It is estimated that 1 in 8 women will be diagnosed with breast cancer in their lifetime. Not so long ago, this diagnosis was often associated with death. But the tide has turned in the Global North, and innovations in healthcare and early detection are expected to continue to reduce mortality rates. The earlier cancer is diagnosed, the better the chances of survival.   

But surviving is not the same as actually living. Several studies have shown that surgical morbidity is a common complication of breast cancer treatment. In fact, up to 70% of patients have been reported to have postoperative breast cancer sequelae, including axillary girdle syndrome, pain, lymphangitis, fatigue, cognitive, physical, social and emotional impairment.

During Breast Cancer Awareness Month, eCAN’s partners and collaborators would like to highlight the need to improve the quality of life of breast cancer patients. Indeed, eCAN is committed to improving their lives by highlighting the vital role of rehabilitation in their recovery process.

 Cancer research has shown that physical activity helps patients regain strength and mobility. According to recent publications, exercise is an effective strategy that positively affects breast cancer survivors’ quality of life, cardiorespiratory fitness, and body composition. Healthcare professionals are encouraged to promote the uptake of exercise.   

Survivors may also experience social and emotional sequelae. In this sense, physical rehabilitation also boosts their confidence and mental well-being. Healthcare professionals and researchers agree that emotional support and counselling are equally important on the journey to recovery. 

The vital role of rehabilitation

The World Health Organisation (WHO) also recognises the impact of rehabilitation and defines it as “the use of all means to reduce the effects of disabling and handicapping conditions and to enable people with disabilities to achieve optimal social integration”.

Despite the recognition of the role of rehabilitation for patients, “the needs of this population of cancer patients are still underestimated and undertreated,” says Vittorio Castaldo, one of the researchers involved in the eCAN pilots. For this reason, this project aims to highlight and incorporate telemedicine tools that can facilitate the assessment of motor and sensory deficits and enable remote training and education of patients.  

The study will use patient-reported outcome measures (PROMs) and experiences (PREMs) to explore how telemonitoring and teleconsultation can improve the physical and psychological rehabilitation processes of these cancer patients. It is expected to enrol 354 patients with breast, head and neck and advanced cancers from 18 cancer centres and ten different EU countries.

References:

Joaquim A, Leão I, Antunes P, Capela A, Viamonte S, Alves AJ, Helguero LA and Macedo A (2022) Impact of physical exercise programs in breast cancer survivors on healthrelated quality of life, physical fitness, and body composition: Evidence from systematic reviews and meta-analyses. Front. Oncol. 12:955505. doi: 10.3389/fonc.2022.955505

This 4th of February, World Cancer Day, the eCAN Joint Action joins the three-year campaign #CloseTheCareGap and advocates for providing access to health prevention and care all over the world. Within its frame of work, as a European research project, eCAN is committed to closing the current care gap among EU countries by strengthening eHealth in cancer.

According to the European Beating Cancer Plan, “a number of indicators show major differences in cancer prevention and care between and within Member States”. As well known, early detection through different means (such as screening) is the best way to increase the chances of beating cancer. However, access to these prevention programmes varies considerably among countries. For example, national cancer programmes’ coverage of the target population ranges from 6% to 90% for breast cancer screening. The inequalities in access to prevention programmes evidence there is much work to provide equal access to health prevention and care.

Such difficulty does not only affect screening access but the entire disease pathway. eCAN aims to contribute to the cancer control continuum by boosting preparedness among the cancer care workforce in the virtual consultation and monitoring, improving healthcare workforces’ response in light of pandemics and crises, enabling cross-border cooperation, and reducing cancer care inequalities between rural and urban areas. Counting with the support of technological tools will enable to close the care gap in terms of prevention, early-detection, timely treatment and recovering.

Taking action is essential to respond to near-future projections on cancer incidence. According to estimated data, 2.7 million cases were diagnosed in the EU in 2020, which is expected to grow by a fourth by 2035. This means that in only 12 years, over 10 million people in the EU will be diagnosed with cancer each year.

The sheer scale of these numbers shows the dimensions of the problem. That is why the Europe’s Beating Cancer Plan is a key pillar for the European healthcare systems, since it also guides the development of national strategies focused on precision health, early-detection and the creation of a comprehensive health data space.

Reimagining healthcare systems 

The 35 organisations involved in this Joint Action believe the sooner cancer is detected, the better the access to adequate treatment. Reimagining the healthcare system and harnessing the new digital tools at people’s disposal for developing new ways of receiving medical assistance and monitoring is the vision this joint action follows and will work until September 2024.

The use of these digital tools will play a key role in strengthening healthcare systems before possible pandemic outbreaks. COVID-19 has evidenced the need of telemedicine in order to not only preserve cancer control continuum, but to also help cancer patients’ mental health. According to a Dutch study, almost one in three breast cancer patients and survivors reported that their emotional functioning and mental health declined from pre-pandemic levels.

 

References:

Bargon, Claudia, et al. Impact of the COVID-19 Pandemic on Patient-Reported Outcomes of Breast Cancer Patients and Survivors. NCI Cancer Spectrum, Volume 5, Issue 1. (2021)

OECD/European Union, Health at a Glance: Europe 2022: State of Health in the EU Cycle, OECD Publishing. (2020)