarily produce the specialized skills needed today, such as data scientists, engineers, or developers. Leaders need to consider how to attract individuals with these skills to the agent level, perhaps targeting students with backgrounds in these areas. Additionally, they must make roles in customer care appealing compared with opportunities in big tech and other industries, where demand for these skills is also high.

Daphne Luchtenberg: That’s interesting. Let’s talk more about the talent pipeline. As Gen Z matures into consumers and the workforce of the future, their perspectives and behaviors might differ from previous generations. I found your insights in the blog post “Why your kids aren’t calling you, but they are calling their bank” particularly interesting, where you noted that some expected trends aren’t necessarily holding true. Could you expand on that?

Brian Blackader: Our research revealed some surprising findings about Gen Z’s communication preferences with companies. Contrary to what might be expected, their behavior isn’t drastically different from millennials, Gen X, or even boomers. When facing an unsolvable problem, about 70 percent of Gen Z individuals prefer to make a phone call, a share similar to older generations. This preference changes when it comes to personal communications, such as contacting friends or family, where they favor texting or messaging apps. However, for serious issues with services like banking or telecommunications, they still turn to phone calls. This indicates that companies that can effectively resolve issues through voice bots and provide excellent experiences will likely outperform their competitors.

Eric Buesing: Adding to that, our research also touched on email preferences across different customer segments. Surprisingly, about 70 percent of customers still prefer using email to resolve issues, despite its decreasing popularity among organizational leaders. Leaders often consider email a challenging channel to manage because it’s hard to track and measure compared with phone or chat interactions. This creates a disconnect, as customers appreciate the asynchronous nature of email—it allows them to send a message at their convenience, while someone else works on the issue later. This discrepancy poses challenges for organizations as they plan future communication strategies.

Brian Blackader: Exactly, and there’s an additional layer to this when considering people’s preferences during work or school hours, where email is particularly favored for its convenience. Additionally, our work in financial services highlighted another unique aspect of Gen Z, especially in the premium segments. Unlike millennials, Gen Z individuals in these segments expect high levels of service, akin to what baby boomers expect. They view phone service as a justified expectation for the fees they pay, demanding quality assistance and a positive experience as part of their service package. This insight is crucial for businesses aiming to cater to this demographic effectively.

Daphne Luchtenberg: It seems like some aspects of customer service are evolving significantly, while others remain unchanged. What do you envision for the future of customer contact centers?

Eric Buesing: As I’ve noted before, I expect a significant shift toward self-service options, predicting that 50 percent of current phone volumes will transition to these channels within the next five years. This shift will likely be driven by improvements in how customer issues are addressed, enhancing interactions with chatbots and virtual assistants to a more meaningful level. Some enthusiasts even believe that virtual voice assistants will become more empathetic than humans, as they won’t carry frustrations from previous interactions. Looking ahead, I’m optimistic about the improvements in service quality. There’s a prevailing acceptance of mediocre service when people call in, often expecting delays and potentially unhelpful responses. However, I foresee a future where service excellence becomes a hallmark of distinguished brands, significantly influencing customer loyalty and brand preference.

Simultaneously, the importance of human interaction will not diminish, especially for critical service moments. If phone volumes reduce by half, the quality and impact of the remaining interactions will become more crucial. I envision a future where customer service agents evolve into “superagents” or “journey managers,” equipped with advanced tools to provide informed, accurate, and empathetic support.

Daphne Luchtenberg: That sounds promising. Brian, would you like to add anything?

Brian Blackader: To summarize, I believe that leading organizations will focus on three key areas over the next five to ten years. First, they will streamline resolutions and enhance self-service capabilities for simpler issues, leaving more complex matters to customer service. Second, echoing Eric’s point, these organizations will empower their agents—whom we might call super agents—with sophisticated tools that aid in resolving customer issues effectively, fostering loyalty, and delivering exceptional experiences, possibly even with minimal training.

Lastly, the concept of an omnichannel experience will be crucial. While this has been discussed for over a decade, truly successful organizations will offer a seamless customer experience across all platforms—whether in-store, over the phone, through chat, or even via underused channels like video, and potentially augmented or virtual reality for specific scenarios. This consistency will ensure that no matter how a customer chooses to interact with a company, the great ones will be able to make sure that that experience is consistent across all the different ways you might contact them.

