Saturday

22nd Sep 2018

Opinion

On breast cancer our work is far from over

  • Women who have breast cancer not only have to fight the disease, they also have to fight against depression, anxiety and sleep disorders that often come with it (Photo: Fort Belvoir Community Hospital)

We have made significant progress in breast cancer treatment and prevention throughout Europe.

Survival for women with metastatic disease has vastly improved and more women who begin treatment early are experiencing successful outcomes.

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However, our work is far from over.

Breast cancer is still the most common form of cancer and the most frequent cause of cancer death for women in Europe. It stops people in the prime of their lives, often when they are raising children, supporting their families and working towards their goals and dreams.

Breast cancer in advanced stages still has low survival rates across Europe, and there is not enough therapeutic support for those who are living with the disease.

Women who have breast cancer not only have to fight the disease, they also have to fight against depression, anxiety and sleep disorders that often come with it.

For younger women, the toxicity of therapies can lead to early menopause, which makes becoming a mother even more difficult.

Of course, developing cancer can have a negative effect on a woman's professional career, as it inevitably means long periods of absence from work.

The burden is both emotional and economic; at €6.73bn, breast cancer is still responsible for the highest healthcare costs in Europe.

It is also important to note that outcomes from breast cancer spending are not uniform across and within countries in Europe.

For instance, Ireland spends as much per capita as France, but life expectancy of patients five years after diagnosis is still lower in Ireland than in France.

Early testing save euros - not just lives

However, there are numerous insights we can learn from the differences in cancer care across Europe, namely that costs could be significantly reduced if we treat the disease in its earliest stages before it becomes metastatic.

In Belgium, for instance the average cost of treating a patient with stage I cancer is almost half of the cost of treating a patient with stage IV disease (€19,827 versus €35,201).

It is abundantly clear that diagnosing and treating breast cancer in its early stages does not only save lives, it also saves substantial health care costs.

Any euro spent towards prevention has to be seen not as a cost but as an investment, because it saves much more resources from the general health care budget.

So how should we move forward with improving cancer care throughout Europe?

We should focus on four elements.

First, we must continue to increase awareness and promote screening at an earlier age than we currently do, notably at the age of 45 across Europe.

At minimum, there should be more intensive efforts to educate younger women about the risks and the importance of self-breast examination starting in their 20s.

Second, we need to design policies to ensure that women living with breast cancer – especially in the advanced stage – have the support they need to ensure the impact on their everyday lives is as low as possible.

Third, we have to become smarter about how we use our health care resources to deliver the best outcomes in a sustainable manner.

It has been shown that chemotherapy can cost much more in direct medication costs and sick days compared with first line hormone therapy.

Countries should also embrace precision medicine to direct women toward the most effective treatment options.

Finally, we need to fight inconsistencies and disparities across Europe in care delivery.

It is unacceptable that life expectancy of cancer patients in countries like Romania or Poland remains considerably lower than the EU average or that participation in breast cancer screening programmes varies hugely, even within the same country.

As an example, while in northern Italy as many as 63 percent of women over 50 years of age regularly perform a mammography, in the south of the country only 34 percent of women do so.

EU key role

EU institutions play a key role in promoting policies to ensure cancer care and resources prioritisation across Europe.

We made good strides on this last November when we hosted an event in the European Parliament to raise awareness about breast cancer, bringing together members of the European Parliament, European Commission, EU member states representatives, experts and stakeholders from the scientific community, civil society and industry to join forces and find solutions.

As a result of the event, a number of stakeholders are closely coordinating to launch a series of events and initiatives throughout Europe to advocate for improved breast cancer and advanced breast cancer care.

This series of initiatives, of which this article is a part of, is known as "String of Pearls for Breast Cancer".

We must continue to come together and build on the progress we have made – because breast cancer still poses a major threat to the health and economic stability of women, their families and communities in the European Union.

Elena Gentile MEP (S&D) and Lieve Wierinck MEP (ALDE)

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