“We Finally Got The Government To Understand That Oncology Is A Challenge For Everyone”

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“We Finally Got The Government To Understand That Oncology Is A Challenge For Everyone”
“We Finally Got The Government To Understand That Oncology Is A Challenge For Everyone”

Video: “We Finally Got The Government To Understand That Oncology Is A Challenge For Everyone”

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Video: the PRACTICE - Episode 21 /HD/ english subtitles 2023, January
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“We finally got the government to understand that oncology is a challenge for everyone”

The Russian cancer service needs serious modernization - from organization and funding to training programs for doctors, experts say: in the Public Chamber, leading oncologists and the patient community discussed the prospects for the National Oncological Strategy.

“We finally got the government to understand that oncology is a challenge for everyone”
“We finally got the government to understand that oncology is a challenge for everyone”

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The Russian cancer service needs serious modernization - from organization and funding to training programs for doctors, experts say: in the Public Chamber, leading oncologists and the patient community discussed the prospects for the National Oncological Strategy.

The financing of the Russian healthcare system is ineffective and does not always bring the desired results, and the actions of its participants are poorly coordinated - these are the conclusions of the authors of a recent study "Healthy healthcare: a step into the future for Russian medicine", conducted by the Moscow office of The Boston Consulting Group (BCG). … Timely diagnosis, prevention and rehabilitation remain in an unsatisfactory state, the education of doctors is of poor quality, and patient information and medical literacy of the population are generally at zero.

A vivid illustration of these conclusions is the state of the national oncological service

Last week in the Public Chamber of the Russian Federation, where the III All-Russian Congress of Oncological Patients was held, the problems of implementing the National Oncological Strategy were discussed. Representatives of the Association of Oncological Patients "Hello!", The Russian Society of Clinical Oncology (RUSSCO), the Eurasian Federation of Oncologists, deputies and officials took part in a broad discussion.

The national strategy for the fight against cancer for the period up to 2030 was adopted at the V All-Russian meeting of the profile commission in the specialty "Oncology" on November 13, 2017. This is the first document in the country that forms the priority of oncology as a social and medical problem. Its main tasks are: increasing the availability and quality of medical care by determining patient routing and an integrated approach to specialized treatment, prevention and reduction of the level of disability.

The implementation of the plans is hindered, first of all, by an acute shortage of qualified personnel, especially in the regions

So, in the Volgograd region, instead of 40 oncologists, half as many work, the chief freelance oncologist of the Ministry of Health, general director of the Federal State Budgetary Institution "National Medical Research Center of Radiology" Academician Andrey Kaprin gave an example. And this is not yet the most disadvantaged region. The work of an oncologist is hard, involves a tremendous burden and responsibility, and there are no queues for empty rates of oncologists in the regions.

The situation with personnel training is not in the best way either. “The revision of the basic curricula of many medical faculties revealed the complete absence of oncological cycles,” said the director of the Oncological Center of Sechenov University, head. Department of Oncology and Reconstructive Surgery Academician Igor Reshetov. “Continuous medical education programs, including residency programs with the transition to a 3-year education, also require attention: it is important not to overlook the issues of rehabilitation, adaptation of cancer patients, and hospice care in their formation.”

At the same time, it is necessary to change the training programs not only for oncologists, but for doctors of other specialties of the general medical network - without the formation of oncological alertness in them, it is impossible to talk about the early detection of cancer. It is especially difficult for pediatricians to detect cancer in the early stages, noted the chief freelance pediatric oncologist of the Ministry of Health for the Central Federal District, deputy. Director of the Research Institute of Pediatric Oncology and Hematology, N.N. N.N.Blokhin Maxim Rykov. “Firstly, pediatric oncological diseases do not have typical clinical symptoms, and secondly, pediatricians have little experience in pediatric oncology, given the rarity of this pathology: according to statistics, on average, a pediatrician meets only 8 patients with cancer in his career,” Rykov explained. - And, thirdly, a lot depends on the work of pathologists, then oncologists,who perform intravital diagnostics and who also have little experience in pediatric oncology, not to mention radiation therapists and other specialists involved in treating children."

