WITH 652 votes in favor, 15 against and 27 abstentions, last week the European Parliament approved a report on the EU Cancer Plan calling for effective prevention measures, better access to cross-border healthcare and clinical trials, and more efficient management of the supply of medicines. “An important initiative that invites us not to underestimate the danger represented by cancer in a difficult historical moment”, comments Rossana Berardi, national councilor of the Italian Association of Medical Oncology (Aiom) and Director of the Oncology Clinic of the Marche Polytechnic University – United Hospitals of Ancona. Which underlines the centrality of the oncologist in the patient’s entire journey. “The oncologist – she explains – is the coordinator of assistance to the patient: taking charge of the patient is a strategic moment and can mark the quality of the therapeutic path. In fact, our role is not only that of rapidly implementing knowledge and skills, but also that of knowing how to guide, with clinical judgment, the diagnostic-therapeutic-assistance path ”.
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The role of the medical oncologist
On this issue, the Italian Association of Medical Oncology, together with the Italian College of Primary Medical Oncologists and the College of University Medical Oncologists, has drawn up the document “Role of the oncologist, profile of skills and specialist training”. Another document – “Organizational processes, paths and networks” – had already focused on the role of the medical oncologist as a specialist with a strategic vision who can make use, in a multidisciplinary management perspective, of organ specialists and specialists in the therapeutic area. “Today more than ever the oncologist is the point of reference for patients, at their service in the context of integrated treatment paths and in full collaboration with other specialists”, continues Berardi: “These are precisely the Diagnostic Therapeutic Paths, carried out in company level, the best tools to formalize management rules at the local level. Just think of identifying the best pharmacological therapeutic approach among those available, also with a view to optimizing resources and sustainability “. “We manage the diagnostic phase, the active therapy with the application of innovative treatments that require the management of new toxicities”, also underlines Rosa Rita Silva, director of the Oncology of the Fabriano Hospital and national councilor of CIPOMO (Italian College of Primary Oncologists Hospital Doctors): “We also represent the guarantor of the correct transition of the patient to palliative care”.
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The need to divert economic, organizational and human resources to deal with the pandemic has penalized oncology. In the next few years this will probably lead to an increase in cases and their severity. “When you feel you are coming out of the emergency, the issue arises of placing the world of oncology at the center of health policy efforts”, adds Paolo Alessandroni, Aiom regional coordinator: “We need to start again with the screening, with the implementation of therapeutic diagnostic paths, with new multidisciplinary logics, in which oncologists represent the centrality linked to the history of our discipline and its clinical research culture “.
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During these two years, the task of medical oncology was also to ensure the most appropriate treatments for all patients. “It was not easy, especially due to the inevitable restrictions we had to put in place”, recalls Nicola Battelli, director of the Oncology of the Macerata Hospital: “Unfortunately, guaranteeing treatment does not always mean guaranteeing the patient’s ‘care’. The human aspect that characterizes our work has been missing or at least significantly reduced. Healing means accompanying the patient during his difficult journey even with a smile, a handshake, a look. In oncology, excellence means putting the patient at the center of our work, guaranteeing not only the best treatment, but also the best quality of life in a physical and psychological sense. And in this the oncologist is the reference “.
Now we need integration with local medicine
There is no doubt that the role of the oncologist has changed in recent years and continues to evolve, integrating their skills with those of territorial medicine The new drugs also bring new toxicities and the oncologist’s commitment is to coordinate the management of actions to be undertaken in relation to the patient “, explains Vincenzo Catalano, director of the Oncology of the Urbino Hospital:” To accompany the patient in all phases of the disease, the oncologist must be perfectly integrated with the territory, General Practitioners and home care services. This aspect is of great importance especially for patients managed far from the cities home to hospitals and in mountain areas “.
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The search did not stop
“Now that Covid recedes, we see more and more clearly the rubble it has left, especially among cancer patients”, concludes Renato Bisonni, director of the Oncology of the Fermo Hospital: “In these two years, the most advanced wing of the The scientific oncology community has continued its work and new therapies have been brought into the field. Today we can record a further small step in survival in some of the most widespread forms of cancer “.