Category: EVALUTION OF CUSTOMER CARE

A Different Chemotherapy Approach for Ovarian Cancer

OVARIAN CANCER that spreads to the lining of the abdominal cavity, called the peritoneum, is difficult to treat. Patients with this advanced cancer typically undergo debulking, also called cytoreductive surgery, a lengthy procedure in which surgeons aim to remove all cancer from the abdominal cavity and affected organs, including the ovaries and fallopian tubes as well as the bladder, colon and other parts of the gastrointestinal tract. In recent years, researchers have looked at the efficacy of using hyperthermic intraperitoneal chemotherapy (HIPEC), which is heated chemotherapy delivered directly to the peritoneum, to destroy remaining cancer cells immediately after debulking surgery.

Scientists in Belgium and the Netherlands published long-term data from OVHIPEC-1, a randomized phase III trial to evaluate adding HIPEC to interval cytoreductive surgery for ovarian cancer, in the October 2023 Lancet Oncology. (In interval surgery, chemotherapy is given to shrink the cancer prior to surgery.) The study enrolled 245 women with stage III epithelial ovarian cancer whose cancer showed no signs of progression after upfront chemotherapy. Researchers randomly assigned women to have debulking surgery alone, or surgery plus HIPEC using the chemotherapy drug cisplatin. After 10 years, median overall survival for the surgery-plus-HIPEC group was 44.9 months versus 33.3 months for the surgery group. Median progression-free survival was 14.3 months and 10.7 months, respectively. The rates of adverse events were similar—25% with surgery alone versus 27% with surgery plus HIPEC—and the most common events were abdominal pain, infection and slowed bowel function.

These results are in line with the researchers’ five-year analysis, published in the New England Journal of Medicine in 2018. In that analysis, 6.6% of patients in the surgery group had survived without progression at five years, compared with 12.3% in the surgery-plus-HIPEC group. At 10 years, 6.6% of the people who received surgery were alive with no progression versus 10.1% in the surgery-plus-HIPEC group. While surgery plus HIPEC did not result in better cure rates, the authors note that it significantly prolonged the time cancer was controlled. “The most important finding is that the benefit for patients with stage III ovarian carcinoma when interval cytoreductive surgery is combined with HIPEC remains present after a 10-year follow up,” says Willemien van Driel, lead author and a gynecologic oncologist at the Netherlands Cancer Institute in Amsterdam, who notes that patients in both arms of the study received similar treatment after subsequent recurrences.

Van Driel says that there is still variation in the use of HIPEC along with cytoreductive surgery. European guidelines published in October 2023 note that HIPEC with cytoreductive surgery should not be considered a standard of care. In the U.S., National Comprehensive Cancer Network guidelines state that HIPEC can be considered for patients with stage III epithelial ovarian cancer.

Van Driel and her colleagues are now enrolling patients in the OVHIPEC-2 trial, which will study the effect of adding HIPEC in women with stage III ovarian cancer undergoing primary surgery, which is surgery done upfront prior to chemotherapy. Other trials are evaluating HIPEC use for recurrent ovarian cancer. She notes there are several unanswered questions, including optimal dosing and temperature for HIPEC and the impact of including other drugs, such as PARP inhibitors, with this approach, since many of these drugs were not standard of care at the time of the trial.

HIPEC may be a valid choice for patients who are generally healthy and open to a longer procedure and hospital stay. Although the length of surgery plus HIPEC varies, HIPEC generally adds 90 minutes or more to debulking surgery, which itself takes several hours. Also, patients typically require a longer hospital stay for recovery, possibly with intravenous or tube feedings while the digestive system recovers. 

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A Different Chemotherapy Approach for Ovarian Cancer

New evidence that brain and body health influence mental wellbeing

The study, published in Nature Mental Health, analysed UK Biobank data from more than 18,000 individuals. Of these, 7,749 people had no major clinically-diagnosed medical or mental health conditions, while 10,334 had reported a diagnosis of either schizophrenia, bipolar disorder, depression or anxiety.

Using advanced statistical models, the researchers found a significant association between poorer organ health and higher depressive symptoms, and that the brain plays an important role in linking body health and depression.

The organ systems studied included the lungs, muscles and bones, kidneys, liver, heart, and the metabolic and immune systems.

Dr Ye Ella Tian, lead author of the study from the Department of Psychiatry at the University of Melbourne, said. “Overall, we found multiple significant pathways through which poor organ health may lead to poor brain health, which may in turn lead to poor mental health.