Needs modernization and organization of oncology service

As the deputy emphasized. Professor Valery Starinskiy, General Director for Research of the Federal State Budgetary Institution “NMIRTs”, we are talking about creating a network of reference centers on the basis of leading medical institutions of Russia, maintaining the federal cancer register when calculating statistical indicators of the incidence of malignant neoplasms. And to solve these issues, it is necessary to create new regulatory documents, coordinate the positions of the Ministry of Health, the government and the State Duma.

As for the financing of oncology, both oncological dispensaries in the country's regions and leading federal centers are experiencing a shortage of funds. It is not uncommon for cancer centers to receive ten times less funds than required for a patient's treatment, and are forced to look for money on their own. Quotas for one sick child are also extremely small: 129-137 thousand rubles. In addition, the financial aspects of organizing diagnostics and treatment in the oncological care system have not been resolved, experts said. It is necessary to calculate the number of beds, a new staffing table, solve other large-scale tasks, both at the federal and regional levels. “We have analyzed the per capita tariff for compulsory medical insurance in all 85 regions, and it differs tenfold,” she cited an example. Valentin Tsyvova, Chairman of the Health Protection Commission of the OP.

Without sufficient funding and its competent use, there is no need to talk about the replication of new technologies throughout the country

At the same time, the medical and economic efficiency of their use is very high: “With the active use of modern inpatient replacement technologies on an outpatient basis, up to 70% of surgical operations can be avoided, for example, if cyst sclerotherapy, nipple secretion study, and various types of biopsy are performed under the control of radiation methods. Both doctors and patients should know about this,”said the head. National Center for Oncology of Reproductive Organs, P.A. Herzen, professor Nadezhda Rozhkova.

Other participants of the Congress also spoke about the need to inform and educate patients and the active role of patient organizations in this

In addition, it is important that patients who express those aspirations and problems that are visible to them from the inside are heard, says Academician Reshetov: “they form a kind of technical task for the development of our professional community”. “We have a position on a number of issues based on the experience of patients from different regions of Russia, which we want to present to doctors and legislators,” confirmed the head of the Association of Cancer Patients “Hello!” Irina Borovova. - I can say for sure that the programs for screening studies, preventive and rehabilitation measures require improvement."

Recently, an information and educational project "Open Oncology" was launched at the National Medical Research Center of Radiology, aimed at bringing the doctor and patient closer together, eliminating the distance between them, which interferes with the effective fight against cancer, said the head of the department for public relations and work with the regions of the Moscow Oncology Research Institute A.P. Herzen Alexander Gnatyuk. One of the activities within the project is the provision of psychological assistance to patients and their relatives. Specific steps are foreseen to provide scientific, clinical and practical assistance to both patients and the professional community. This should ultimately improve the provision of cancer care in the country.

“A constructive dialogue with patients is, of course, a big step forward in improving the quality of cancer care,” Borovova said. “We hope for further close cooperation with doctors and authorities, and we propose to submit the National Cancer Strategy to a broad discussion of the patient community”.

The presentation of the National Strategy itself is expected in mid-December

As the head of the Ministry of Health Veronika Skvortsova said earlier, the goals to be achieved should be "to increase the rates of early detection of cancer and 5-year survival rate of patients after treatment up to 70%." The minister acknowledged that, despite the results achieved by the oncological service, "some personnel and organizational issues remain unresolved."

Experts hope that the document can become the basis for increasing funding and developing infrastructure for cancer care. “We finally got the state to understand that oncology is a challenge for all medical specialties, from primary care physicians to rehabilitation therapists,” noted the First Deputy Chairman of the Public Chamber's Commission for Health Protection, Director of the Federal Research Center of Otorhinolaryngology of the FMBA of Russia, professor Nikolay Daikhes.

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