Eric Buesing: Brian, I really appreciate the concepts of omnichannel and optichannel, which refers to using the optimal channel for resolving issues. Currently, customers face a confusing array of options—social media, YouTube, websites, apps, calls, chats, and more. It’s not transparent which channel is best for their needs, leading to random choices. However, with the optichannel approach, it will become clear to customers which channel is most effective for their specific issues.

Daphne Luchtenberg: So, this would also mean that customers will grow more sophisticated at selecting the right tools for their needs, correct?

Eric Buesing: Exactly. It boils down to whether it’s simpler to handle an issue ourselves or to call for help. As long as calling remains the easier option, that’s what people will choose.

Daphne Luchtenberg: We’ve discussed many important points today. Before we conclude, Eric, where should leaders look for inspiration as they move forward?

Eric Buesing: Leadership in this area really requires courage. I’m often underwhelmed when we are asked, “Hey, do you have a North Star vision? What do you want out of your customer care, your servicing function?” The answers are often very incremental: “I’d love to see a 5 percent improvement in this. I’d like our budgets to be down, our handle times to go down, and our customer satisfaction score to go up slightly.”

We need to think bolder than that. Being a courageous leader means having a plan and setting an aspiration that is difficult and makes people uncomfortable, and then seeing it through. It’s one thing to say, “Hey, we want to cut our volume by 50 percent.” It’s another challenge to actually go after it.

In many ways, it requires collaboration outside of the contact center. The contact center is the receiver of somebody else’s problem. There has been a breakdown somewhere else in the customer journey, either by a product that didn’t deliver, a service that didn’t meet expectations, or an experience that was subpar. That drives volume.

So how do we look upstream and tackle those issues? How do we bring together the organizations or business units within an organization that need to come together to resolve them?

Daphne Luchtenberg: Yeah, I love that. Brian, what do you think?

Brian Blackader: In my interactions with customer care leaders, I’ve noticed they typically align with one of two approaches. The first group is action-oriented; they want to start immediately and tackle tasks head-on. The second group prefers to strategize, aiming to develop a North Star vision and a detailed road map, as Eric mentioned. It’s crucial to combine both approaches.

Creating a North Star vision and a road map is essential to avoid merely making incremental changes and to thinking in the long term. This involves making necessary investments and managing change over time. However, it’s also important to recognize that presenting such plans isn’t new to boards, and there might be limited patience for long-term results. Therefore, I advise leaders to also focus on achieving quick wins. By demonstrating early successes, you can build credibility within the organization and show tangible progress.

Additionally, I want to emphasize the importance of voice communication. Despite advancements in technology like chatbots, many customers still prefer calling. If these calls go unanswered, customers might escalate issues to regulators. With today’s technology nearing the capability to automate voice interactions effectively, there’s a significant opportunity to enhance customer experiences through this channel.

Eric Buesing: Adding to Brian’s points, another aspect we briefly touched on is transforming the role of contact centers from purely service-oriented to also encompassing sales. While “sales” can sometimes be perceived negatively, it shouldn’t be feared. Customers expect a high level of service that not only addresses their immediate issues but also anticipates their needs. This could involve better use of current products or introducing superior ones. The contact center is uniquely positioned to not just solve problems but also to provide valuable advice and recommendations. This shift from aggressive selling to thoughtful consultation can significantly enhance customer satisfaction and loyalty.

Daphne Luchtenberg: Fantastic, Eric. I couldn’t have said it better myself. Thank you so much.

Here’s a few things that I loved about the conversation today to think about as we close: first, this idea that customer service and contact centers are not a game you win, but rather a game you choose to play. Secondly, that gen AI is changing that game, albeit not as quickly as we might have expected, including through ways such as voice automation. And finally, there’s no better place in the contact center to build and deepen customer relationships and to give them better experiences during those moments that really matter.

Πηγή: mckinsey.com

CANCER MAY CONTROL YOUR BODY FOR A WHILE, BUT ΝΟΤ YOUR SOUL…

We dreamed it, we organized it and we finally accomplished it!

Kapa3, always thinking and implementing actions whose main priority and beneficiaries are the patients with cancer, overcoming barriers, social, economic, and social and cultural characteristics! Cancer has no gender, no country, no color, no religion!!!

The team of Kapa3 could not ignore the challenges and needs of people who are forced to leave their countries of origin and, having the problems of their disease out of their priorities, put themselves in danger, crossing the borders of our country, hoping for a better and safer future.

