twrama 1990_final oc.. - AMA WA

FEATURE
for both health professionals and consumers alike but the
evidence remains convincing –screening works and the rates of
over-diagnosis are probably smaller than we think. Diagnosing
and treating ductal carcinoma in situ early is a vital element in
Australia’s world-leading low breast cancer mortality rates.
Keeping the focus on the patient is paramount. Australia
leads the world in its commitment to consumer involvement
in healthcare and patient-centred care and a personal and
individualised approach to treatment, is the current expectation.
Genetic profiling and testing and detailed pathology reporting
has allowed the
development of
this personalised
approach. We know
that responsiveness
to all treatments
(surgery, radiation,
chemotherapy,
targeted and
hormonal therapies)
is highly dependant
on the patient’s cancer
and the mutations
driving it. SIBCC
will commence with
two sessions devoted
to personalised
medicine. A lot has
happened in breast
Priority: Elisabeth Black is Convenor of
the Sydney International Breast Cancer
Congress and Director of Research,
Education & Practice Development, Head of
Breast Care Nursing at the Westmead Breast
Cancer Institute.
cancer since the inaugural congress in November 1988.
In this era of personalised medicine, this multi-disciplinary
model will become increasingly important as more precise
information at diagnosis determines the treatment plan and
requires input from a variety of clinicians, specialist breast care
nurses, allied health therapists, general practitioners and other
health professionals involved in supportive and psychosocial care.
Effective coordination and communication will be even more
crucial as our patients progress along the treatment trajectory.
At each stage their needs will change and bring a new set of
challenges to be faced by the woman and the team supporting her.
As more and more women are surviving the disease, they will
be faced with living with the life-long effects (both physical and
emotional) of their treatments. Survivorship care is complex and
many of the long-term side effects of treatment impact adversely
on quality of life. A recent report by BCNA has found that sexual
well-being, a key aspect of quality of life, is often significantly
impacted on by treatment and is one of the longest lasting and
most devastating consequences of breast cancer and its treatments.
Their research found that even though the majority of women
said they had experienced negative changes to their sexual wellbeing,
only 35 per cent of women had spoken to someone about
this. Less t han a
third of health
professionals
reported always
addressing
issues related
to sexual
well being.
Bone health
is another key
area of concern.
Having a
Collaboration: Professor John Boyages
is Chair of the Sydney International Breast
Cancer Congress, Director and Professor
of Breast Oncology, Macquarie University
Cancer Institute and founding Director of the
Westmead Breast Cancer Institute.
sufficiently
large and high
quality oncology
workforce to
manage this
patient load is
a key challenge
for the future. Translating research into evidence-based multidisciplinary
patient-centred care – right across the treatment
trajectory, is another. Access to psychosocial care and support
(particularly for women living with metastatic disease) is another
ongoing priority. The collaborative approach between breast
cancer and consumer organisations together with a strong
commitment to multi-disciplinary breast cancer care have
contributed significantly to our recent advances in breast cancer
care, but we can’t rest on laurels – we need to continue to work
together to maintain the gains we have achieved in recent years
and to prepare for those future challenges looming on the
horizon. ■
References:
1. Australian Institute of Health and Welfare 2011. BreastScreen Australia Monitoring Report 2008-2009. Cancer series no. 63. Cat. No. CAN 60. Canberra: AIHW
2. Australian Institute of Health and Welfare 2010. Cancer in Australia 2010: an overview. Cancer series no. 60. Cat. No. CAN 56. Canberra: AIHW
3. Australian Institute of Health and Welfare 2012. Cancer incidence projections: Australia, 2011 to 2020. Cancer Series no. 66. Cat. No. CAN 62. Canberra: AIHW.
4. Australian Institute of Health and Welfare 2012. Cancer survival and prevalence in Australia: period estimates from 1982 to 2010. Cancer Series no. 69. Cat. no.
CAN 65. Canberra: AIHW.
5. Breast Cancer Network Australia (2011): Sexual wellbeing and Breast Cancer in Australia
6. Brennan, Butow & Spillane (2008): Survivorship Care after Breast Cancer in Australian Family Physician, Vol37, No 18.
7. Cancer Australia ( 2012 ) Breast Cancer Statistics http://www.canceraustralia.gov.au/affected-cancer/cancer-types/breast-cancer/breast-cancer-statistics
8. Economist Intelligence Unit (2011):Getting it all together- Connecting Australian Breast Cancer Care
9. National Breast and Ovarian Cancer Centre (2010): Report to the Nation- Breast Cancer 2010
10. National Breast Cancer Centre (2003). Multidisciplinary Care in Australia: a National Demonstration Project in Breast Cancer. National Breast Cancer Centre.
Camperdown, NSW
11. National Breast Cancer Centre (2005). Multidisciplinary meetings for cancer care: a guide for health service providers. National Breast Cancer Centre,
Camperdown, NSW
12. National Breast Cancer Foundation (2010): National Action Plan for Breast Cancer Research 2010.
October MEDICUS 29