I could editorialize...but I won't even bother!

[Lani]

Political decisions harming cancer treatment in Europe; time to stand up and be counted, say oncologists [European Cancer Organization]
Barcelona, Spain: Recent political decisions have had serious consequences for European oncology, said Professor John Smyth at ECCO 14, the European Cancer Conference, today (Monday 24 September 24). Professor Smyth, President of the Federation of European Cancer Societies (FECS) said that the new European CanCer Organisation (ECCO) would take an active role in engaging with policymakers to ensure that future legislation did not have a similarly negative impact.
Professor Smyth cited the Clinical Trials Directive and the recent Directive on Physical Agents (Electromagnetic Fields) as two examples of legislation that had had a major negative impact on oncology in Europe. "In the first, the academic oncology community woke up too late and found that the administrative and financial burden of running clinical trials had increased to the extent that many simply gave up," he said. "Now the Directive on Electromagnetic Fields looks as though it may stop all MRI scanning in Europe. We simply cannot continue to bury our heads in the sand on these issues, which affect doctors and patients alike."
Forthcoming topics of concern were the problems of international collaboration on stem cell research where European countries had widely differing legislation, and the whole area of the escalating cost of cancer treatment. "The successful development of many new anti-cancer drugs in recent years is challenging every health economic programme in Europe," said Professor Smyth. "It is imperative to find ways to improve the cost effectiveness of cancer treatment in general, and particularly the use of drugs. Improving the cost effective use of medicines is a major priority for industry, politicians and the public at large.
"Due to these new and improved treatments, screening, and earlier and better diagnosis, cancer patients are living longer and better lives. But how will the huge financial burden on society that this implies be met? ECCO will be asking governments and the European Commission to consider these issues as a matter or urgency."
ECCO will bring together major players in cancer research, treatment, and care in order to create awareness of patients' wishes and needs, encourage progressive thinking in cancer policy, education, and training, and continue to promote European cancer research and its application through the organisation of multi-disciplinary meetings and conferences, he said.
"The difference between the new ECCO and the old FECS will be that the new organisation has decided to take a far more active role in engaging with policymakers to promote the interests of both cancer patients, those who care for them; and those without whose research there would be no advances in treatment and care," he said. "For too long oncologists have sat back and said that getting involved in politics is not their business, and recent events have shown us that this is an attitude which is no longer sustainable.
" The last two years had given ample opportunity for reflection, said Professor Smyth. "Not only did we consult our members, but we also carried out an audit of many players in oncology, patient groups, media, and other stakeholders. They all told us the same thing - they wanted to see a democratic, representative, and visionary organisation tackle the problems that are currently besetting oncology science and practice. An organisation that would provide consistently dependable information on the state of oncology in Europe, and through that information provision would strive to improve the lot of everyone involved in cancer.
"It is a daunting task, but one that needs to be undertaken. And we will do our very best to carry it out."
European Directive will halt use of MRI scans; cancer diagnosis and treatment will suffer [European Cancer Organization]
Barcelona, Spain: Implementation of the Physical Agents (Electromagnetic Fields) Directive 2004/40/EC in all Member States could effectively halt the use of magnetic resonance imaging (MRI), an important tool in cancer diagnosis, treatment, and research, a scientist told a press conference at the European Cancer Conference (ECCO 14) today (Monday September 24). The Directive is due to be implemented across Europe by April 2008.
The Directive was drafted by DG Employment, with the aim of minimising workers' exposure to electromagnetic fields (EMF). Currently 8 million MRI patient examinations per year are carried out in Europe, said Professor Dag Rune Olsen, who works in experimental radiation therapy at the Norwegian Radiation Hospital, Oslo, Norway, and is chairman of the physics committee of the European Society for Therapeutic Radiology and Oncology (ESTRO). "But these are likely to have to stop, since the Directive sets limits to occupational radiation exposure which will mean that anyone working or moving near MRI equipment will breach them, thus making it possible for them to sue their employers. Even those maintaining or servicing the equipment may be affected," he said.
A British study into operator exposure to electromagnetic fields from MRI, published by the Heath and Safety Executive in June 2007, and carried out by Professor Stuart Crozier from Brisbane University, Australia, found that anyone standing within about 1 metre of an MRI scanner in use would breach the exposure limits laid down in the directive. The Commission has accepted this, and said that it will consider the HSE report together with the study it has commissioned itself, and which is due for publication in October 2007, when deciding whether and how to propose amendments to the directive or to extend the implementation period.
"But they may already be too late," said Professor Olsen. "Slovakia has already implemented the directive, on the grounds that it was based on the assumption that the limits which it sets would have no effect. This would appear to mean that it now illegal to carry out MRI scanning in the country."
The directive in its present form poses particular problems to those healthcare staff who care for patients such as children, the elderly, or those who have been anaesthetised, who need help and comfort during scans. It will also stop the use of MRI for interventional and surgical procedures, and will curtail cutting edge research.
A recent Eurobarometer (Europe-wide opinion poll) showed that most EU citizens felt that they were inadequately protected by authorities against the potential health risk posed by electromagnetic fields. More than two-thirds of people interviewed said that they were not satisfied with the information they received on EMF, and one-third said that they had not been informed at all.
However, in the medical field the use of MRI may lead to less exposure to radiation rather than more, said Professor Olsen. "MRI has to a certain extent contributed to a limit in the increase in the use of ionising radiation in medical imaging, for example, in CT scans. This is important with respect to radiation-related cancer mortality risks and is as such in line with requirements laid down in EURATOM Directive 97/43 regarding optimisation and justification of medical exposure to ionising radiation," he said. "If the public were informed of this I am sure that they would be as keen as I am to see that MRI is allowed to continue. The added value that MRI represents to medical diagnostics has been tremendous.
"Policy-making should be based on sound science, and to my knowledge there is no scientific evidence of long-term adverse health effects of exposure to static or fluctuating magnetic fields that are commonly found during MR scanning. Hasty decisions without scientific support will in this case have a severe impact on medical diagnostics and must thus be avoided. I hope that the Commission will allow a delay in implementation to enable it to examine this issue again and that the Directive could be amended to allow an EU-wide derogation for MRI," he concluded.