Thus, studying the needs of these people, the group of professionals of KAPA3, being active and present in the wider region of Macedonia and Thrace, submitted a proposal for the implementation of actions in these areas, targeting the refugees and migrants of the region.

With great pleasure, we received the response of the King Baudouin Foundation, which recognized in this proposal our vision and approved funding to support and develop the Cancer Patient Guidance Centre-Kapa3, to provide immediate assistance to refugees and migrants crossing the borders of our country.

Together we can achieve the impossible! Looking cancer in the eye and fighting every day together, is a small but important battle for life, against cancer!

More specifically: The development of the existing network, the addition of mental health professionals, and the development of actions and activities in new places, with new partners, will allow us to help much more in the process of better and more complete treatment of the incidents and difficulties we face.

With funding from the King Baudouin Foundation, over the next 6 months, we will strengthen our network of psychologists, sociologists, and social workers, with a focus on the 15-24 age group, to continue providing primary care and support throughout their treatment. Part of the funding will be used to translate the Kapa3 online portal into at least two languages, in addition to English, with Ukrainian being the first, so that our citizen’s accessibility to any portal of the Public Health System is immediate and seamless.

The Organization has a website and an app where it provides general support and information as well as personalized support to each beneficiary. The staffing of the network with permanent personnel will become the basis for the successful targeting, which is, No One Feels Alone! The activation of psychological support for patients, the categorization of patients by age and the activation of actions to solve additional problems related to each of these age groups are some of the actions that we are ready to take to support these vulnerable groups!

We are well aware that the Greek health system and the support of medical care for cancer patients provided mainly in the country’s public hospitals, given high care costs and economic conditions, are not chosen by a significant number of patients, mainly immigrants, and refugees. The fact that Kapa3 operates in the structures and departments of hospitals that exclusively support cancer patients allows us to be able to record cases and extract qualitative and quantitative data and results to improve and create new actions in this direction.

Our vision has inspired and found support beyond borders! Cancer can control the body of patients for a while, but the soul, which strengthens the power in the battle with cancer, cannot be controlled!!!

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Digital-in-Health: Unlocking the Value for Everyone

Digital technology can strengthen health systems, improve health financing and public health, and increase reach to underserved populations, according to a new World Bank report launched today. The report also finds that digital technology and data are especially helpful to prevent and manage chronic diseases, care for both young and aging populations, and prepare for future health emergencies and health risks triggered by climate change.

The report, Digital-in-Health: Unlocking the Value for Everyone, was launched today during the G20 Health Ministers Meeting in Gandhinagar, India. It presents a new way of thinking from simple digitization of health data to fully integrating digital technology in health systems: Digital-in-health. This means, for example, infusing digital technologies in health financing, service delivery, diagnostics, medical education, pandemic preparedness, climate and health efforts, nutrition, and aging.

The report also underscores that the successful use of digital technologies must be inclusive of all population groups, and ensure access to digital infrastructure, modern technologies, and skills, especially for vulnerable people.

Designed with people at the center, digital technology can make health services more personal, prevent healthcare costs from increasing, reduce differences in care, and make the job easier for those who provide health services,” said Mamta Murthi, Vice President for Human Development, World Bank. “We hope that this report will give governments confidence and practical guidance, regardless of the country’s stage of digital maturity or fiscal challenges.

Improving health is getting harder, not easier. Health systems face serious and growing challenges and policy decisions are too often not based on reliable data.  It is estimated that some countries use less than 5% of health data to improve health which means that decisions are not based on data or data is not used effectively to make improvements. Within challenging fiscal environments, people-centered and evidence-based digital investments can help governments save up to 15% of health costs. The report presents pragmatic, low-cost actions to improve digital-in-health, no matter the maturity of a country’s systems or digital infrastructure. For example, better health data governance and standards to ensure systems can readily connect and exchange information are not costly but will be game changing in reducing siloed digital solutions and fragmentation.

In India, we have shown that digital innovations such as tele-consultations have reached more than 140 million people and provided accessible, affordable and efficient healthcare for everyone,” said Mansukh L Mandaviya, Minister for Health and Family Welfare, India. “We believe a digital-in-health approach can unlock the value of digital technologies and data and has the potential to prevent disease and lower healthcare costs while helping patients monitor and manage chronic conditions.” 