“By integrating clinical data, brain imaging and a wide array of organ-specific biomarkers in a large population-based cohort, for the first time we were able to establish multiple pathways involving the brain as a mediating factor and through which poor physical health of body organ systems may lead to poor mental health.

“We identified modifiable lifestyle factors that can potentially lead to improved mental health through their impact on these specific organ systems and neurobiology.

“Our work provides a holistic characterisation of brain, body, lifestyle and mental health.”

Physical health was also taken into account, as well as lifestyle factors such as sleep quality, diet, exercise, smoking, and alcohol consumption.

Professor James Cole, an author of the study from UCL Computer Science, said: “While it’s well-known in healthcare that all the body’s organs and systems influence each other, it’s rarely reflected in research studies. So, it’s exciting to see these results, as it really emphases the value in combining measures from different parts of the body together.”

Professor Andrew Zalesky, an author of the study from the Departments of Psychiatry and Biomedical Engineering at the University of Melbourne, said. “This is a significant body of work because we have shown the link between physical health and depression and anxiety, and how that is partially influenced by individual changes in brain structure.

“Our results suggest that poor physical health across multiple organ systems, such as liver and heart, the immune system and muscles and bones, may lead to subsequent alterations in brain structure.

“These structural changes of the brain may lead to or exacerbate symptoms of depression and anxiety, as well as neuroticism.”

 

Find more : https://www.ucl.ac.uk/news/2024/aug/new-evidence-brain-and-body-health-influence-mental-wellbeing?utm_source=linkedin&utm_medium=social&utm_campaign=vpee_linkedin_newsletter&utm_content=bodyhealth_aug24

Stem Cell Therapy: A New Horizon in Breast Cancer Treatment

Breast cancer is one of the most common cancers affecting women worldwide, with millions of new cases diagnosed each year. Despite advances in treatment, it remains a leading cause of cancer-related deaths among women. Traditional treatments such as surgery, chemotherapy, and radiation have improved survival rates, but they often come with significant side effects and may not be effective in all cases, particularly in advanced or metastatic stages of the disease. As the medical community continues to seek more effective and less invasive treatments, stem cell therapy is emerging as a promising frontier in the fight against breast cancer.

Understanding Breast Cancer: A Global Challenge

Breast cancer occurs when cells in the breast tissue grow uncontrollably, forming a tumor that can invade surrounding tissues and spread to other parts of the body. The causes of breast cancer are multifactorial, involving genetic, environmental, and lifestyle factors. Early detection through screening programs like mammography has significantly improved outcomes, but the need for more effective treatments remains critical, especially for patients with aggressive or resistant forms of the disease.

Traditional treatments, while often life-saving, can have significant drawbacks. Surgery can be disfiguring and may not completely eliminate the risk of recurrence. Chemotherapy and radiation, although effective at killing cancer cells, also damage healthy cells, leading to side effects like fatigue, hair loss, and compromised immune function. Moreover, some breast cancers do not respond well to these treatments, particularly triple-negative breast cancer, which lacks the hormone receptors targeted by many therapies.

This is where stem cell therapy comes into play—a novel approach that has the potential to revolutionize breast cancer treatment.

Stem Cell Therapy: A New Horizon in Breast Cancer Treatment

Stem cell therapy has garnered significant attention in recent years as a potential game-changer in cancer treatment. Unlike traditional therapies that target the symptoms or manifestations of the disease, stem cell therapy aims to address the underlying causes by regenerating damaged tissues, boosting the immune system, and even targeting cancer stem cells that are believed to drive tumor growth and recurrence.

1. Understanding Stem Cells:

  • Stem cells are unique in their ability to develop into different types of cells in the body. They have the potential to repair or replace damaged tissues and can be used to regenerate healthy tissue in areas affected by cancer.
  • There are two primary types of stem cells relevant to cancer therapy: embryonic stem cells, which can differentiate into any cell type, and adult stem cells, which are more limited but still hold significant therapeutic potential. In breast cancer, researchers are particularly interested in the role of cancer stem cells— a small subset of cells within tumors that are resistant to conventional treatments and are thought to be responsible for relapse and metastasis.

