Telehealth Palliative Care Provides the Same Benefits as In-person Care

A recent study found that video-based telehealth palliative care produced results similar to in-person palliative care for patients with advanced non-small cell lung cancer and their caregivers. The study, presented at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting in June, found that quality-of-life scores were virtually the same for telehealth and in-person palliative care.

Barriers Impacting Access to Palliative Care

According to Lindsey Ulin, a palliative care fellow at Massachusetts General Hospital and Dana-Farber Cancer Institute in Boston, who was not involved in the study, palliative care is focused on providing supportive care to people living with cancer and other serious illnesses. Palliative care physicians help manage symptoms and side effects like pain, fatigue and nausea.

According to a 2019 analysis in Quality of Life Research, patients with advanced non-small cell lung cancer and family members or friends who care for them often face physical, emotional and financial challenges that may impact their mental health and overall quality of life. And a 2024 article in American Society of Clinical Oncology Educational Book argued that early integration of palliative care alongside cancer treatment can improve patients’ quality of life.

However, both Greer and Ulin say many barriers limit access to this care for advanced-stage patients and their caregivers. Common roadblocks include hospitals and clinics not offering palliative care, the misconception that palliative care is only for people at the end of life, transportation issues and the cost of care.

“The hope is that telehealth palliative care reduces these burdens for the patient and the caregiver,” Greer says.

Telehealth Palliative Care Study Shows Promising Results

Greer’s study involved 1,250 patients with advanced non-small cell lung cancer and their caregivers. His research team randomly assigned participants to telehealth or in-person early palliative care across 22 cancer centers in the United States.

Participants attended palliative care appointments every four weeks throughout their cancer treatment. At the week 24 assessments, quality-of-life scores were similar for telehealth (99.67) and in-person palliative care (97.67) based on the Functional Assessment of Cancer Therapy-Lung (FACT-L).

Researchers found there wasn’t a significant difference in patient-reported symptoms, such as anxiety and depression, between the groups. “These are fairly standard measures when looking at the effects of palliative care,” Greer says. “We look at these because we’ve found that palliative care clinicians can help patients improve their quality of life, as well as their symptoms of anxiety.”

One difference that study data revealed was less caregiver involvement (36.6%) in virtual palliative care than in-person care (49.7%). “We had hypothesized that, given how convenient telehealth is, it would be easier for caregivers to participate,” Greer says. “We realized that telehealth gives patients more autonomy to decide when to have a caregiver present. But with in-person care, the patient often needs a loved one to help them get to the clinic.”

“In palliative care, we think about the person living with cancer and their caregiver together as a unit,” Ulin says. “Palliative care is an extra layer of support, helping caregivers cope, communicate with other providers, understand a cancer diagnosis and treatment options, and provide resources.”

See more
https://www.cancertodaymag.org/cancer-talk/telehealth-palliative-care-provides-the-same-benefits-as-in-person-care/

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

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!!!

Δελτίο Τύπου EN Δελτίο Τύπου EN

Conceptualizing the Mechanisms of Social Determinants of Health: A Heuristic Framework to Inform Future Directions for Mitigation

A large body of scientific work examines the mechanisms through which social determinants of health (SDOH) shape health inequities. However, the nuances described in the literature are infrequently reflected in the applied frameworks that inform health policy and programming.

We synthesize extant SDOH research into a heuristic framework that provides policymakers, practitioners, and researchers with a customizable template for conceptualizing and operationalizing key mechanisms that represent intervention opportunities for mitigating the impact of harmful SDOH.

In light of scarce existing SDOH mitigation strategies, the framework addresses an important research-to-practice translation gap and missed opportunity for advancing health equity.

Conceptualizing the Mechanisms of Social Determinants of Health!

