Transforming the crisis into an opportunity to work more incisively on prevention which, in the oncology field, has not always been the protagonist given that the primary objective is to save patients’ lives. But now that, thanks to scientific advances, cancer has become a chronic disease that can – in most cases – be cured, it is time to devote more energy and competence to prevention, starting with the training of oncologists. She is convinced of it As long as Peters president of the European Society for Medical Oncology (Esmo). This is also demonstrated by the beginning of a collaboration with the WHO International Agency for Research on Cancer (IARC). At Oncoline, Professor Peters explains why this is the right time to focus on prevention, what the impact Covid is having on cancer patients and what we are learning.
Why is it now more important than ever to dedicate energy and time to prevention policies?
The Covid-19 pandemic is making it difficult not only to give the issue the visibility it deserves, but also to improve good prevention practices at a time when global screening programs have suffered widespread disruptions. The collaboration between Esmo and Iarc goes precisely in this direction and is based on our shared commitment to understand the risk factors of cancer on a scientific basis. We have collected all the easily searchable online resources to complement everything healthcare professionals need to know about prevention. The resources available on the World Cancer Report Updates e-learning platform are designed for the oncology world and to help doctors refine or develop the skills they need to deliver an accurate and impactful message.
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How can oncologists contribute to prevention as they see patients who have already been diagnosed with cancer?
Nothing is more reliable than the information provided by professionals. Our community has traditionally seen prevention as a topic primarily for family doctors and specialists, but it is interesting to point out that journalists usually refer to oncologists when they need an opinion on the issue. As professionals we need to be able to provide competent answers based on a solid understanding of the latest scientific data, healing data and research findings. We now know that behaviors such as quitting smoking, improving one’s diet or starting an exercise routine can improve a patient’s quality of life even after cancer has been diagnosed, and can positively influence the outcome of the disease and prevent relapses.
We are used to considering lifestyles important above all for the prevention of other diseases, but not for cancers. How are things?
In reality, according to IARC’s estimate, up to half of the cases in the world could be prevented by eliminating risk factors related to lifestyle and the environment. Furthermore, among these cancers more than one in eight include malignant tumors related to infectious diseases such as hepatitis, Hpv and HIV which in turn could be controlled thanks to social measures and vaccines. On the other hand, we are increasingly discovering the benefits of physical activity, which not only reduces the overall risk of cancer by contributing to weight control, but also has protective effects against several types of cancer not related to body mass. These are easily implemented preventive measures that need to be considered now, especially given the limited options available to us in the face of metastatic cancer.
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In the case of infectious diseases such as HPV or papilloma virus and hepatitis, another problem is that many people are more afraid of vaccines than of diseases themselves. How do you overcome this obstacle?
A strong political push is needed to explain that vaccines also protect against cancer, which is an opportunity for all adolescents and adults who can still rely on prevention rather than trying to cure what continues to be a high-rate disease. mortality.
Speaking of vaccines, Europe is racing to immunize as many people as possible in the shortest possible time and in many countries, including Italy, we are also asking to give priority to cancer patients. Do you have data that ‘photograph’ the European situation?
We are urging institutions and health care providers as much as possible to ensure urgent vaccination for cancer patients and their caregivers. We still have very limited data regarding vaccination procedures for this specific patient population. For this reason Esmo has launched a call to action which also concerns accurate data collection. This is a fundamental step to better understand the depth and duration of the immune response of cancer patients to Covid-19 vaccination. In addition, I would like to emphasize that all our patients must be vaccinated, including frail people, the elderly, those facing care, as cancer patients are most at risk, with a mortality due to Covid-19 ranging from 15% to over 40%.
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During the pandemic, doctors and patients discovered telemedicine: what role is it playing for cancer patients and what role can it later play also as a tool to bring prevention to young people?
The pandemic has further contributed to encouraging consultations, visits and virtual meetings. During the first wave, when many oncology visits and services were delayed or suspended, it was a valuable tool for communicating with patients, and the feedback was very positive. I believe it is a useful and effective support that will remain even at the end of the pandemic, but it will be essential to optimize the use of this service, which could be integrated into the clinical routine. As for young people, the use of new digital resources and the organization of moments of sharing and participation such as meetings, could become a tool to reach an ever-wider audience and raise awareness on important issues such as prevention and adoption. of a healthier lifestyle.
What can the cancer community do to raise awareness and acceptance of cancer prevention?
First of all, prevention will be integrated in a more systematic way in the events of Esmo and then it will also become a clear priority in the activities of the future foundation “International Cancer Foundation”, which we are establishing and through which we will be able to plan programs aimed at promoting prevention in everything. the world. As oncologists we must focus on the fact that our discipline, oncology, has reached a point where we are making a lot of progress with treatments such as immunotherapy, but we will not be able to provide them to all patients if cases continue. to increase exponentially. The incidence of cancer combined with the epidemiology of a population with a high life expectancy will make our task unsustainable over time, which means that the only way to avoid future inequalities in access to care is to reduce the number of tumors and their severity once identified through screening. The situation is not desperate, but it is urgent to reverse the current trend.
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