Oncological diseases: tendencies and perspectives

“On the World Cancer Day, it is important to raise public awareness of the importance of the prevention and early diagnosis of oncological diseases, and the impact of physical activity and a healthy lifestyle on cancer,” says Prof. Elona Juozaitytė, head of the Clinic of Oncology and Hematology of Kauno klinikos, and she stresses that, although science is advancing rapidly and awareness is rising, there is too little participation in cancer prevention programmes paid for by Health Insurance Funds.

Cases of cancer increase every year

As population ages, the incidence of cancer is rising every year. According to the International Agency for Research on Cancer, more than 18 million new cases of cancer are registered worldwide each year, and approximately 9 million people die from cancer. By 2040, the number of new cancer cases is projected to increase by 63.4 %, overtaking even cardiovascular diseases as the leading cause of death.

According to Prof. E. Juozaitytė, around 4 million new cancer cases are diagnosed in Europe every year and around 2 million people die. The most common types of cancer are breast, colorectal, lung and prostate.

Cancer incidence in Lithuania is also rising. The average number of new cases is slightly higher than the European Union (EU) average, i.e. 576.5 new cases per 100 000 population. And the incidence of cancer in men is about 64 % higher than in women.

The spectrum of oncological diseases is very broad. Some, according to Prof. E. Juozaitytė, are more often diagnosed in young people, while others affect the elderly. “With an ageing population and longer life expectancy, more tumours are being diagnosed in older people. However, onco-haematological diseases, sarcomas and brain tumours are more often diagnosed in young patients. Unfortunately, the causes of their occurrence are still unclear,” explains the doctor.

Researchers examine genetic aspects and consider cancer risk factors, as well. The main challenge for all of us, she says, is to reduce smoking and drinking, and to improve our health through good nutrition and active lifestyle. It is essential to step up vaccination against human papillomavirus and hepatitis B virus, to improve public health literacy, and to strengthen scientific development in cancer prevention.

Aim – personalized cancer treatment

The European Commission launched Cancer Action Plan with the main objective to invest in new technologies and scientific research seeking to accelerate progress in treating patients. Many scientific projects are being initiated to understand cancer and its development.

“New molecular and genetic tests are essential, leading to personalized cancer treatment. After all, each person is an individual and each cancer is also different according to its original set of genes. Specific information about the tumour helps to make an accurate diagnosis, plan treatment, monitor its effectiveness, and predict the course and outcome of the disease,” tells a scientist and stresses that cancer cannot be said to be a death sentence, but that it is a chronic disease that is being tackled through different treatment methods.

“The progress in oncological science have opened the door to a new paradigm – personalizing treatment according to molecular changes detected in the tumour. This led to the development of a target therapy – medications, that block the growth and spread of tumour cells by targeting specific molecules “targets”, responsible for tumour development,” says the doctor.

However, the professor states that new therapies have also revealed shortcomings that do not provide a definitive solution to cancer problem: cancer cells can become resistant to targeted therapy. Another problem is that cancer can change during treatment. The initial treatment then becomes ineffective.

“Immunotherapy has opened up new perspectives and has made a significant difference for some incurable patients. Some oncological diseases have become eminently controllable. Advances in radiotherapy are equally important. It is predicted to remain the main weapon in the fight against cancer,” Prof. E. Juozaitytė believes.

The importance of cancer prevention programmes is enormous

The Action Plan for the Implementation of the National Programme for Cancer Prevention and Control 2023-2025 provides for the development of preventive health care services, the creation of an informed and healthy society, and the improvement of the organisation and implementation of cancer screening programmes. However, Prof. E. Juozaitytė mentions, that the participation of target population in screening programmes is still far behind the EU average.

“Prevention programmes are regularly communicated to the public, and family doctors are active in this area, but participation is insufficient, even though services are fully reimbursed. This is bad, because many early-diagnosed cancers are perfectly treatable and patients have a chance to recover. Some diseases are untreatable because they have already spread to various organs at the time of the diagnosis – so they are detected too late,” regrets the professor and reminds that breast, cervical, colorectal and prostate cancer screening programmes are implemented in Lithuania.

Women aged 50-69 (inclusive) may participate in breast cancer prevention programme. They have mammographies performed every two years. Breast cancer is the most common cancer among women not only in Lithuania but also worldwide. According to the Institute of Hygiene, it ranks second among malignant tumours.

Cervical cancer prevention programme is for women aged 25–59 (inclusive). Women aged 25-34 years (inclusive) can have a cervical smear test every three years, and women aged 35-59 years can have a high-risk cervical papillomavirus test performed. If the test is positive, a cervical cytology smear based on fluid is performed every five years.

Colorectal cancer prevention programme includes residents aged 50–74 (inclusive). Testing every two years is recommended.

Prostate cancer prevention programme includes men aged 50-69 (inlusive) and men of 45 years old, if their father or brother had a prostate cancer. Blood tests for prostate-specific antigen are recommended every two to five years.

Health Insurance Funds remind that patients who do not fall into the age group defined by the programme, but who are experiencing symptoms and are worried about their health, should contact their family doctor without delay. After assessing your health, he or she will carry out the necessary tests to determine the cause of your ailments and start treatment, and, if necessary, issue a referral for a consultation with a specialist doctor.

(A. Koroliovas photo)

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