I. SDOH
Health inequities are most often understood as associated with the social determinants of health (SDOH)

II. Opportunity
A practical, heuristic framework for policymakers, practitioners, and researchers is needed to serves as a roadmap for conceptualizing and targeting the key mechanisms of SDOH influence

  • Unifying principles

1. SDOH are underlying causes of health inequities
-> Meaningful community engagement in data generation and interpretation for understanding and mitigating underlying health inequity drivers and multilevel resilience factors

2. SDOH shape health inequities through contextual influences
-> Development, evaluation, and scale up of multilevel interventions that address the mechanisms of SDOH at the structural, psychosocial, and clinical/biomedical levels

3. SDOH contextual disadvantage is not deterministic
-> Adoption of individualized/differentiated, decentralized, and community-based service delivery models

4. SDOH shape health over the life course
-> Proactive intervention focused on prevention and health promotion as well as restorative care to maintain and improve physical, mental, and psychosocial functioning and quality of life

5. SDOH operate through biological embedding
-> Greater prioritization of harmful SDOH mechanisms and mitigation of their biological impact in clinical education and practice, including investment in biomarkers for early detection of and intervention on emerging disease trajectories

6.SDOH operate intergenerationally
-> Prioritization of family-based approaches to restorative health care, prevention, and health promotion

7. SDOH shape clustering and synergies of health inequities
-> Greater integration of comprehensive, interdisciplinary, team-based health services delivered within a value-based framework and at the top of providers’ licenses

8. SDOH mechanisms to produce health inequities
-> Departure from vulnerability- and deficiency-focused paradigms for understanding health inequities toward multilevel resilience-focused paradigms for reducing health inequitiess

An Organizing Framework of SDOH Mechanisms

1. Underlying causal factors
-> Two distinct classes of social influence: SDOH capital and SDOH processes

2. Mediating factors
-> Two mechanisms: environmental and behavioral exposure and biological susceptibility

3. Moderating factors
-> Resilience – as collective action that supports the ability of communities to thrive when confronted with structural challenge

4. Health inequity outcomes
-> The impact of SDOH mechanisms on health inequities is dependent on the broader patterns of morbidity within the community of interest

Check out the article by Marco Thimm-KaiserAdam Benzekri and Vincent Guilamo-Ramos here:

https://lnkd.in/e57GXthQ

New modern facilities of the non-profit organization KAPA3

With immense joy and pride, we announce that the non-profit organization Kapa3, with a mission to offer to people suffering from Cancer, will continue the creative and productive work from the new, modern offices at 13 Kostis Palamas Street, Athens.

Το ΚΑΠΑ3, is an organization that aims to support and inform people suffering from cancer, and their families, regarding their accessibility to the beneficial provisions of the current legislation, as well as the utilization of existing structures and services that operate for this purpose throughout the Greek territory. The organization and the members of the organization believe that people with cancer and their families should have access to accurate information at the time they need it. The organization’s website and the free kapa3 app (available on smartphone, tablet, Android, and iOS), operate as a guide to specific Rights and Benefits.

Improving the quality of life for Cancer patients is a top priority for the Kapa3 organization. A team of professionals supports patients in all procedural matters outside and inside the hospitals. The measurement of social impact had excellent results with 91% of patients stating that the presence of the service was instrumental in making their daily life easier.

The Movable Groups operate from the Theagenio Cancer Hospital of Thessaloniki and the University General Hospital of Alexandroupolis, covering the region of Macedonia – Thrace and beyond, while their aim is to improve the quality of life of oncology patients and to provide new prospects for social integration, social protection, and employment. Soon we will be able to announce new “Information and Management” groups.

The Movable Units started their work with the foundational donation of TIMA Public Benefit Foundation https://www.timafoundation.org/el/ which supports Greek non-profit organizations that contribute to social improvement with a focus on the Elderly.

Kapa3, in three years of operation, has employed more than 15 people, while it has been the first preference in the choice of graduates of social support professionals, in the context of their internship, resulting in the strengthening of the action groups and its network, with more than 25 students. In addition, it has proceeded to establish collaborations with Universities in Northern Greece and beyond, as well as with Research Laboratories of Medical Departments of Universities in the country and abroad, in an effort to improve and scientifically approach and document activities and services provided to cancer patients throughout the country..