 

To help countries embrace a digital-in-health approach, the report proposes three essential areas to guide investments:

  1. Prioritizeevidence-based digital investments that tackle the biggest problems and focus on the needs of patients and providers.
  2. Connect the regulatory, governance, information, and infrastructure dots so that patients know that data is safe and health workers can use digital solutions transparently.
  3. Scale digital health for the long run based on trust with sustainable financing, and improved capacity and skills for digital solutions.

It will take global, regional, and country leadership to make digital-in-health a reality. The report recommends strong country leadership involving all relevant sectors and stakeholders, including civil society. Digital technology and data improvements will involve investments beyond the health sector and new partnerships with the private sector. A digital-in-health mindset needs to be a routine aspect of annual health system planning, budgeting, and implementation.

The World Bank is committed to helping low-and middle-income countries to make digital-in-health a reality to improve health for everyone. Over the past decade, the World Bank has invested almost $4 billion in digital health including in health information systems, digital governance, identification systems, and infrastructure.

For more information, including a copy of the new report, Digital-in-Health: Unlocking the Value for Everyone, please visit:

Website: www.worldbank.org/en/topic/health

Twitter: http://www.twitter.com/WBG_Health

Facebook: http://www.facebook.com/worldbank

YouTube: http://www.youtube.com/worldbank

 

Cancer Effects on Caregivers and Work

A CANCER DIAGNOSIS RESULTS IN A LOT OF CHANGES for both the patient and the caregiver.

For the caregiver, those changes can include adjusting work schedules, which, in turn, can affect their finances.

The unexpected expense of cancer treatments coupled with the lack of paid leave can be a one-two punch to caregivers’ financial resources. “For many caregivers, keeping debt low or nonexistent may not be possible,” says Cathy J. Bradley, a health economics researcher and co-author of a study titled “Working, Low Income, and Cancer Caregiving: Financial and Mental Health Impacts,” published online April 12 in the Journal of Clinical Oncology. “The Federal Reserve reports that many households would have difficulty absorbing $400 in unexpected costs. Cancer treatments are among the most expensive treatments in the United States.”

In many instances, caregivers can take paid leave to care for their loved one, which can mitigate financial hardship, but that’s not always the case. Often, caregivers are faced with taking unpaid leave or having to stop working altogether—both of which negatively impact their finances.

According to Bradley’s study, 35% of cancer caregivers stopped working and 30% saw their household debt increase. Those in households earning less than the median household income were more likely to experience decreased income and stop work than peers in similar financial situations who were caring for people with conditions other than cancer.

“Data on reasons for stopping work was not part of this study, but we speculate that caregiving demands are greater for cancer patients,” says Bradley, an associate dean of the Colorado School of Public Health and deputy director of the University of Colorado Cancer Center. “We also speculate that lower-income households cannot pay for additional help so that the caregiver can continue working.”

A key element forcing caregivers to stop work is no paid leave at their workplace. According to the American Cancer Society Cancer Action Network (ACS CAN), studies show that cancer patients with paid leave have higher rates of job retention and lower rates of financial burden. However, 48% of caregivers report experiencing problems related to financial pressure caused by not being able to work or having to reduce work hours to care for their loved one.

“Cancer treatment is so all-consuming for the patient but also for the family and anyone who is caregiving for the patient,” says Jennifer Hoque, associate policy principal on access to care for ACS CAN. “And that includes all-consuming with finances and time. Time is money. The more time you have to spend caregiving for the cancer patient, the more potential for lost wages and other money you’re spending. And it’s not just time caring for the patient. It’s also transportation, taking the patient to and from their treatments. Sometimes it’s lodging because sometimes you have to stay overnight.”

To help cancer caregivers, ACS CAN supports legislation providing for paid leave in the workplace so everyone has access to it and can help their family members. The Family and Medical Insurance Leave (FAMILY) Act was introduced in Congress on May 17. If passed, it would provide workers with a maximum of 12 weeks of financial support during a family or medical leave from work. In addition, 11 states and Washington, D.C., have enacted paid leave laws.

Finding assistance is crucial for cancer caregivers. “Caregivers provide a tremendous service to their families and society at large with very few supports,” Bradley says. “As a result, they suffer not only physical and mental consequences, but they also suffer financial consequences that last for years. Lower-income households take on the greatest financial burden and may never recover.”

