News

Breast Cancer: International Experience Sharing Online

28.10.2013

The first open webinar for physicians dealing with the issues of breast cancer diagnosis and treatment was held on October 17, 2013. The key objective of this educational event was to strengthen international scientific and practical cooperation among leading oncologists from Russia and other countries in view of implementation of the Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases. The event was held at the initiative of “Equal Right to Life” Nonprofit Partnership, with assistance of A.M. Gorchakov Public Diplomacy Support Fund.

Speaking at the webinar, Russian and foreign opinion leaders in oncology shared international experience in breast cancer therapy, the latest results and the ways to solve the problems of access to cancer care.
All experts have noted that the level of access to cancer care remains low both in Russia and in Ukraine - only 18-20 % of patients who need advanced and expensive treatment can receive it in full in accordance with the generally recognized clinical practice guidelines. The problem of access to care has long ago ceased to be medical only and requires consolidation of all related economic sectors.   Implementation of efficient economic means to provide access to treatment of non-communicable, first of all, oncological diseases is the main prospect of healthcare development and improvement of social and financial security of people.
To implement these objectives, Russia needs to develop and adopt the Clinical Practice Guidelines for Cancer Treatment and Detection, including breast cancer, as soon as possible.  This was what Irina Poddubnaya, a correspondent member of the Russian Academy of Medical Sciences, professor, announced at the webinar. She said that according to available statistics, about 2% of the population of Russia has various oncological diseases – the figure is big enough to pay the most careful attention to the needs of patients. Unfortunately, the five-year survival rate of patients with cancer in our country is comparable to that in developing countries, being 43 % only. At the same time, the developed system of prevention, diagnosis and screening in combination with access to advanced treatment would significantly improve the situation. “That is why we need to develop the clinical practice guidelines and take practical steps to implement medical and economic standards of management of patients with cancer on an ongoing basis,” she said.
Igor Sedakov, M.D., Chief Oncologist of the Ukraine, Chief Physician of Donetsk Regional Anticancer Center told in his report about the experience of Ukrainian colleagues in breast cancer therapy. He presented rather frustrating data of cancer prevalence and death rates in the Ukraine that are far from those in the European countries.Surgery remains the main method of breast cancer therapy in the Ukraine since the comprehensive combined therapy with the use of advanced medicines is still difficult to access for patients. The expert presented data from research and development carried out under his guidance focused on the optimization and enhancement of efficacy of surgery treatment.
Felicia Marie Knaul, Associate Professor at Harvard Medical School presented in her report the project concept on expanding access to cancer care and detection of breast cancer. This problem is especially urgent in the lower middle income countries. She proposed to use a diagonal approach - balanced investments into the disease detection and treatment to ensure the maximum coverage and access to effective technologies of care. 
The control of breast cancer includes not only medical, but also financial, legal and administrative aspects.  These were discussed in the report of Dmitry Borisov, Executive Director of “Equal Right to Life” NP.  "Ensuring stable level of financing of the existing needs for medical technologies in the framework of the declared system of government guarantees and adopting the uniform clinical practice guidelines and uniform economic standards of care in the country providing them with the required financing shall become the main ways for improvement of access to cancer detection and treatment. We need to develop the system for assessment of actual needs for medical technologies (create registers of patients) that will ensure adequate financial planning and budget resource management, as well as to more actively use the possibilities of public private partnership for co-financing of cancer care through the development of voluntary insurance system for the healthy population. These are the approaches actively promoted and recommended by the WHO experts and, definitely, they should be carefully considered both in Russia and in other CIS countries,” he said.
Marina Stenina, M.D., the Leading Researcher of Clinical Pharmacology and Chemotherapy Department at N.N. Blokhin Russian Cancer Research Center presented the report titled "Adjuvant Drug Therapy of Breast Cancer". She noted that recurrences develop in about one third of patients with early breast cancer after the primary treatment. The recurrences can occur with any initial stage, at any time and with any content of the primary treatment. This phenomenon is explained in theory by the assumption that micro-metastases appear in the earliest stages of the disease, therefore, local therapy (surgery, radiotherapy) is insufficient for most patients with early breast cancer, and supplementary (adjuvant) systemic drug therapy is required. The methods of adjuvant drug therapy include chemotherapy, hormonotherapy, and target (anti-HER2) therapy that must be administered according to biological profile of the tumor.
Apart from breast physicians, oncologists, gynecologists, surgeons, and therapists from Russia and the Ukraine, experts from Harvard University also participated in webinar sessions. The participants pointed out high value of such events in terms of experience sharing and acquaintance with the practice of colleagues from different countries. Similar sessions are expected to be held regularly in the future.