2. The Role of Stem Cells in Breast Cancer:

  • One of the most promising aspects of stem cell therapy in breast cancer is its potential to target cancer stem cells. These cells are thought to be the root cause of tumor growth and metastasis, and they often evade traditional therapies, leading to recurrence. By specifically targeting and eliminating these cells, stem cell therapy could significantly reduce the risk of relapse and improve long-term outcomes.
  • Additionally, stem cell therapy can be used to regenerate healthy tissue damaged by surgery, chemotherapy, or radiation. For example, adipose-derived stem cells (from fat tissue) are being explored for their ability to repair tissue damage after a mastectomy or lumpectomy, improving cosmetic outcomes and reducing the need for additional surgeries.

3. Current Research and Clinical Trials:

  • While stem cell therapy for breast cancer is still in its early stages, there have been promising developments in both preclinical and clinical research. Clinical trials are currently underway to evaluate the safety and efficacy of various stem cell-based therapies for breast cancer.
  • One area of focus is the use of mesenchymal stem cells (MSCs), which have shown potential in targeting breast cancer cells and enhancing the effects of chemotherapy. These stem cells can be engineered to deliver anti-cancer drugs directly to tumors, increasing the precision and effectiveness of treatment while minimizing side effects.
  • Another exciting avenue is the use of stem cells in combination with immunotherapy. By enhancing the body’s immune response to cancer, stem cells could help to overcome the immune evasion tactics used by tumors, making immunotherapy more effective.

4. Challenges and Future Directions:

  • Despite the promise of stem cell therapy, there are still significant challenges to overcome. Ensuring the safety of these therapies is paramount, as there is a risk that stem cells could promote tumor growth if not properly controlled. Moreover, the complex nature of cancer stem cells means that therapies must be precisely targeted to avoid unintended consequences.
  • The future of stem cell therapy in breast cancer will likely involve a combination of approaches, integrating stem cells with existing treatments such as chemotherapy, radiation, and immunotherapy. As our understanding of cancer biology continues to grow, so too will the potential of stem cell therapy to provide more effective and less toxic treatment options for breast cancer patients.

    Conclusion: A Promising Future Ahead

    The fight against breast cancer is far from over, but the advent of stem cell therapy offers a new ray of hope. As research continues to advance, this innovative approach could become a cornerstone of breast cancer treatment, offering patients more effective, personalized, and less invasive options. While challenges remain, the potential of stem cell therapy to transform breast cancer care is undeniable, and the ongoing research in this field is something that the medical community and patients alike should watch closely.

    As we move forward, it is essential to continue supporting research and clinical trials that explore the full potential of stem cell therapy in breast cancer. With continued innovation and collaboration, we may one day see a world where breast cancer is not only treatable but curable—thanks in part to the incredible power of stem cells.

    Find more : https://www.linkedin.com/company/medipocketusa/posts/?feedView=all

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.

Find more:

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

Commercial determinants of health: how they are driving up rates of cancer and other NCDs

A new report from the WHO Regional Office for Europe looks at the impacts of the commercial determinants of health

Tobacco, alcohol, highly processed foods and fossil fuel industries cause 19 million deaths per year globally. These shocking statistics, reported in Commercial Determinants of noncommunicable diseases in the WHO European Region, show how commercial activities are harming our health and increasing the global burden of non-communicable diseases (NCDs), including cancer (WCRF International contributed to two case studies to this report, one on civil society engagement and one on alcohol warning labels).

The commercial determinants of health (CDOH) assess how commercial industries and their products can influence and impact the overall health and health equity of people, and whole societies.

Impacts of CDOH are felt across society, from the individual consumer, their health behaviours and choices, extending to global levels of consumption, and the politics and economics of increasing globalisation.

Health-harming industries

Commercial determinants that negatively impact health involve products from unhealthy commodity industries, which produce and sell health-harming products such as:

  • tobacco
  • alcohol
  • highly processed foods
  • and fossil fuels

The recent WHO/Europe report shows how exposure to these health-harming products is driving up already exceptionally high rates of cancer and other NCDs globally.

In the European Region alone, almost two thirds (61.3%) of deaths caused by NCDs can be attributed directly to risk factors linked to unhealthy diets, physical inactivity, alcohol and tobacco consumption.

This equates to an estimated 2.7m deaths annually, or more than 7,400 deaths every day. Many of these deaths could be prevented with reduced exposure to these commercial products.