If you’re caring for a cancer patient, it’s important to find out what type of leave is available. For instance, the Family and Medical Leave Act currently in effect provides 12 weeks of unpaid leave during a one-year period. Although leave is unpaid, the law protects your job while you’re away from work. Also, find out how flexible your employer is in allowing remote work or changing your work hours for doctor appointments and treatments.

Other assistance may be available through local, state and national programs such as the CancerCare Co-Payment Assistance Foundation, HealthWell Foundation, and the Leukemia & Lymphoma Society. Patient navigators at your loved one’s hospital or cancer treatment center can also be a valuable resource in advising you about financial assistance.

Cancer Effects on Caregivers and Work

Empowering patients through medical technologies for a healthier future

By constantly investing in existing and future technologies, the medical technology sector contributes to a healthier Europe. The 2023 MedTech Forum looked at some key trends in legislation and business and the role that EU policymakers can play to bring medical innovations to patients in a timely manner.

Europe takes great pride in its robust social security systems and the fundamental principles of equitable healthcare access. Data indicates however that significant efforts are still required to ensure that all patients across the continent enjoy top-tier quality care and unfettered access to medical services and technologies.

Medical technologies empower early diagnoses, timely interventions, and remarkable outcomes. Medical technologies mend, revive, and improve body functions, while telemedicine and connected devices bring patient monitoring to new frontiers. Innovations speed up recovery, safeguard well-being, and equip healthcare workers with vital insights for optimal decisions and fewer complications. By relieving strain on healthcare systems, fostering social and economic vitality, averting complications, and advancing efficiency through cutting-edge data and machine learning, medical technologies are high-tech, high-value game-changers in healthcare. Diagnostic technologies also act as a first line of defence against disease outbreaks and help support their management.

Because of its innovation power, and its positive impact on patients, healthcare professionals, and health systems, the medical technology sector has developed into a key industry with an important economic and societal impact in Europe.

European leadership for the benefit of patients 

Europe’s 34,000 medical technology companies invest heavily in improving existing and innovating breakthrough technologies for the benefit of patients. These companies, 95% of which are SMEs, drive economic growth, provide employment in Europe, and boost EU exports. In doing so, the sector adheres to strict regulatory standards that ensure safe devices which live up to their performance claims. Patient health and well-being in mind, no other region in the world sets such high standards to guarantee that medical technologies are safe for patients and healthcare professionals to use.

Despite Europe’s fundamental strengths in health and medical solutions, there are growing indicationsthat new and existing products will struggle to reach European patients and health systems in a timely manner: 17% of today’s in vitro diagnostics are expected to be discontinued in Europe, particularly among SMEs and approximately 50% of medical device manufacturers are deprioritising the EU market (or will do so) as the geography of choice for first regulatory clearance of their new devices.

MedTech Europe, the leading European medical technology trade association, believes that there are persistent, system-level issues within the European regulations for medical technologies which lead to unpredictability and delays, dampen innovation, and undermine confidence in the long-term viability of the regulatory framework.

To remain a global leader in medical technologies, the EU must deliver a more patient-centred and innovation-friendly regulatory framework that addresses the system-level challenges of today while preparing for the opportunities of tomorrow.

Getting through the maze 

Beyond the medical technology industry’s sector-specific developments, fundamental changes have been brought about in the last decade by the mega trends of digitalisation and sustainability. Such trends contribute to a revolution in the way innovation in medical technologies is happening, driving the need for a more forward-looking regulatory mentality to allow innovation to thrive.

Legislative activity of the EU in this area has been, rightly, immense – and much more needs to be done to ensure that all the rules-in-development which will impact medical technologies will actually work together to deliver products to patients. The EU’s Digital Strategy, driving regulation on artificial intelligence, cybersecurity, and data, including the European Health Data Space and the European Green Deal will legislate tectonic changes, including in the area of product design, are coming with a substantial set of new or updated requirements for medical technologies.

Against this background, substantial legislations are also being revised, such as the ones on Product Liability and Corporate Sustainability Due Diligence. It is paramount to include principles that ensure patients across the EU can benefit from a high level of protection and businesses are provided with legal certainty.

These new rules will significantly impact the way and speed in which technologies can be brought to market and accessed by those who need them. Getting medical technology innovations to European patients and healthcare systems in fact can often feel like navigating a complex and ever-shifting maze.

