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BCNA News 09 Apr 2020

OP-ED: Is there a silver lining for breast cancer patients?

by Kirsten Pilatti, CEO Breast Cancer Network Australia

Psychologists tell us to look for joy each day and to focus on what we can control in times of crisis. As we at BCNA updated our information to the 120,000 women and men we support through their breast cancer treatment and beyond, it came to me that yes, there may be a number of silver linings from the current COVID–19 experience.

Over the last 20 years, treatment options and care for Australians diagnosed with breast cancer have significantly improved, resulting in a current survival rate of over 90 per cent for patients diagnosed with early breast cancer. We have also seen new treatments that can extend the lives of people with metastatic (advanced) breast cancer, often with good quality of life. This means these people, who not so long ago often had a very poor prognosis, can now reach significant milestones, such as seeing a child start school, attending a family wedding or meeting a first grandchild.

We have also seen new studies that show that, for some patients, less treatment can be better. Mastectomy can be safely avoided for most patients with early breast cancer, routine removal of the lymph glands is unnecessary, and shorter courses of radiotherapy are just as effective as longer courses, with better cosmetic outcomes. New tests can identify many women who can safely avoid chemotherapy, and less intense chemotherapy options are sometimes just as effective as standard ones.

COVID-19 has caused governments and healthcare providers to look at our healthcare resources and prioritise the Australian community’s healthcare needs. I think it is these prioritisations that will see real benefits for breast cancer patients in the long term.

A great example is the potential improved access to telehealth services. This would mean regional patients would no longer have to drive for many hours for a consultation with a specialist - sometimes just to hear ‘your scan results are fine’. They could also spend time on a call with a psychologist who specialises in cancer care but who would otherwise not be available to them because they live on the other side of the country.

The other silver lining is that we may finally see the widespread implementation of hypofractionated radiation treatment as mentioned above. Studies have shown that some patients can have a good outcome with this shorter course of higher-dose radiation treatment. The big bonus is less time in treatment, by days and sometimes weeks, and a fewer side effects with the same long term health outcomes.

The current international health crisis has also seen a sometimes fractured and competitive cancer space come together, with regular online meetings to share experiences, implement new ways of working and, most of all, improve communications. The patient voice has not been forgotten, with many patient advocacy organisations consulted and given an opportunity to make a real contribution to the discussions.

Maybe, just maybe, this crisis will ensure we implement a better, more patient focused health system.

Thank you to all the government and the health professionals who are working around the clock to ensure we have plans in place for this pandemic, while never losing sight of the women and men we must treat and care for now.