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Supportive care in oncology Learning Zone

Transcript: What barriers are preventing implementation of supportive care models?

Last updated:20th May 2024
Published:20th May 2024

Dr Matti Aapro

All transcripts are created from interview footage and directly reflect the content of the interview at the time. The content is that of the speaker and is not adjusted by Medthority.

Unfortunately, in spite of efforts of many in the past 30 to 40 years, to promote an approach of the patient and the patient's disease, which looks not only at the appropriate surgery, radiation therapy, or medical therapy, or the combination of these, but also looks at the impact of the disease and its treatment on the patient's wellbeing, this is very difficult to put in place in many countries. One of the reasons is the way that hospitals were traditionally organised, they had the expert of this type of disease, or of this type of organ. Let's take the example of, for example, of the lung specialists among which there were also those that treated lung cancer. Then, things evolved. And, in many countries, but not in all countries, the medical oncologists emerged besides the surgeons and radiation oncologists, again, centred on a specific tumour type in a specific organ. And, then some expressed the fact that we have to deal not only with the disease, but with what the disease does to the patient, and what the treatment of the disease does to the patient. And, this is an area which needs personnel, needs funding for this personnel, needs the time of those that are surgeons, medical oncology, radiation oncologist, that also have the time and the willingness to dedicate some of the time to these aspects of the treatment. So, it's extremely complex. And, the bottom line is that in most situations, in order to convince the authorities, which are variable country per country, but let's just take simply in a hospital. Convince your director that it is worth investing into a team that takes care of all of these issues. It's going to be a question of, where do I find the money to pay for all of that? How is that going to change my budget? And then if it goes above that, there is the insurance company or the health minister that says, convince me that this is really changing in a positive way the approach to this disease, so that I don't have to seek for more money to pay for all of this. So, I'm sorry to be very money-oriented about this, but this is the reality. There's a lot of goodwill. There are lots of people that would like to dedicate their time, but, then when they want to expand, and I was recently at a meeting in which I was discussing with some colleagues, specifically about pain treatment, and they said, we cannot recruit a nurse to help us and to help the patients, because the hospital director says there's no money left. So, it's not a question of people wanting to do something. It is a question of being able to organise everything. And, then it depends on where you are, and which country you are, and which hospital you are.

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