“With Covid, more teleconsultation and medicines at home”

Even today, breast cancer is the most frequently diagnosed cancer in women in Italy: this is sobering, especially if we consider that between 2008 and 2016 as a whole, all cancers grew by 1.3% in women. annual average. The data comes from the report The numbers of cancer in Italy, also wanted this year by Aiom (Italian Association of Medical Oncology) and by Airtum (Italian Association of Cancer Registries) which shows how breast cancer, in the same period of time, has seen an increase in diagnoses of 2% globally, and in particular among the under 50s. In times of pandemic these data are particularly significant given the challenges imposed by the containment measures and the commitment of hospitals with Covid patients. Still, there are some very comforting aspects.

On the one hand, thanks to screening and the greater awareness of women, the majority of breast malignancies are now diagnosed at an early stage. On the other hand, the emergency from Sars-CoV-2 has led to accelerate the development of new ways, digital and non-digital, to continue to ensure affected women the same level of care as in the pre-Covid era. “For example, the emergency has given an impulse to telemedicine and the delivery of medicines at home. These are changes already underway, but certainly the pandemic has represented an additional incentive to put them into practice”, explains Matteo Lambertini, oncologist and researcher at the University of Genoa – Irccs Policlinico San Martino hospital, in an interview published on the Aleati per la Salute portal (www.alleatiperlasalute.it), the new portal dedicated to medical-scientific information created by Novartis.

Of course, telemedicine in oncology can never replace the face-to-face visit: “On the one hand, the physical examination requires direct contact with the patient, on the other hand the doctor-patient relationship can only develop in the best possible way in many clinical situations. “, goes on. Surely the pandemic has led to streamlining some activities, to the benefit of all: “This is the case of the patient who had to come to the hospital only to show the latest tests after a visit made a short time before: this type of activity can be easily moved online, through video consultations “. Less access to the hospital means more safety in terms of possible infections but also less psychological impact for the person. Covid, then, has given impetus to the home delivery of drugs, clearly where possible:” It is a a service much appreciated by patients, which allows them to receive class H drugs, available only in the hospital with prior authorization from the medical team “.

Despite the inevitable organizational complexities, the various Italian Breast Units, or the centers that deal with breast cancer, have managed to maintain high levels of treatment by ensuring compliance with anti-Covid regulations. All thanks to some precautions: in addition to the telemedicine services, some appointments for drug infusions have been reorganized in all the centers: “The infusions of some drugs can be performed weekly or three times a week”, explains Lambertini. “Whenever possible and equally effective, more three-weekly administrations are now established than before so as to reduce unnecessary access”.

Naturally, every Breast Unit on the national territory is for him, but overall Lambertini does not notice substantial differences: “In most of the centers these changes have been successfully implemented”. These changes are the natural consequence of a process of clinical innovation and patient management that has been underway for some time thanks to the development of the Breast Units themselves.

For several years these ultra-specialized centers have allowed an increasingly multidisciplinary approach to breast cancer, thanks to the involvement of figures who work with the oncologist: from the clinical geneticist to the anatomopathologist, from the radiotherapist to the gynecologist up to the psychologist. “This allows us to characterize the individual tumors and thus to offer more and more therapies tailored to each individual patient”, explains Lambertini. Without forgetting the introduction of rigid indicators for the control of work organization and, therefore, for the reduction of errors. It is not difficult to imagine that these steps forward can continue beyond the pandemic: “Of course, telemedicine and other innovations will have to be defined by guidelines that do not exist for now”, concludes the oncologist, “and a specific regulatory framework will have to be created to regulate these practices, also in terms of the doctor’s relationship with the National Health Service “.

read the news also on https://www.alleatiperlasalute.it/salute-20/emergenza-covid-e-telemedicina


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