LUNG CANCER MISSION 2024 - 2034

- With these challenges in mind, the Polish Lung Cancer Group, in cooperation with more than 10 scientific societies and patient organizations working in the areas of family medicine, diagnostics, surgery and oncology, today established the Lung Cancer MISSION 2024 - 2034, for improving the outcomes of lung cancer care in Poland over the next 10 years. - said Prof. Dariusz M. Kowalski, secretary general of the Polish Lung Cancer Group.

The aim of the cooperation undertaken is to counteract the negative - health, social and economic - consequences of the increasing incidence and excess mortality of Polish women and men from lung cancer, the most common cause of death in Poland.

- I hope that the cooperation of so many circles, will bear tangible fruit, which we will inform you about. We are also counting on the support of the media for information about the change in the approach to lung cancer, where patients, even with advanced disease, can live many years thanks to modern treatment," stressed Prof. Rodryg Ramlau, president of the Polish Lung Cancer Group.

- Mission Lung Cancer is a good course of action - diagnostic and therapeutic management in oncology, because it is the interplay of various specialties, and here in the area of thoracic malignancies, especially lung cancer, the interaction of specialists, lung diseases, thoracic surgery and clinical oncology, radiation therapy is essential. It is increasingly rare that we have to deal with patients in whom we use only one method of treatment, we associate surgery or radiotherapy with systemic treatment and use complementary and supportive treatment. - stressed Prof. Maciej Krzakowski, national consultant for clinical oncology, president of the Polish Society of Clinical Oncology.

As early as this November, a directional document "Lung Cancer Mission 2024 - 2034" will be released along with a roadmap of the current state of care, which will be a guidepost for both systemic and organizational solutions in the short and long term.

Up to 95% of patients are former or current tobacco smokers

Tobacco smoke remains the main and modifiable risk factor, contributing to about two-thirds of cancer deaths in Poland. - If smoking trends continue, estimates indicate even the possibility of doubling the number of lung cancer cases in European Union countries. - indicated Prof. Rodryg Ramlau.

- Smoking is undoubtedly a major health risk factor that directly correlates with the incidence of lung cancer. More than 8 million people in our country smoke (about 29% of adults), including a growing number of female smokers. - Dr. Jerzy Gryglewicz, a health care expert, said. - The problem has been noted in all the country's major strategic documents. However, a new, effective and comprehensive anti-tobacco strategy is needed.

- It' s hard to find a better studied cause of diseases, including cancer, than smoking! In addition, we see a new health threat, in the form of new nicotine products that may encourage children and adolescents to start smoking. - added Dr. Pawel Koczkodaj of the Department of Cancer Epidemiology and Prevention, National Cancer Institute, National Research Institute in Warsaw.

In this context, primary prevention efforts to reduce the percentage of smokers in the population cannot be overestimated. It is necessary to promote and support health policy measures, including education, legislation and fiscal policy, aimed at reducing tobacco initiation among children and adolescents as much as possible, as well as successively reducing the smoking rate in the adult population.

Only 20% of cases of lung cancer cases diagnosed at an early stage

Lung cancer does not produce symptoms in its early stages, which is why it is so important for people at risk, such as compulsive smokers, to get screened prophylactically. The most effective screening test is a low-dose CT scan, which is very sensitive and can detect very small lesions. The program, in the form of a pilot, has been implemented for several years in Poland and continues until the end of this year. - We have promises from policymakers and the payer that this type of examination will enter the basket and can be performed in a more systematic way. - stressed Prof. Tadeusz Orlowski, vice president of the Polish Lung Cancer Group.

- It is incredibly important to establish a diagnosis of lung cancer before surgery, which increases the chances of a less invasive procedure, but importantly, we already have drug programs that allow the inclusion of preoperative treatment that gives a chance of a cure. Diagnosis before the decision to treat, should be timely and effective enough. We would like the entire diagnostic process, from suspicion to a decision on effective treatment, to close within a month. - Prof. Orlowski added.

