Is there a female perspective on oncology? Yes, and this perspective would make it possible to save more lives and remedy some inequalities. This is the opinion of the experts of the “Women, power, and cancer” commission commissioned by The Lancet, one of the most prestigious medical journals in the world.
To build a new way of understanding and acting on cancer treatment, however, the Lancet underlines, there are still many actions to be undertaken; because today research, clinics and health policy, and in particular oncology, are all firmly in the hands of men. If things changed, say the experts in a long dossier that appeared in the magazine, it would be possible to improve screening programs, the effectiveness of drugs, the organization of care and, above all, save 800 thousand women who every year all over the world they die due to prevention and management that is not designed by them and for them.
Tumors, the differences between women and men by Elisa Manacorda 26 September 2022
We are not only talking about a medicine that recognizes the biological differences between men and women, but also about a social system that values the work of caregivers – almost always women – and that encourages female careers in research and clinics. Of a policy where equal opportunities pass through the fair representation of women in the positions that matter, in the public and private sectors. Only in this way, according to the Commission, will it be possible to build a more equitable medicine. And alongside this, there is the problem of the governance of the industry, which researches and offers therapies against cancer.
When we talk about cancer and women we immediately think of breast or ovarian cancer but, unfortunately, these are not the only pathologies on which it is important to have an eye that respects the differences. Globally, in women, the top five cancers by incidence are breast, colorectal, lung, cervix and thyroid, which together account for more than half of all new cases. Italy is no exception: the classification is the same, except for the cervix, which in our country is replaced by the endometrium.
Cancer, 71% of transgender people do not access screening by Elisa Manacorda 23 September 2022
Include women in trials
“Our company developed the first drug capable of counteracting tumor growth, tamoxifen, used in breast cancer therapy, but a long way has come since then: today we work on different precision mechanisms of action to being able to target many types of tumors from several different points. We range from gynecological tumors to blood tumors, from those of the urinary system to those of the digestive tract”, he explains Alessandra Dorigo – Head of Oncology Italy of Astra Zeneca, a company that has put the development of oncology in the hands of three women in Italy: “We work to have a concrete impact on society, an impact that is measured not only in drugs but also in research, with 90 active clinical studies in oncology alone and collaboration with the main Italian research centers”.
The challenge remains to accelerate clinical research, but in an inclusive manner, that is, one that takes women into consideration and represents them, as necessary, in clinical studies. “Enrollment must reproduce the reality of the outside world in miniature and we know that there are pathologies where the incidence in women is growing, as in the case of lung cancer. This is why our commitment is to enroll a good number of female patients,” she says Paola Morosini, Medical Affairs Head Oncology at Astra Zeneca.
Immunotherapy in melanoma: men and women respond differently? by Tina Simoniello 07 January 2022
Promote the careers of female researchers
And the right representation of women must also be promoted among researchers: women are often penalized because they are unable to give the right relevance to their work within organisations. “We designed the Researchalize portal precisely to give researchers additional tools for connection between them and advocacy towards their superiors, to give the right emphasis to their results”, he explains Francesca Patarnello – Vice President Market Access & Government Affairs of Astra Zeneca. But the fight against discrimination, in addition to research, also involves prevention. “As women we have a different sensitivity, we are more attentive to health but we often exercise this attention for our loved ones. Our commitment is to raise awareness among women to take time to prevent and treat not only others, but also themselves “, underlines Dorigo. Hence the promotion of information campaigns in favor of screening programs, for example that of lung cancer.
Bring medications to patients
Finally, there is the delicate and fundamental area of access, without which no innovation can truly reach patients. “The time that passes between the authorization of a drug and its actual availability for patients is often underlined. The problem is not the 12-14 months that pass, but what is done during this time: we must work to ensure that it is a of dialogue between central and regional institutions, companies, doctors and patients so as to prepare the ground for the arrival of the drug, and then be able to immediately use it in the correct way once available”, concludes Patarnello. Once again a markedly female perspective.