As a result, whether for R&D investment, clinical research, manufacturing or new product launches, Europe slowly losing ground to other geographies on innovation, because the maze seems to be getting harder to navigate. The EU thus has a big task ahead to further its efforts towards driving harmonisation and creating an environment of legal certainty for businesses.

The slowly approaching end of the EU legislative cycle is a unique opportunity to reflect on what has been achieved and what is still to be done. It is not a time to rush to the finish line but to stay level-headed and look for effective solutions to ensure medical technologies reach patients on time. We need to solve existing challenges in a comprehensive, sustainable manner, setting the tone for a future environment that will allow patients to continue benefiting from first-line, quality medical technologies and more equitable access to healthcare, and health systems to build the long-term resilience they need. The medical technology industry in Europe stands ready to contribute and collaborate to make this a reality.

This article was produced in partnership with Medtech Europe. MedTech Europe is the European trade association for the medical technology industry including diagnostics, medical devices and digital health.

https://www.theparliamentmagazine.eu/news/article/empowering-patients-through-medical-technologies-for-a-healthier-future

Quality Questions:When you are diagnosed with cancer, how can you be sure you’re getting appropriate care?

IN APRIL 2020, truck driver John Lex was waiting to load up his tractor trailer at a Walmart distribution center in LaGrange, Georgia, when he felt a severe, sharp pain in his lower abdomen. The self-proclaimed “stubborn guy” figured if he went home to lie down, he would feel better. However, by the time he arrived home in Monroe, Georgia, the pain had amped up to “an eight out of 10.” He asked his wife to drive him to the local hospital’s emergency room.

Doctors there thought his pain might be appendicitis, but a CT scan revealed something unexpected: a mass in his colon. “The doctor told me that they believed it was cancerous, but he wouldn’t know for sure until they got in there,” says Lex, now 56, who had immediate surgery to remove the mass and have his colon resected. He would need to wait for results from the biopsy to get confirmation, but “[the doctor] was pretty confident that it was cancer,” Lex says

Three days after surgery, on April 25, 2020, these suspicions were confirmed. Lex’s tumor was malignant—with 19 positive lymph nodes. He had stage IIIC colon cancer. He was referred to a medical oncologist at Piedmont Walton Hospital in Monroe—the same hospital where he had his surgery. He completed a six-month course of chemotherapy with FOLFOX (folinic acid, fluorouracil and oxaliplatin), but in January 2021, the scans showed that the tumors were back in his colon, as well as the lining of his abdominal cavity.

At that time, his oncologist suggested another chemotherapy combination and referred Lex to a colleague at Atlanta-based Winship Cancer Institute at Emory University, which is less than 30 miles away from Lex’s home, for a second opinion. Winship Cancer Institute has earned the National Cancer Institute’s highest honor—a comprehensive cancer center designation—which signifies significant research infrastructure along with the capacity to provide high-quality treatments to patients. The oncologist at Winship confirmed the treatment plan. Lex continued to be treated by his original oncologist, satisfied that he was receiving appropriate care.

Treatment Close to Home

Like an estimated 80% to 85% of people with cancer in the U.S., Lex sought treatment at a community cancer center. Community cancer centers typically provide care through oncology practices or networks, offering treatment at local hospitals instead of specialty cancer centers. They are not usually a part of large academic teaching hospitals and don’t have NCI designations.

“Community hospitals are those institutions that are designed to take care of patients. They’re not necessarily teaching and they’re not necessarily doing research. That’s not to say that they never do,” says Thomas Tucker, the senior director for cancer surveillance and associate director of the Kentucky Cancer Registry at the Markey Cancer Center Prevention and Control Program at the University of Kentucky in Lexington. Tucker has published research on Markey Cancer Center’s efforts to form an alliance with community cancer hospitals to help provide more standardized cancer care throughout Kentucky.

The decision to receive care in a community cancer center is often influenced by geography, given that many people in the U.S. do not live near large academic teaching hospitals or one of the 71 NCI-designated cancer centers spread across 36 states and the District of Columbia. “The number one criterion that’s going to affect where a cancer patient gets treated is going to be their location,” says Rose Gerber, a breast cancer survivor who is the director of patient advocacy and education at the Community Oncology Alliance, a nonprofit organization based in Washington, D.C., that advocates for the preservation of oncology private practices that offer patients high-quality, affordable cancer care close to home. Gerber notes referrals often come from a patient’s primary care doctor who is familiar with local oncologists. In addition, a patient’s and doctor’s familiarity with the local health system and the convenience of not traveling far for what are usually multiple treatments often provide reassurance to patients, Gerber says

Experience Matters

Other variables, including a person’s cancer type, stage, the pathology and genetic makeup of the tumor, and any previous treatments, can all factor into people’s decisions about where they go for their care. When analyzing choices, oncologist Diane Reidy-Lagunes suggests that patients start by asking questions to gain an understanding of the doctor’s experience with the patient’s stage and type of cancer.

