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Working to improve cancer patient care through multi-disciplinarity

Article-Working to improve cancer patient care through multi-disciplinarity

According to the World Health Organization, cancer causes 20 percent of deaths in the European region.

With more than 3 million new cases and 1.7 million deaths each year, cancer is the most important cause of death and morbidity in Europe after cardiovascular diseases. How can we ensure that patients have access to the best possible treatment and care? How can care for cancer patients be improved across Europe? These are the many questions and key focuses for the European CanCer Organisation (ECCO), established in 1981 to unite all healthcare professionals in oncology with the aim to improve health outcomes for all patients.

As a federation of European Associations, ECCO needs to bridge together different professional traditions and cultures like those of surgeons, radiologists, medical oncologists, pathologists, pharmacists, researchers, nurses, psychologists etc. It connects the European cancer community by leveraging knowledge, promoting education and building awareness. ECCO also plays an important role in engaging with policymakers at European and national levels to promote the interests of cancer patients, research, as well all other members of the oncocommunity.

ECCO was founded with a vision is to improve outcomes for all cancer patients in Europe through multidisciplinarity. There is not one golden standard; recommendations can lead the way to improve each healthcare system which vary largely across the WHO-Europe region by providing a toolbox for change.

Quality Cancer Care

Our research greatly reflects the debate on quality cancer care: what are the elements required to deliver high quality cancer care for all patients in Europe? For selected tumour types, ECCO has produced ‘Essential Requirements for Quality Cancer Care’ (ERQCCs). These are checklists and explanations of organisation and actions that are necessary to give high-quality care to patients who have a specific tumour type.

These provide oncology teams, patients, policymakers and managers an overview of the elements needed in any healthcare system to provide high-quality care throughout the patient journey.
How do we contribute to cancer research? Apart from the organisation of several congresses for our members, ECCO is a founding member of the Alliance of Biomedical Research in Europe, which represents a unique initiative of leading European medical societies that together include more than 400,000 researchers and health professionals. It is also a longstanding partner of the Joint Research Centre, which provides the European Union with scientific knowledge when formulating policies and legislation. In this role, ECCO made important contributions to the development of European Guidelines for Breast Cancer Screening and Diagnosis - the European Breast Guidelines.

Lastly, ECCO also sets its own focus on cancer research, by providing feedback to the European Commission to its consultation on the Advisory group report for the Horizon 2020 Societal Challenge on health, demographic change and well-being. Horizon 2020 is the biggest EU Research and Innovation programme ever with nearly €80 billion of funding available over seven years (2014 to 2020) – in addition to the private investment that this money will attract. It promises more breakthroughs, discoveries and world-firsts by taking great ideas from the lab to the market.

In addition to this, we have set new priorities for policy and advocacy, uniting our members in fresh positions in respect to, not only quality cancer care, but also access to innovation, integration of care, as well as emerging oncology workforce issues. Where there is a grand debate concerning the future of cancer care, ECCO intends to help its members be present, articulate, and advocate for the interest of best quality patient care and outcomes.

Cancer research and beyond

ECCO tries to bridge the world of fellow researchers, healthcare providers in oncology and the broader public on burning topics in oncology. Our latest paper sets out that access to innovation is about more than pharmaceuticals alone. It challenges our own professions to identify potential areas of inefficient or outdated practice and treatment. It also brings the use of real world data to the heart of the access debate. These and more act as an example of how ECCO would like to bring about awareness and change into cancer research and beyond.

The ECCO 2018 European Cancer Summit takes place in Vienna, Austria on 7-9th September 2018. It aims at taking the congress to a higher level, namely to a summit where worldwide leaders from the cancer healthcare, patient advocacy and stakeholder communities come together in a unique multidisciplinary forum. The idea is to complete the summit with the agreement of consensus statements by leaders in cancer policy, which will shape oncopolicy in healthcare systems across Europe.