[Christine MH-UK]

Oh Lani, this is very bad. That's the problem with the European Union, they don't consult enough before they make legislation. I had read a few months ago through a specialised subscription publication I get at work that the Clinical Trials Directive was bad news, but I couldn't post it because of copyright rules. This doctor is not a lone voice.

Thank you for this. I will alert British breast cancer patients of this. Some of them have media contacts because of that herceptin campaign and some British papers will print any story in which the EU messes up.

Take care,

Christine

[fullofbeans]

..you for bringing this up to our attention..this is ridiculous. I am pro European but man sometimes they come up with the most stupid directives..

Also just generally Lani thank you for posting interesting studies and keeping us informed (editorioalised or not), I for one really appreciate it.

[Christine MH-UK]

According to the Guardian, the EU has decided not to introduce the directive for at least four years while it reviews the scientific evidence (of course, they probably should have done this before they introduced the directive in the first place). Apparently there were quite a few groups that had pointed out the difficulties with the directive, but maybe all our letters helped tip the balance.

http://www.guardian.co.uk/science/20...esearch.health

[hutchibk]

"The successful development of many new anti-cancer drugs in recent years is challenging every health economic programme in Europe," said Professor Smyth. "It is imperative to find ways to improve the cost effectiveness of cancer treatment in general, and particularly the use of drugs. Improving the cost effective use of medicines is a major priority for industry, politicians and the public at large....Due to these new and improved treatments, screening, and earlier and better diagnosis, cancer patients are living longer and better lives. But how will the huge financial burden on society that this implies be met?"

IMO, this is very important to monitor and consider as our country steadily marches toward government owned health care. Yikes.

[Christine MH-UK]

Government-owned healthcare in Europe is not that universally common. The UK is an exceptional case where the government pays for almost all of the care for everyone out of taxes and also provides almost all of it as well, but in the other systems government plays less of a role.

Although Professor Smyth only mentioned European programmes, health care costs are universally challenging, just look at the number of people in the US who can't afford coverage. When I was in the US last summer there seemed to be alot of concern that even people with coverage often didn't have enough coverage.

