HEALTHCARE

Advancing breast cancer in the developing world: Challenges in Zimbabwe

SUMMARY

Breast cancer has become the leading cause of cancer-related deaths in women living in Africa. Women in Zimbabwe experience some of the worst outcomes. A study of more than 1,400 Matabeleland South Province and Bulawayo City residents investigated the reasons for this shocking situation. This involved women and their families, health professionals, specialists, patient representatives, and other stakeholders. The study disclosed a range of reasons for major delays at every stage of the diagnostic pathway. Women and families delayed seeking help because of ignorance, lack of trust and the high cost of treatment. Health practitioners delayed referring patients because of a lack of training skills and confidence. Central hospitals postponed treatment because of a lack of specialisation and skills, and over-centralisation. In conclusion, many factors delay the presentation, diagnosis, and treatment of breast cancer in Zimbabwe. These factors are being addressed by the phased implementation of a programme prioritising training, new diagnostic skills, and resource-appropriate service reconfiguration, backed up by data collection, audit and public awareness initiatives.

(BELG J MED ONCOL 2023;17(7):259–63)

Early-onset cancers: Incidence trends in Belgium, 2004–2020

SUMMARY

Early-onset cancers are often defined as diagnoses below 50 years of age. Cancer incidence in this age group increases for specific cancer sites according to several international publications. This study describes the cancer incidence trends in Belgium in 2004–2020 in 20–49-year-old people. Overall cancer incidence increases by 0.3% per year in this age group. A decrease is observed for several cancers, including breast, prostate and lung cancer. On the other hand, the risk of being diagnosed with, e.g. melanoma, testicular cancer and thyroid cancer increases. Besides describing incidence trends in young and middle-aged adults, this study demonstrates that data from other (high-income) countries do not necessarily reflect the situation in Belgium and highlights the importance of national population-based data from cancer registries.

(Belg J Med Oncol 2023;17(6):230–5)

Burnout in resident physicians

SUMMARY

Burnout is an important consequence of work-related stress. It is observed in 15–40% of resident physicians and has an important influence on their wellbeing, their professional career, and their patient-doctor relationship. Different interventions at the organisational, interpersonal and personal levels can be performed to prevent the development of burnout.

(BELG J MED ONCOL 2023;17(3):85–7)

Audits in medical oncology

SUMMARY

The quality of oncological care can be ensured by different means, such as graduate and postgraduate education, guidelines, quality labels and audits. Audits in medical oncology departments are not routinely performed and are only used in case of problems. In this article, the introduction of audits in the medical oncology department is advocated, and a strategy to implement this quality improving tool is proposed.

(BELG J MED ONCOL 2023;17(1):19–26)

Relationship between volume and outcome in lung cancer

SUMMARY

The use of survival data to compare hospitals remains controversial. Recently three studies could not find an association between outcome and volume. More important than the volume of surgery seems to be the concentration of oncological care in centres with multidisciplinary teams around the patient. A framework for implementing Value-Based health care has to be defined, measuring outcomes that matter to patients and cost.

(BELG J MED ONCOL 2022;16(2):70–3)

Moving forward together: The power of collaboration via networks

(BELG J MED ONCOL 2022;16(1):33-6)

Palliative Care: A Shift in Paradigm

SUMMARY

The integration of palliative care (PC) in standard oncological care (SOC) has become ‘state-of-the art’. Its benefits have increasingly been appreciated and extensively studied, and guidelines have been developed to achieve this goal. However, an integrated, patient-centred approach also implies detecting patients care needs at an earlier stage and defining PC in a different way, i.e. based on care needs instead of life expectancy only. The ‘Palliative Care Indicator Tool’ PICT is instrumental in identifying the palliative patient and distinguishing different levels of needs in the palliative population. The status of ‘palliative patient’, access to PC benefits and facilities and the organisation and reimbursement of PC services should be based on care needs instead of life expectancy. Palliative care for every palliative patient requires an educated workforce, particularly with regard to communication skills, and the presence of a multidisciplinary team. Discussing goals of care (GoC), advance care planning (ACP) and end-of-life decisions (ELD) should be the basis for ‘negotiated care’.

(BELG J MED ONCOL 2021;15(6):315-20)