world cancer report - iarc

TELEMEDICINE
The prospects for telemedicine in cancer
treatment primarily involve information
distribution for quality assurance and
sharing of medical technology resources.
The Internet provides a powerful platform
for information and knowledge distribution
worldwide. Routine use of telemedicine
is currently limited to developed
countries. The impact of telemedicine in
developing countries remains limited
since Internet access is often restricted.
In developed countries, sharing of medical
technology resources among health
care institutions is likely to increase
markedly with the development of
advanced Internet-based services. These
may include remote diagnosis, telemedical
services such as remote image processing
(including 3D or virtual reality for
diagnosis or training), remote therapy
planning (e.g. in radiation therapy) and
expert system counterchecks (e.g. to
monitor treatment courses) which may
improve treatment outcome at affordable
costs.
REFERENCES
1. Vetto J, ed. (1999) Current Practice and Therapy in
Surgical Oncology, Hagerstown, MD, Lippincott Williams &
Wilkins Publishers.
2. Feig BW, Berger DH, Fuhrman GM, eds (1998) The M.D.
Anderson Surgical Oncology Handbook, Hagerstown, MD,
Lippincott Williams & Wilkins Publishers.
3. Mion F, Grozel L, Boillot O, Paliard P, Berger F (1996)
Adult cirrhotic liver explants: precancerous lesions and undetected
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4. Bremers AJ, Rutgers EJ, van de Velde CJ (1999) Cancer
surgery: the last 25 years. Cancer Treat Rev, 25: 333-353.
5. Fisher B (1999) From Halsted to prevention and beyond:
276 Cancer management
Today, with modern network capacities no
longer limiting electronic medical data transfer,
the management of huge quantities of
information and quality assurance are the
major challenges in advanced medical informatics.
Although much effort has been
directed towards the development of electronic
patient records, no truly authoritative
standard has thus far evolved (European
Committee for Standar- dization, Technical
Committee for Health Informatics,
http://www.centc251.org/).
In developed countries, most hospitals rely
on electronic data processing as the means
of delivering services. Individual medical
departments often employ their own digital
information systems. In most instances,
these applications will have been implemented
over many years without reference
to sharing, and communication, even within
the hospital information system, may not
be practicable due to proprietary communication
standards. In effect, within a single
health care institution, relevant patient
information is distributed in numerous
information systems without proper
exchange capabilities. Attempts have been
advances in the management of breast cancer during the
twentieth century. Eur J Cancer, 35: 1963-1973.
6. Berry DP, Maddern GJ (2000) Other in situ ablative
techniques for unresectable liver tumours. Asian J Surg, 23:
22-31.
7. Luck AJ, Maddern GJ (1999) Intraoperative abdominal
ultrasonography. Br J Surg, 86: 5-16.
8. Partensky C, Maddern GJ (1999) Pancreatectomy after
neoadjuvant chemoradiation for potentially resectable
exocrine adenocarcinoma of the pancreas. In: Mornex F,
Mazeron, JJ, Droz, JP, Marty, M eds, Concomitant
Chemoradiation: Current Status and Future, Paris, Elsevier.
made to utilize Web technology to create
integration platforms, with HL 7 as the
communication standard (Health Level 7,
http:// www.HL7.org). However, disadvantages
apply with respect to data handling,
security and speed of performance.
An alternative, as integration middleware,
may be CORBA (Object Management
Group, http://www.omg.org/) but commercial
applications still have to prove
their value in clinical routine.
Only broad distribution of electronic infrastructures
in health care will allow the
integration of beneficial telemedical services
into medical practice. In developed
countries, the evolution of electronic
patient records promises extensive
advantages in terms of quality assurance
and cost-effectiveness of patient treatment.
In developing countries, ubiquitous
access to Internet information sources
will help tremendously in the distribution
of medical standards and knowledge
(Ricke J and Bartelink H, Eur J Cancer 36,
827-834, 2000; Wootton R ed., European
telemedicine 1998/99. Kensington publications,
London 1999).
WEBSITES
Society of Surgical Oncology (USA):
http://www.surgonc.org
European Society for Surgical Oncology:
http://www.esso-surgeonline.be/
World Federation of Surgical Oncology Society:
http://www.wfsos.com/
On-line Medical Dictionary (CancerWeb):
http://cancerweb.ncl.ac.uk/omd/