“There are definitely some questions that you want to ask the oncologist when you’re meeting them … particularly for instances of rare diseases,” says Reidy-Lagunes, who is the associate deputy physician-in-chief of the Regional Care Network at Memorial Sloan Kettering Cancer Center in New York City. She suggests asking, “Is this a disease that you’re often taking care of? Have you only seen one in your lifetime or do you see five in clinic daily?”

Patients can also look up a physician’s specialties online before the office visit, says Nancy Keating, a primary care physician at Brigham and Women’s Hospital and a researcher in the Department of Health Care Policy at Harvard Medical School in Boston, who studies factors that influence the delivery of high-quality care for people with cancer. “The more specialized training someone has, the better, especially when complex care is needed,” she says, using the example of a surgeon who specializes in a certain kind of cancer. “If you are a colorectal surgeon, you’ve done a fellowship, and you only do colorectal surgery. In addition, you are continually getting exposed to new cases daily and that’s all you do.”

With more experience comes greater proficiency. Research indicates that people with cancer who undergo complex procedures at high-volume surgical centers have better outcomes compared to low-volume centers, including for lung, esophageal and pancreatic cancer. For example, one study published in the April 2017 Annals of Surgery suggests patients with esophageal cancer who traveled to high-volume surgical centers had significantly better five-year survival rates, with 39.8% of patients living five years or longer compared to 20.6% who sought treatment at low-volume surgical centers. Another study published Nov. 1, 2021, in Cancer, compared outcomes at high-volume and low-volume radiation centers for a number of cancers and found patients receiving adjuvant radiation had significantly improved survival at very high-volume facilities when compared to low-volume facilities. Patients who received radiation alone for prostate, non-small cell lung, pancreatic, and head and neck cancer without surgery or other treatments also had increased survival, according to the study.

Lindsay Longo, an IT services director who lives in Tampa, Florida, was diagnosed with stage II Hodgkin lymphoma in November 2020 after going to an emergency room with escalating symptoms from COVID-19. While she was there, doctors performed a CT scan and discovered a large mass in her left lung, a rare presentation of Hodgkin lymphoma. She had a lung biopsy on Nov. 25, 2020, and five days later was diagnosed with cancer.

Longo ultimately decided to get her treatment at Moffitt Cancer Center, an NCI-designated cancer center in Tampa. The 39-year-old was impressed with the depth of experience that Moffitt provided, including swift coordination of care. “I didn’t feel like [the hospital where I was diagnosed] was moving fast enough for me, so I decided on Moffitt for its credibility and the top ranking. For me, it was a no-brainer,” she says.

On Dec. 31, 2020, Longo began treatment, receiving eight rounds of ABVD (Adriamycin, bleomycin, vinblastine, and dacarbazine) administered every two weeks. At the end of treatment, a scan revealed one spot on a lymph node. At that point, a tumor board, consisting of a multidisciplinary team of physicians at Moffitt, reviewed her case and suggested she have four more rounds of chemotherapy. On July 27, 2020, her scans were clear.

Access to Clinical Trials

While the standard-of-care treatments offered in cancer centers and community hospitals already have proven efficacy, some patients may also be interested in experimental treatments and clinical trials, says Gerber, who was diagnosed with stage II HER2-positive breast cancer in 2003.

Gerber had a lumpectomy followed by eight rounds of chemotherapy and radiation at Eastern Connecticut Hematology and Oncology, an oncology practice affiliated with Backus Hospital in Norwich, Connecticut. Her physicians also offered her an opportunity to participate in a clinical trial that tested the use of a targeted medication called Herceptin (trastuzumab) to reduce the chance of her cancer returning.

