National Cancer Plan envisages streamlining of treatment

Over the course of their treatment, cancer patients could have to deal with up 19 different practitioners which often results in them experiencing further stress, according to Danika Marmara’, the director of cancer care pathways.

Marmara’ was addressing the parliamentary committee for health which tonight discussed the proposed National Cancer Plan (NCP), which is currently under consultation. She said that for the plan to be effective, it must be holistic and must offer a more streamlined system of care.

For this reason, she said, the plan was envisaging integrated care pathways each of which will have be tailored to specific type of cancer and the patient’s needs.

In addition to this, she said a fast-track system for referrals using e-forms was also being piloted. Through this system, suspected cases can be sent directly to a consultant.

“We have seen 64 patients so far out of which 2% were found to have a cancer,” she said.

Another proposal to have a “key person” at the centre of cancer pathways, who will be specifically trained to deal with the cancer in questions. Marmara’ said that under the current plan, 2 persons shall be assigned to each of the most common cancer types in Malta.

Miriam Dalmas, a consultant in public health, explained that 30% of deaths in Malta were the result of cancer and that through the NCP, authorities will aim to reduce the incidence of cancer, improve rates of survival through quicker diagnosis and better screening, as well as improve patient experience and quality of life.

Dalmas also argued that there was an economic case to be made for the plan, explaining that the set of diseases were a cause of substantial years of potential life lost – an estimate of the average years a person would have lived in the absence of a premature death.

Christopher Barbara, head of the pathology department at Mater Dei Hospital (MDH) underscored, first and foremost, the importance of the plan educating people in terms of diet and lifestyle to prevent cancer, as well as on the need for regular check-ups that could help in identifying the disease early on.

In addition to this, he said it was imperative for there to be shorter turn-around times for diagnoses through better tracking of patients, making results available electronically and the introduction of more biomarkers for cancer detection.

Asked by Opposition health spokesperson Claudette Buttigieg whether the wealth of information being collected from these tests is being used for research, Barbara said that the pathology lab gets roughly 4 million test results a year and works hand in hand with the University of Malta to facilitate research.

Histopathologist James Degaetano spoke about the need to keep improving methods of diagnosis. “A hospital is only as good as its pathology department,” he said, stressing that proper diagnosis of an ailment was key to successful treatment.

For this reason, he said, the department was constantly working to increase its collection of antibodies which are required to detect markers for the presence, severity and development of different cancers.

He said that while the turn-around time for most test was relatively short, there was a particular problem with pap smears, which he said can take up to a month, mainly due to a lack of trained personnel.

Degaetano also insisted that it was essential for the treatment to be based more on multi-disciplinary meetings. He said that policy decisions needed to be made to support this, by increasing both financial and human resources. This was echoed by Stefan Laspina, the head of department of oncology at MDH, who insisted that a multidisciplinary approach was now “the standard of care” worldwide, adding that the new plan made provisions for this.