Not only the slowdown in cancer screening, diagnostic delays and postponed interventions: the Covid-19 pandemic has also worsened adherence to anti-cancer treatments. That was already not optimal, given that before the infection boom, half of the breast cancer patients who had been prescribed endocrine therapy had not maintained adherence at five years. Complicating the situation is the fact that about 19,000 fewer cancer patients were treated compared to 2019.
The webinar “Adherence to therapies in Oncology” is dedicated to the phenomenon of poor adherence to treatments, promoted and organized by the Together Against Cancer Foundation (live today, from 3 to 5 pm on the Fb page of the foundation) and attended by representatives of the institutions, clinicians, general practitioners, nurses and patients. The event is realized thanks to the unconditional support of Astrazeneca, Bayer and Astellas and to the liberal unconditional contribution of GSK.
The Advantage and Risk of Oral Therapies
“Oral therapies are increasingly important and used for the treatment of many oncological diseases”, explains Francesco Cognetti, President of Insieme Contro il Cancro: “They represent about a quarter of the molecules in the development phase and this modality of assumption presents great advantages, especially in this complex historical moment. They can in fact reduce hospital admissions and costs and have a positive impact on the quality of life of patients and caregivers. At the same time, the autonomous intake of drugs involves some critical issues, first of all poor or incorrect adherence ”. The trend observed is that of not taking therapies regularly due to underestimation of the risks or fear of side effects. It is the same phenomenon found in half of chronic patients suffering from diseases such as diabetes, hypertension or hypercholesterolemia. In the management of cancer this can have very serious effects. For example in breast cancer, if adherence to adjuvant endocrine therapy is less than 80%, the risk of recurrence increases and survival is reduced.
Knowing how to manage side effects to increase adherence
“The oral oncological therapies available today are easy to take and on average are well tolerated, although sometimes they can be associated with important side effects – continues Massimo Di Maio, National Secretary of the Italian Association of Medical Oncology AIOM:” Adherence to therapy is not it is optimal especially when side effects occur. The priority aspect on which we must intervene is a correct and precise communication with the patient, and a more careful and timely management of the toxicities related to the treatments. It is essential to inform and prepare the patient on the behaviors he must adopt “. To promote adherence to therapies, greater collaboration is then necessary between the various professional figures involved: oncologists, pharmacists and nurses. “For example – continues Di Maio – in the hospital where I work, the Mauriziano in Turin, an outpatient clinic has been active for a couple of years with the simultaneous physical presence of oncologists, pharmacists and nurses”.
When the patient is elderly
It should be noted that many of these patients are elderly. “Every year in Italy over 188 thousand over 70 are affected by a form of cancer – concludes Roberto Messina, Senior President of Italy FederAnziani:“ The cancer patient is often elderly and with multiple concomitant pathologies, and must take several drugs at the same time. There is therefore a great risk of making mistakes in taking the various therapies or of having less adherence. There are also problems of possible drug interactions. Closer collaboration between the various health professionals – Messina concludes – must become a custom in the interest of both the sick and the entire national health system ”.