“[HER2-positive breast cancer] at the time was one of the deadliest diagnoses with a very poor prognosis,” she says. Gerber realizes now how fortunate she was to take part in a ground-breaking clinical trial. Today, she credits her survival and good health to being a part of the Herceptin clinical trial, and the drug is now the standard of care for patients with HER2-positive breast cancer. Gerber notes that many community cancer centers offer clinical trials—and the idea that this type of research is only offered at larger research or academic hospitals is a misconception.

Having access to a range of treatment options—both the standard of care and experimental drugs—is especially important for patients who have advanced cancer, says Heidi Nelson, medical director of the American College of Surgeons, Cancer Programs, which is responsible for the Commission on Cancer (CoC) accreditation program for hospitals. The accreditation means facilities have demonstrated that they provide a range of services, either on-site or through referrals to other facilities, including diagnostic imaging, radiation oncology, systemic therapy, psychosocial support, rehabilitation, nutrition and access to clinical research.

Collaboration between medical oncologists, surgeons, radiation oncologists, nurses and social workers provides a good measure for quality care, Nelson says. “With an appropriate team of specialists, each professional sees a different part of the patients’ needs and the cancer details. The full picture comes together when all the professionals come together around each patient to make sure nothing is left out of the care plan,” she says.

That type of collaboration can also extend across hospital systems—including between NCI-designated cancer centers and community hospitals. One example of this type of collaboration is with the NCI-designated University of Kentucky Markey Cancer Center, in Lexington, which started an affiliate program in 2006 that now includes 21 community hospitals. One of the requirements for facilities taking part in the alliance is achieving and maintaining CoC accreditation, as a means to increase quality of care in cancer hospitals across the state. A study of 13 hospitals in the network published in the February 2021 Annals of Surgical Oncology showed this collaboration increased the hospitals’ ability to meet quality measures three years after they joined the network compared to three years prior. In addition, the number of hospitals that received CoC accreditation increased from three to 12.

“This is an opportunity for the medium- and small-sized hospitals to have access to resources for facing issues or problems they may not have seen before,” says Tucker, who notes that academic and research hospitals don’t have the capacity to treat every cancer patient. “The smart thing [to do] is to help community hospitals develop that capacity. Many of them are quite good at it [already],” he says.

For patients like Lex, having the ability to tap into expertise at both his local cancer center and a larger cancer center provided extra reassurance. This collaboration included having a multidisciplinary team review his case at the hospital to determine the best course of care. “Knowing that it’s not just [my oncologist] that’s looking at my records, that it’s all the doctors that she works with really eased my mind,” he says.

In May 2021, Lex went back to Winship for another second opinion after a PET scan showed one of his three tumors was growing. Genetic testing in early 2021 showed his tumors tested positive for BRAF mutations, which made Lex eligible for a combination of targeted therapies, Erbitux (cetuximab) and Braftovi (encorafenib). Since starting treatment, his tumors have appeared to be less active in the PET scans, which could be an indication that treatment is working. In addition, one tumor has gotten smaller in size. He hopes the targeted therapy will keep his tumors at bay. “We’re hoping that maybe the treatment will knock it out completely,” says Lex. “I am so happy I got the second opinion. It just eases your mind because I have two great doctors looking over me.”

Quality Questions

Digital and digital non-clinical solutions

➡️What will be the digital and digital non-clinical solutions for people with cancer in the future 🧐
This post aims to consider some possible digital solutions to bring medical resources and information to patients in the future.

➡️📱Mobile Apps: Mobile cancer apps can play a crucial role in patient education, symptom management and treatment monitoring.
These apps could provide information about cancer, medications, side effects, proper diets, as well as reminders for medications and medical appointments.

➡️⌨️Connected objects and wearables:
Wearable devices such as smart watches, bracelets and monitoring sensors could be used to monitor the vital signs of cancer patients in real time.

➡️Artificial Intelligence
(Al) and Data
Analytics: Al can be used to analyze large amounts of medical data and help identify patterns, correlations and predictions. This could contribute to a better understanding of risk factors,
treatment responses and patient
outcomes.

➡️Virtual Reality (VR):
Virtual reality can be used to help cancer
patients manage pain, anxiety and stress. Calming and interactive virtual environments can be created to distract patients during medical treatments or to help them relax during difficult times

For more just read: E-Health4Cancer : Sharing good practices in the use of nonclinical e-health solutions for cancer patients and their caregivers in Europe. Non-profit Organizations

https://www.linkedin.com/company/ehealth4cancer/