On the basis of the activation of the organization’s new offices and according to the needs of its beneficiaries and employees, another step is taken to encourage the development and expansion of the organization’s network, through proper cooperation, flexibility, empowerment, trust, and equality. “The beneficiaries and partners of the organization find support at all levels and thus are encouraged to be the best version of themselves in an environment that is built based on the vision and mission of the organization”, said by, Ms. Bista Evangeli, Development and Operations Manager of Kapa3.“In an environment where each of us feels cared of, supported, and connected, with a strong sense of ownership, the organization’s growth is taken for granted,” she added.

In addition, Ms. Bista emphasized that the organization’s new offices are made possible with the valuable support of the company “THENAMARIS” which she thanked for its valuable assistance.

“The contribution to our community is at the forefront for the company, leaving a strong, continuous, and positive social footprint that meets the specific features and needs of Greek society. Moreover, the ability to respond to challenges, to anticipate and adapt to the “seas and storms” is a warranty of viability for us and an important partner in the work and contribution of Kapa3“, Ms. Bista concluded.

Essential cancer screening and diagnosis services must be included in UHC schemes to reduce mortality

The earlier a cancer is detected, the easier it is to treat successfully, often with fewer side effects, and at a lower cost. In many high-income regions, such as Europe and the United States, survival rates for cancer have risen in past decades, in part thanks to routine screening that detects cancers at an early stage. It’s especially true for common cancers like cervical, breast, colorectal, and prostate, where routine screening offers a clear test and methodology for early detection.

Investing in routine screening programmes for asymptomatic cancers as well as the early detection of symptomatic cancers and diagnostic and referral services is, therefore, a cost-efficient approach to mitigate the public health costs of cancer. These are estimated to reach USD 458 billion globally by 2030, and cut the projected global economic cost of cancers, estimated at USD 25.2 trillion for the period 2020-2050.

Such investments in services must be accompanied by clear communication about the necessity and benefits of such measures. It is also critical that the general public have access to reliable information on possible early signs of certain cancers (notably, breast, cervical, lung, prostate, ovarian and testicular) and primary healthcare staff must be equipped to spot signs of cancer – with rapid referral options for screening and then treatment.

Unfortunately, many people around the world still lack access to these essential services. In low- and middle-income countries in particular, cancer prevention, diagnosis and care remain a luxury that is out of reach for many.

A significant number of people, particularly those from low-income communities, face barriers that prevent them from accessing necessary health services, such as the distance to healthcare facilities and costs of healthcare – with the risk of financial toxicity if they must be paid for out of pocket.

A weak health system and an absence of knowledgeable healthcare providers can also stand in the way of timely cancer detection and diagnosis.

To close these gaps, routine screening, cancer diagnosis and referral services must be included in health insurance benefits packages.

UHC cannot be achieved unless everyone has access to affordable cancer care. At the same time, without the benefits offered by UHC, access to potentially life-saving screenings remains limited. This means someone may die of a cancer that could have been detected and treated at an earlier stage, but either an early detection programme was not available or that person could not access it, for financial or other reasons. A cost-efficient national cancer control plan with essential services – including routine screening and diagnosis – covered by national health insurance schemes available to everyone – can break down these barriers to accessibility, availability and affordability.

Indeed, often cancer treatment by national health insurance schemes but not screening. Issues of stigma that surround many cancer tests (for instance, those that concern sexual organs) therefore compound concerns about cost or fears of a diagnosis (e.g. cancer may be considered a death sentence, so why get tested?) to prevent high numbers of people getting a timely diagnosis, resulting in many patients presenting with late-stage cancers.

At the second High-level Meeting on Universal Health Coverage taking place on 21 September 2023, Governments are expected to adopt a set of new commitments to accelerate UHC implementation. This meeting will provide an opportunity for UICC to advocate for including comprehensive cancer prevention and control measures in UHC benefits packages.