- We see a great need to educate family physicians about oncological vigilance for lung cancer, so that they can catch patients who may be at risk or have worrisome symptoms and need initial diagnosis. The PCP should be the first link to refer the patient, preferably to a specialized center, where the patient will be comprehensively cared for. - indicated Dr. Janusz Krupa, president of the Institute for Conscious Man.

The application of proper treatment is contingent on good, efficient and correct diagnosis. - And here we have a problem in Poland, first of all, it takes too long to refer a person with suspected chest cancer to a pneumonologist. As a consequence, too much time elapses for the basic examination with which to start, that is, chest CT, another time elapses for bronchoscopy, (collection of tissue material for histopathological and molecular studies), which is not always performed correctly and has to be, in many cases, repeated, resulting in a median time from chest CT to resection of the lung parenchyma of about 50 days. - Prof. Maciej Krzakowski noted.

- The sore point of lung cancer care in Poland is the fragmentation of the diagnostic and therapeutic process among many centers. Tissue material is always scarce, so the patient should be taken care of comprehensively and diagnosed in a comprehensive manner. - indicated Prof. Artur Kowalik, member of the board of the Polish Society of Human Genetics and head of the Department of Molecular Diagnostics at the Świętokrzyskie Oncology Center.

Experts noted that in lung cancer, due to the large number of molecular abnormalities, next-generation sequencing technology should be used, which allows all mutations to be examined at once.

- Our therapeutic options are growing all the time, we have a good drug program, only we get too few patients. The problem is too late or inadequate diagnosis. We wait for these patients, because we have a variety of treatment options for them. Only then can we qualify patients for appropriate therapies, and only then will we get spectacular results. - emphasized Prof. Dariusz. M. Kowalski.

Care coordination and centers of excellence

- Currently, patients face many barriers on their path and the diagnostic time is too long, so we see great potential in the implementation of Lung Cancer Units, where patients will have access to the right specialists, tools and technology under one roof, which will translate into shorter diagnostic times and the inclusion of more patients in the drug program. - Aleksandra Wilk, Director of the Lung Cancer Section, TO SIĘ LECZY Foundation, said.

- The time from suspicion and the first symptoms, through diagnosis to the start of treatment, is crucial, meanwhile many patients lose the chance for radical treatment and thus a cure, because the diagnostic process has been dramatically delayed. Nowadays, perioperative, highly radical treatment with the idea of a cure has gained in importance, which, however, is only possible after a very detailed diagnosis. All this therefore necessitates the establishment of highly specialized centers that will eventually cover the entire country. - Prof. Rodryg Ramalu pointed out.

Comprehensive and effective care of patients with lung cancer requires multidisciplinary cooperation and the development of solutions accepted by a wide range of experts involved in the process of diagnosis and treatment of this cancer, based on current clinical guidelines and epidemiological and scientific data.

- A month ago, a team of specialists representing thoracic surgery, pneumonology and oncology was set up, within which we developed the structure and requirements that the center of competence - Lung Cancer Unit - will meet. I think this is the final stage of arrangements, and at the next meeting of the National Oncology Council we will be able to present the project, which, after the Council's opinion, will go to the Minister for implementation," announced Prof. Maciej Krzakowski.

As stressed by Dr. Beata Jagielska, chairwoman of the National Cancer Council and director of the National Cancer Institute - PIB, the current draft of the LCU will go to the ministry to review the need for possible legislative changes. A molecular testing team was also recently established, which will be in place until September of this year and will look at BRCA-dependent cancers and comprehensive molecular diagnostics, among other things, and will also analyze currently funded services in this area. - We know that funding alone doesn't get the job done, the essence is organizational changes and cooperation that follow. No country in the world works in such a way that the smallest hospital has all the most modern technologies available, but that doesn't mean that a patient from a small town or village can't benefit from the gains of these technologies. This is the coordination of care, and the system should direct the patient so that he or she has a specific stage of diagnosis or treatment performed on a specific day and at a specific center. - Dr. Beata Jagielska pointed out.

Source: Press Mat.