ESMOs Position on Quality Cancer Care

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ESMOs Position on Quality Cancer Care

• Heinz Ludwig, MD
• Department of Medicine I, Center for Oncology and
  Hematology
• Wilhelminenspital, Vienna
• Vienna, Austria

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Important Elements of ESMOs Mission

• To improve the quality of prevention, diagnosis,
  treatment, supportive and palliative care, as
  well as the follow up of patients with malignant
  disorders
• To disseminate knowledge to cancer patients and
  the public
• To promote equal access to optimal cancer care of
  all cancer patients

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EUROCARE Trial 5-year Survival () 1988 - 1992
Incidence period
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Five-year (Relative, age Standardised) Survival
() for Colon Cancer by sex
Males
EUROCARE-3 Study
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Observed Survival of Breast Cancer (all ages) in
Different Regions of Switzerland
Fisch T et al. Ann Oncol, 2005
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Trends in Mortality from Lung Cancer (ASR) in
Females in Selected European Countries
ESEC 2005, Primic-akelj M
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Patient and society oriented activities for
enhancing the quality of cancer care

• ESMOs Patient Seminars
• ESMOs Consultation Forum
• ESMOs Cancer Patients Working Group
• ASCO ESMO Charta on Cancer Patients Rights

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What do Patient Seminars offer?

• Information on
• Nature of disease
• Diagnostic measures
• Treatment options
• Late consequences
• Latest developments in treatment
• Nutrition
• Clinical trials
• Alternative treatments.

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What do Patient Seminars offer?

• Improvement of
• Patient / Doctor communication
• Coping strategies
• Facilitating
• Social contacts
• Training
• Relaxation techniques
• Health in body and mind

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Greater autonomy Less unfounded fears Better
relationships More feedback for Medical
Community Consumerism leads to greater patient
orientation Alliances between patients and care
givers Greater pressure on health care provider
and political systems
ESMO Patient Seminars 2002 Nice 2003
Edinburgh 2004 Vienna 2005 Budapest 2006
Istanbul 2007 Lugano 2007 Brussels
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Annals of Oncology ASCO ESMO Consensus
Statement on Quality Cancer Care
Working Group Paula Trahan Rieger ASCO
Kathy Redmond - ECPC Adamos Adamou European
Commission Raphael Catane - ESMO Tony Mok -
CISCO Heinz Ludwig - ESMO
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1. Access to Information

• Patients should receive adequate information
  about their illness, possible interventions, and
  the known benefits and risks of specific
  treatment options
• Patients should have the ability to ascertain
  names, roles, and the qualifications of those who
  are treating them

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2. Privacy, Confidentiality, and Dignity

• Patients should have the benefit of privacy
• Medical records and other patient-specific
  information, including genetic information,
  should be regarded as private except to the
  extent that they are required to be shared for
  treatment or payment purposes
• If access to patient specific information is
  necessary for research, patients should be given
  the opportunity to agree
• Patients should be treated with dignity at all
  times.

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3. Access to Medical Records

• Patients should be permitted to review their
• medical records and obtain copies for free or for
  a reasonable fee
• Healthcare providers should be available to
  explain the contents of medical records to
  patients

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4. Prevention Services

• Individuals should be advised with respect to
• the prevention of cancer and should be provided
• any preventive interventions that are evidence
  based
• and available.

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5. Nondiscrimination

• Access to healthcare services should be provided
• without discrimination regarding race, religion,
  sex, national origin, or disability
• Patients should also be free from discrimination
  on the basis of their disease, with respect to
  both employment and health insurance accessibility

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6. Consent to Treatment and Choice

• Patients should be empowered to participate in
  decision making
• and the healthcare team should respect
  those decisions.
• Patients should have access to a second opinion
  and the ability to choose among different
  treatments and providers.

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7. Multidisciplinary Cancer Care

• Optimal treatment of cancer should be provided by
  a team that includes multidisciplinary medical
  expertise
• Patients should also have access to counseling
  for their psychosocial, nutritional, and other
  needs.

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8. Innovative Cancer Care

• Patients should be offered the opportunity to
• participate in relevant clinical trials
• Should have access to innovative therapies, which
  may improve their disease outcome.

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9. Survivorship Care Planning

• Cancer survivors should be provided a
  comprehensive care summary and follow-up plan at
• the completion of primary therapy
• Should be systematically monitored for long-term
  and late effects of treatment. The need for
  rehabilitation
• services should be evaluated as part of the long
  term
• follow-up plan.

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10. Pain Management, Supportive, and Palliative
Care

• Quality cancer care requires pain management,
• including the use of opioid analgesics and other
  supportive care, for conditions induced by cancer
  treatment or by the disease itself.
• Patients should have access to optimal palliative
  care and counseling with respect to end-of-life
  issues.

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Is a powerful driving force for quality cancer
care Support ESMO in its important
endeavors ESMO is ready to support patients
concerns as much as possible