To connect science with real life, outcome research forms a decisive part, i.e., using real-world data to observe how new treatments and diagnostic modalities have performed in cancer care delivery. Health economics of cancer care is another decisive topic, which is highly connected with outcome research and cannot be surpassed in any oncology debate today. Lastly, ECCO aims to focus on the patient voice to determine an agreed vision for guiding and supporting patients through diagnosis, treatment and follow-up in a world facing an ageing population, increasing survivorship and a technological revolution in e-health resources.

ECCO’s vision is to inspire a movement in the oncology community, which will change policies and clinical practice across Europe. Access to innovation is a goal which is high on the agenda in Europe.
 Innovation in cancer care is certainly more than the scientific progress in immuno-oncology and personalised medicine. In oncology, cancer care has seen remarkable developments in such areas as:

  • The speed and accuracy of diagnostic procedures;
  • The effectiveness of surgery, radiation therapy; 
  • The power of information technology; and,
  • The development of multidisciplinary, specialist-led approaches to care.

From a European perspective, the European Commission sees cancer research and cancer control still as an important topic, though health policy overall does not seem to be high on the priority list of the current Commission.  However, we are delighted that a new EU ‘Joint Action’, following CanCon and aiming to implement the CanCon European Guide on Quality Improvement in Comprehensive Cancer Control, will start in 2018.

Educational Awareness
The EU’s research programme, Horizon 2020, has also set aside substantive resources for cancer research. This reflects the demographic changes and the increase of cancer incidences, but also the growing success in treating cancer, which provides strong motivation among politicians to invest in cancer research. However, the more research advances, the more it becomes apparent how many gaps there are still to close before science is anywhere near mastering cancer. Though there is the firm belief among researchers that cancer will be curable, there needs to be more research into the varieties of cancer we discover. The perception and understanding of cancer has become much more differentiated and will have to become even more so to help advance with therapies delivering best health outcomes.

ECCO has longstanding relationships with the American Society of Clinical Oncology (ASCO) and with the Japan Society of Clinical Oncology (JSCO) including via joint sessions at each other’s congresses.

Established in 1999, ECCO has been co-organising the Methods in Clinical Cancer Research (MCCR) Workshop, which is an educational programme that introduces junior clinical oncologists in any oncology subspecialty to the principles of good clinical trial design. The workshop is the product of co-operation between ECCO, the American Association for Cancer Research (AACR), European Organisation for Research and Treatment of Cancer (EORTC) and the European Society for Medical Oncology (ESMO). The junior clinical oncologists not only come from all specialities, but also from all over the world, which makes the workshop an international and inspiring event.

Beyond this, ECCO also strives to cooperate more on a policy level. For example, the question of protocols for clinical trials, clinical trial data and ethical questions are of international relevance and therefore, a joint approach is highly desirable.

ECCO is also involved as a contributing member of the Union for International Cancer Control (UICC) and aims at being an active partner internationally wherever there is common ground for the development of policy, for example via the World Cancer Declaration.

Given the dimensions addressed above, the growing importance of cancer research, the global co-operation needs, ECCO’s role of fostering multidisciplinary throughout the European region, but not stopping at this, is the right way forward.

Integration of health data

One important task is to deal correctly with health data. There is the need to compile data, evaluate it and use it in the best of patients’ interest. The means of our age, electronic tools and systems seem to offer endless opportunities if the society manages to harness digital health in an ethical and legally correct manner. All health stakeholders, healthcare professionals, patients and others have a duty to help maintain the political will among governments and health systems to adopt the approaches that can truly unleash the power of data for better healthcare.

Another challenge that remains today is the integration of health data generated in one component of healthcare delivery into the wider healthcare IT system, so that in terms of providing good patient care, a more seamless record can be shared across all three fields of primary, secondary and social care. For cancer research, the need to collect data as well to share results from clinical trials, independent as to whether they are positive, negative or inclusive, is decisive. Despite the establishment of Cancer Registries and European Reference Networks, it is still challenging within Europe. However, there are still many steps ahead before the challenge of data is managed appropriately in cancer research.

TAGS: Oncology
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