In preparation for this pivotal meeting, UICC reached out to its members to learn about their concerns and inform its advocacy strategy in the lead-up to the UN HLM on UHC.

UICC is also organising a series of Virtual Dialogues intended to facilitate discussions around UHC and its impact on cancer control. The first dialogue organised in early May looked at UHC and prevention. A second Virtual Dialogue on UHC and early detection will take place on 20 July, and look at examples of successful advocacy to include screening and early detection in UHC benefit packages (for instance, mammography reimbursement in Algeria) and the use of legislation to support screening and early detection programmes and referral to treatment.

Read more :

https://www.linkedin.com/pulse/essential-cancer-screening-diagnosis-services-must-included-uhc-schemes%3FtrackingId=yU3y0j6Af4hHzyucBwUSyw%253D%253D/?trackingId=yU3y0j6Af4hHzyucBwUSyw%3D%3D

 

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/

WHO/Europe explores collaborations to improve quality of health information online

The WHO Office on Quality of Care and Patient Safety in Athens recently joined forces with YouTube Health to host a workshop in Berlin to enhance the quality of health information online and support Member States’ efforts in this area. This collaborative endeavour lays the groundwork to promote health literacy and make high-quality health information universally accessible.

“We are very much looking forward to working together for a world where people can access the health information they need online without having to guess its accuracy,” noted Dr Natasha Azzopardi-Muscat, Director of WHO/Europe’s Division of Country Health Policies and Systems, at the workshop.

The role of digital platforms in health

The COVID-19 pandemic brought into the spotlight the prominent role of digital platforms in disseminating health-related information and the importance of reliable information, while also exposing the potential perils of misinformation and disinformation. Data indicates that, in the WHO European Region, a large share of consultations now take place online, as people’s initial approach is to search for symptoms and medical advice online. Health-related searches make up 7% of daily online searches, with approximately 4 billion results related to COVID-19.

In 2021, YouTube had over 110 billion views of health condition videos globally and is working on raising high-quality health content to make it easier for people to identify credible information that can help answer their questions. Commenting on the platform’s impact in the online space, Dr Nira Goren, Clinical Lead at YouTube Health, said, “People use platforms like YouTube to seek answers to questions, such as how do I live with breast cancer or how do I take care of myself.” An increasing number of individuals are also turning to online platforms to share personal stories, alleviate acute distress, and build a community to help decrease feelings of isolation.

However, online health information that is inaccurate or misleading can pose a significant risk to one’s health. A recent WHO review showed that infodemics and misinformation negatively affect people’s health behaviours. The distorted understanding of health hazards, such as smoking, alcohol intake, unhealthy eating habits, or physical inactivity, can result in various life-altering and potentially fatal noncommunicable diseases (NCDs), such as cancer or diabetes.

Empowering health through high-quality health information online

High-quality health information can empower individuals to take control of their health, make informed decisions about their treatment options, and improve their overall well-being and quality of life. With more and more people relying on the internet for medical advice, it is essential that the information available is reliable, accurate, easy to understand, and up-to-date. Collaboration with health care stakeholders in Member States across the Region is needed to ensure this. It also requires fostering inclusive partnerships that bring together patients, health care professionals, ministries, nongovernmental organizations, and major social media platforms.

“Social media platforms are crucial tools to improve and disseminate high-quality health information online and we should work on that together, involving everyone in this process. Our primary focus should be to actively listen to community concerns, promote understanding of risk and health expert advice, engage and empower communities to take positive action, and support health professionals and

Moreover, fostering trust in authoritative online health information sources at the population level entails working with academia and other partners to create further scientific evidence on the impact of misinformation on quality of care, acting as a lighthouse in consolidating the creation of scientific evidence.

“Empowering communities with education is essential to helping people live healthier lives. YouTube Health is delighted to interact with WHO and authoritative health sources across Europe to increase access to evidence-based, equitable and engaging health information,” noted Dr Garth Graham, Director and Global Head, Healthcare and Public Health, YouTube.

Πηγή: who.int