UK professionals say cancer patients need to know the facts

During the Malta Cancer Foundation Symposium held today, professionals discussed the necessity to avoid withholding any information regarding cancer treatment from their patients.

In his opening speech, Health Minister Joe Cassar said he had always had cancer at the top his agenda since the start of his term as minister of health.

“We, the government, appreciate the challenges and are determined to address them as best as this country can. A National Cancer Strategy, launched in 2011, directs and steers the development and activity that is continually unfolding in this specific field of practice,” Cassar said.
Cassar expressed excitement at sending patients to the new EU funded oncology centre due to open in 2013 and said it was to be the hallmark of this government.

“We cannot wait to take our patients there. The current oncology hospital, Boffa Hospital, holds many virtues with its sterling workforce being undoubtedly the central one, but, its dated nature calls for modern new premises, which the new oncology centre at Mater Dei Hospital promises,” Cassar said.

While trying to find the best methods to treat cancer, with the hopes of finally eliminating it, oncologists and urologists from Cambridge University said that doctors must not forget they are treating people who need to find a way to continue living when they are not receiving treatment.

Discussing the surgical management of early bladder cancer, Consultant Urologist Christof Kastner said that professionals needed to find holistic forms of cancer treatment.

“As professionals, we should not allow our own personality to affect the way we offer treatment. Thinking we are the best and know everything will not be beneficial for the patient. Helping them improve their quality of life and treating them appropriately will make it slightly less stressful,” Kastner said.

The consultant urologist added that while there was no real prevention of muscle invasive cancer, reducing smoking in the population would certainly improve the situation.

“There is no evidence of effective oral anticancer agents although there have been interesting leads. However, I don’t really think agents such as vitamin B and D3 actually help. Taking aspirin has shown some improvement for the prevention. There is not enough evidence of prevention but do stop smoking,” Kastner said.  

Bladder cancer remains a significant health economic burden and several different surgical and non-invasive treatments are continuously being developed to reach more “acceptable mortality rate”.

“Despite my expertise in surgical management, I also think there should be neo adjuvant chemotherapy and radiotherapy as part of the treatment with evidence of a 16% improvement in the mortality rate which I believe is definitely worthwhile,” Kastner said.

Consultant Oncologist Dr Simon Russell discussed the less invasive forms of treatment for bladder cancer and ways to improve radiotherapy for patients.

“But we need to be able to choose the right treatment for each individual patient. Surgical treatment could be the most effective and safest form of treatment for some patients, particularly if pregnant,” Russell said.

Russell added that one thing which should definitely be attempted by oncologists is the preservation of the bladder. “It is time to re-evaluate bladder preserving treatment to provide patients with good long term bladder function, thus improving their quality of life.”

Moving on to the topic of prostate cancer, Russell warned all men that they were at risk. “We are picking up too much prostate cancer among men. Live long enough and we’re all gonna get it fellas! Statistically, 20% of men will be diagnosed at a young age, 80% will be diagnosed when they are older but only 3% of us will die of it.”

Russell said that cancer professionals can offer several methods to try and prevent prostate cancer but when asked which would be best, “we don’t know”.

“What we do know is that we have to teach cancer patients to live with cancer without worrying. Worrying throughout treatment will reduce their quality of life. We also need to fully advise our patients of the effects of treatment on their quality of life so they can make a well-informed decision,” Russell said.

One such decision, which would require plenty of information, would be whether to have a prostatectomy. “A ratio commonly used by doctors when discussing prostatectomy is that for every 50 prostatectomies, just one survives. A 50:1 ratio is not good and does not give patients much hope, but not everyone knows about it and there are alternative methods of treatment with higher success rates,” Russell said.

Kastner agreed saying that doctors have a responsibility to give the right advice and a responsibility to protect the patient. “We need to inform them of the side-effects of treatment as urologists and oncologists. Offer the right treatments so they can choose and be aware of each method and the potential effects on their quality of life.”