Women with breast cancer in rural and regional Australia face many challenges as a result of their relative isolation. Cancer services, medical facilities and expertise tend to be concentrated in cities and larger regional centres, making it difficult for women in rural and remote areas to access a full range of treatment options.
Whilst multidisciplinary care is demonstrated best practice for breast cancer patients, its uptake in the rural and remote context is more limited than in metropolitan settings. Accessing breast care nurses, allied health services, and psychosocial supports can be a difficult task.
Travel to metropolitan or larger regional centres for treatment and follow up care can exact a heavy financial and emotional burden to the women concerned - not only with finding appropriate transport and/or accommodation. Alternative arrangements need to be made for children and others in their care during long periods of time away, and employment and income may be affected. Local support networks are often left behind as women make their journey, adding an extra emotional level to the experience.
For women living near state borders, complex state-based travel and accommodation assistance schemes may only provide funding for travel to their capital city. This may not be the nearest or most convenient treatment centre, which may be across the border.
Women in rural and remote areas may sometimes find it difficult to get up-to-date information at a time when they need it as they are sometimes living far away from libraries, health centres, and others who may share similar experiences.
- Women in rural and remote Australia should have access to breast cancer treatment and care of the same standard as those available to metropolitan residents.
- Women in rural and remote areas should have access to high quality consumer-focused information throughout their treatment and beyond.
- Women should have access to Patient Assisted Travel and Accommodation Schemes (PATS) that are nationally standardised and monitored. Financial support should be for travel to specialist centres that are best suited to treating women's breast cancer and meeting their needs. For more, see our submission to the Senate Community Affairs Committee Inquiry into the Operation and Effectiveness of PATS.
- Women, their carers and their dependent children should have access to affordable and appropriate accommodation that is close to their specialist treatment.
- Women should have appropriate follow up care and support on their return home. This includes appropriate referral pathways for psychosocial interventions and supports.
- Multidisciplinary treatment and care should be provided to all women in rural and remote areas. Specifically:
- specialists and health professionals should be encouraged to use Medicare Benefit Schedule (MBS) items that provide rebates for participation in multidisciplinary treatment planning meetings
- creative communication options, such as telephone or video conferencing, should be used by specialists and health professionals to facilitate multidisciplinary treatment planning meetings
- the following Cancer Australia guidelines for the treatment and care of women with breast cancer should be implemented in all rural and remote areas: Clinical practice guidelines for the management of early breast cancer, Clinical practice guidelines or the management of advanced breast cancer, Clinical practice guidelines for the management and support of younger women with breast cancer, and Psychosocial clinical practice guidelines.