8 measures to improve childhood cancer survival

2024-02-15 08:49:20

In Spain, 82% of children under 14 years of age with cancer survive the disease five years after diagnosis, a high percentage but one that should not lead to “a triumphalist” and conformist attitude, warns the Spanish Society of Hematology and Oncology. Pediatric (SEHOP) that proposes eight measures to improve survival.

Spaceships painted in one of the isolation rooms of the pediatric oncology ward at the Gregorio Marañón Hospital in Madrid. EFE/Emilio Naranjo

On International Childhood Cancer Day, the president of the SEHOP, the doctor Ana Fernández-Teijeiroinsists: “We should not adopt a triumphalist attitude and be satisfied with these figures, because recent reports, which show an analysis compared to other countries, warn us of the need to improve the survival of our patients with leukemias and brain tumors” in children. .

Thus, the CONCORD-3 study, published in Lancet Child Adolescent Health, after analyzing 258 cancer registries in 61 different countries, reveals that survival figures for childhood leukemia range from 46% in Mexico to more than 85% in Canada , Cyprus, Belgium, Denmark, Finland and Australia.

According to data updated in 2023 from Spanish Registry of Childhood Tumors (RETI-SEHOP), survival in children under 14 years of age with cancer is 82%, a figure that has increased five points in the last fifteen years.

A progress that SEHOP believes can improve with the adoption of a series of measures to advance the quality of care for pediatric cancer patients to increase their chances of cure and survival.

Steps to increase childhood cancer survival

1.Networking:

• Effective implementation of networking between units of greater and lesser complexity so that children and adolescents with cancer benefit from the best diagnosis and the best therapeutic options.
• Encourage referral and/or consultation of reference units (CSUR) for those highly complex patients and procedures.
• “And we especially demand the concentration of pediatric brain tumor surgeryin order to improve the survival and morbidity results of our patients in Spain,” says the president of SEHOP.

2. Transversality

• Facilitate the creation of specific transverse units for shared and multidisciplinary care of adolescents with malignant tumors by adult specialists and pediatric specialists.

3. Facilitate inclusion in clinical trials

• Health institutions must provide the legal and logistical framework that facilitates the inclusion of patients in clinical trials.
• Since 2017, the ECLIM-SEHOP Platform provides comprehensive support to 21 clinical trials phase III for the benefit of more than 500 patients.
• “Thanks to the Spanish Association against Cancer; to the Federation of Parents of Children with Cancer; to the Pablo Ugarte Association; to One among a hundred thousand; to Achaye; to the MAR Foundation and other donations during these five years we have been able to offer our patients the best opportunities for healing, but we need to be able to guarantee the continuity of this ECLIM-SEHO PlatformP”, demands Fernández-Teijeiro.

4. Optimize information systems

Although the Spanish Registry of Childhood Tumors has had support from the Ministry of Health, the University of Valencia and the SEHOP for years, its continuity and improve your information system to be able to know and optimally analyze the incidence and survival data of pediatric cancers in Spain.

5. Accelerate access to new drugs

The doctor applauds, in the era of personalized medicine, that the Ministry of Health recently made public the “Common Catalog of Genetic Tests” which includes specific molecular studies of pediatric malignant tumors.

Pending its development in all the autonomous communities, the PENCIL project “constitutes an excellent opportunity to begin implement the analysis of molecular targets in Spain in patients with refractory and relapsed solid tumors through network collaboration of different clinical units and research institutes,” considers the doctor.

“However, its application in clinical practice may be limited by the difficulty of access in our country to new drugs already approved by the European Medicines Agency (EMA), not only because the Spanish Agency for Medicines and Health Products only approves 50% of new drugs, but because authorization can take more than 500 days. These are too long times if compared to other European countries,” says the president of SEHOP.

EFE/Stringer

6. Multidisciplinariedad

All pediatric cancers are rare diseases and require care by multidisciplinary teams (doctors, nurses, psychologists, biologists, etc.) with specific and in-depth knowledge of the different pathologies in the diagnosis, as well as during their treatment and in the follow-up of survivors.

7. Recognition of the consequences

• More than 70% of pediatric cancer survivors will have aftermath long-term consequences derived from the treatment, which can condition their academic, work, social and emotional integration.
• The SEHOP proposes the progressive integration into specific queries within the public health system and that both patients and the doctors who may care for them in the future are aware of the possible side effects for their early prevention, diagnosis and treatment.
• The continuing training and the so-called “survivor passport” They should be the subject of attention in the coming years for better care of these patients.

8. Recognition of the specialty

• Pediatric oncologists and hematologists, after their comprehensive training in Pediatrics, require a specific training to be able to face the rare and complex diseases that are cancers at this critical stage of life. This training must include the management of the diagnosis and treatment of all pediatric malignant tumors and supportive therapies and also include specific training in oncological molecular genetics, hematopoietic stem cell transplantation, advanced therapies, under investigation (clinical trials I-III) and in personalized medicine.
• To ensure adequate coverage of the vacant by pediatric specialists with the best training and experience in the discipline, it is essential, as in other European countries, to recognize the specialty of pediatric oncology and hematology.
• “At SEHOP we continue working towards its achievement and we hope and wish that the process will be resolved favorably as quickly as possible to guarantee the adequate provision of our healthcare system with the best-trained specialists in pediatric cancers when, in addition, we face the retirement of 20% of our physicians in the next ten years,” explains the president of the Society.

On International Childhood Cancer Day, the SEHOP does not want to forget the 18-20% of children and adolescents who are not going to be cured and demands that all autonomous communities have pediatric palliative care units, as well as home hospitalization to guarantee the best care and quality of life for the patient and their family in the last phase of their illness.