Corporate channels of influence

You will certainly have experienced commercial forces at play in the world in both visible and invisible ways. Industries influence and impact health, and undermine policymaking through the following corporate channels:

  • marketing and advertising
  • engaging in corporate social responsibility strategies and activities
  • lobbying governments and policymakers; and
  • deflecting attention away from their role and responsibilities in causing health harms

Marketing and advertising enhance the acceptability and desirability of health-harming products. Often selling a certain lifestyle, aesthetic or experience, it normalises these products as part of everyday life, as well as more aspirational ways of living.

Marketing and promotions have been found to disproportionately target low socioeconomic status or minority populations, with industry tactics ranging from timing marketing campaigns to coincide with the distribution of benefits from food assistance programmes, to aiming advertisements directly at children.

Corporate social responsibility activities serve to improve corporate brands and reputations. Coca-Cola or PepsiCo’s frequent sponsorship of sports teams, events, and funding children’s physical activity programmes seeks to shift focus away from how their own products contribute to the obesity epidemic, and instead reflect favourably on their support for physical activity promotion.

DrinkAware, an alcohol-industry funded health information organisation, promotes “responsible drinking” campaigns (despite alcohol being classified as a Group 1 carcinogen that is causally linked to 7 types of cancer), and engages in partnerships with government and public health agencies.

Lobbying governments and policymakers works to avoid or circumvent regulation. Examples include the food and beverage industry’s opposition to sugar-sweetened beverage taxes, or the alcohol industry’s use of legal threats to stop the implementation of health warning labels.

Public health experts are also targeted through less obvious channels, such as Coca-Cola’s emails to the US Centre for Disease Control (obtained through Freedom of Information Act requests) to advance corporate objectives over health, including trying to influence the WHO.

Other tactics include funding research and political parties to sway the evidence base and policymakers in their favour—influencing all levels of policy, from scientific evidence through to policy development and implementation.

Where does the buck stop?

Perhaps the most significant and insidious tactic used by health-harming industries is their deflection of responsibility. Industry uses the rhetoric of ‘personal responsibility’, ‘individual’ or ‘freedom of choice’ around the consumption of their products.

These messages shift the blame away from health-harming industries, and onto their customers. This argument is used not only to shape societal views around consuming tobacco, alcohol and unhealthy foods, but also in legal arguments to deny or downplay their responsibility and liability for the costs they impose on society.

Do not be mistaken: these efforts are intentionally well-crafted and funded. Health-harming industries seek to protect their own interests and offload their responsibility at the expense of public health. These narratives serve to manufacture doubt and increase uncertainty in the public, while simultaneously undermining trust in government agencies and scientific evidence to normalise the prevalence and use of their products.

Is addressing commercial determinants of health anti-business?

It’s also important to recognise what addressing CDOH is not. Addressing CDOH is not anti-business; but rather, it challenges the existing status quo and power imbalances. It also does not assume a solely negative impact: it accounts for industry actors to drive health and equity in either direction.

Profitable business and health promotion do not need to be mutually exclusive. For example, a coalition of Nestlé shareholders (co-ordinated by Share Action) has filed a resolution to challenge the company to increase their proportion of sales from healthier products.

Work to address CDOH is also not an attack on the free market, or personal liberties. It is about a consumer’s right to know about the risks involved with consuming a harmful product.

Say for instance you had a higher risk of developing breast cancer. Would knowing that drinking alcohol increases your risk of developing it, or 6 other types of cancer, impact whether you decide to consume alcohol? When buying products, would you want to be thoroughly informed about the risks you take?

Interestingly, critics of responses aimed to address CDOH often (knowingly or unknowingly) follow the same script taken straight from health-harming industries’ playbook.

This upholds the narrative that responsibility solely rests with the individual and does not hold corporations accountable for the health impacts of their products, or their influence through the four corporate channels.

Getting rid of the industry playbook; reframing the issues

But this criticism is misplaced: rather than effecting a ‘nanny-state’ or ‘prohibition’, addressing CDOH is an act to abolish and break free from the false-narratives and manipulation that industries employ for their own profit and gains.

Given the scale and size of transnational corporations, some with incomes higher than GDPs of whole countries, putting a focus on the CDOH and their impacts will have a global effect.

This is a movement to shift the focus and alignment of political will in a direction that better serves public health and health outcomes, including the reduction of health inequities, and incidence of cancer and other NCDs.

For more information on CDOH
> WHO Europe Report Commercial Determinants of noncommunicable diseases in the WHO European Region – the report also contains a number of case studies, which WCRF International has contributed to.

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.

Daphne Luchtenberg: Eric, what does good customer service look like in today’s contact centers? What should companies strive for?

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