Ironically, one of the big barriers to sensible reform in the UK is that Britons look at the inadequacies of the US and freak out about any attempt to get the more market involvement in healthcare. So, in the US when they want to block reform they bring out the extreme example of Britain and in the UK they bring out the extreme example of the US and nothing changes that much, which is very convenient for the powerful interests who benefit from the way things are.

"as our country steadily marches toward government owned health care." Hooray!

[vickie h]

I haven't been to this site for awhile, but now that I'm here I want to say AMEN, GRACE. Government healthcare, Yeah!!!!!

[fullofbeans]

Dear Christine MH UK,

Unfortunately I have to disagree with your opinion of the NHS is the only Universical care of the sort in Europe, au contraire.


If you can name me a single western european country that does not cover cancer at 100% please let me know. But has it stand the facts are as follows;

"In the 1880s, most Germans became covered under the mandatory health care system championed by Bismarck. The National Health Service (NHS) in the United Kingdom was the world's first universal health care system provided by government. It was established in 1948. The most comprehensive today is in France, and the second most is in Italy. Other examples are Medicare in Australia, established in the 1970s, and by the same name Medicare in Canada, established between 1966 and 1984. Universal health care contrasts to the systems like health care in the United States or South Africa, though South Africa is one of the many countries attempting health care reform"

http://en.wikipedia.org/wiki/Universal_health_care

The fact that you were under the impression that only in the UK you have universal care is common and was true a long while back. This is unfortunately what it often misrepresentated in the some of the press. I suspect that it an intended message from (?) to justify their poor rate of success compared the other European countries.
<SCRIPT type=text/javascript> vbmenu_register("postmenu_139417", true); </SCRIPT>

[Christine MH-UK]

This is exactly what I am talking about! Universal care and government-owned care are not the same thing at all.

I have lived in Germany, so I know what I am talking about. It has universal coverage, but not government-owned coverage. The difficulty with the UK is that the government tries to do everything in medical care and nobody is willing to change because they all think (wrongly) that if it's not universal care it must be government-owned care.

You could have universal coverage with a much more minimal government role by requiring coverage and having the government provide healthcare vouchers to those who can't afford it. (This is off the top of my head, but I know that the state of Massachusetts is thinking about requiring people to get coverage and helping people who can't afford it otherwise).

In addition to Masschusetts, the State of Maine also has a form of universal health care; premiums are based on ability to pay and recently Maine, which is one of the poorer states if measured by per capita income, was listed (#7) among the top ten states for health care. In fact, the New England states occupy half the positions in the top ten. One reason for Maine's rating was its very low number of uninsured people (9%). In some of our southern states, the number of uninsured is as high as 45%. And New York, my other home state, was 29 in the rankings, which is pathetic considering its wealth compared to Maine. The number everywhere should, of course, be zero but we're getting there, in Maine at least.

I agree, of the EU countries, England is near the bottom in quality of health care. France has an excellent system, as does Italy, and from what you write, I assume Germany does as well. And after reading posts from Ireland, it also seems to have good care While I was still fighting to get herceptin in New York State, herceptin had already been approved for early stage breast cancer in Italy. I was set to leave for Italy when my oncologist managed to get it approved for me in New York, mainly because I had just become eligible for Medicare, which is our form of universal health care. And I celebrate Medicare every day, as my care as been excellent and at very low cost.

[Jean]

when I read your post that you almsot had to go to Italy and leave the good old USA to get hercetpin. It is just unblieveable!

Jean

Thanks Jean. But in the end, I didn't have to leave, and I have had superior care here, better than I ever imagined, in fact. My oncologist has pushed through every medicine and test he thought necessary. It was touch and go until he got herceptin approved, but it's been go ever since. I just wish this could be true for all woman--and if any one had ever suggested I would celebrate turning 65, I would have denied it all the way. And that's just what I did, celebrate.

[michka]

I live in France. Every women, rich or poor can get cancer care... Herceptine, Scans, IRMs.. and choose her doctors. In the private or public medical system. I just hope France has enough money left to keep this wonderful medical coverage.
Michka