Malta does not have a national cancer screening programme in place and this is reflected in the fact that the island is one of the worst performers among the 27 EU member states in preventing cancer. The EU has recommended that all members embark on national programmes for the screening of breast, cervical and colorectal cancers, cancer being the second most common cause of death within the EU. Breast, cervical and colorectal cancers account for a third of all cancer deaths in women and 11 per cent in men. And the three types of cancer are considered to be not only the most common cancers but also the most curable if caught early.
Specifically, what is meant by breast cancer screening? Screening means checking for the presence of pathology that may indicate the risk of cancer. This may be done in one of two ways: by ultrasound or by x-ray (mammography).
Malta declared its intention to start a national breast screening cancer programme from 2008 for women aged 50-59 years (mammography screening should be done every three years) but this has not materialised despite budgetary allowances. Of course, simply throwing money at a desire/wish will not suffice in the absence of planning. The required paramedical staff must not only be enrolled but also trained and an organisational infrastructure set up to support such a service, something that perhaps eluded the incumbent Administration when announcing the project.
Interestingly, the Administration's left hand blames the right hand for lack of take-off in that the Ministry for Social Policy complains that the Ministry of Finance is being stingy and not providing sufficient funding, and vice versa. Well, yes, minister/s, these projects are very expensive and better planning and avoiding promising heaven on earth in health care, no matter the cost, especially during electioneering, would have led to a smaller letdown.
A real shame indeed as breast cancer appears to be increasing in Malta, possibly also because of higher numbers of smoking women, though not just due to that, of course. Moreover, as breast disease awareness grows, so do the demands on service. Indeed, for example, the Breast Care Clinic has more than trebled its work over the past eight years.
Costs to the national health service will also rise as new and expensive anti-cancer treatments (such as herceptin) are inevitably made available in Malta. Again, it is all a matter of policy and priority. However, the people have been promised a revamp of the prevailing entitlement system for free medicines, which will reduce waste and inappropriate entitlements, thereby freeing up funds for expensive medications.
On a more positive note, the Mater Dei Hospital Medical Imaging Department is in the process of acquiring a cyclotron, a particle accelerator that can be used to generate isotopes that can be used for PET (positron emission tomography) scanning in the detection and follow-up of cancer.
Moreover, cyclotrons may also be used to treat cancer by a special kind of radiation (proton beam therapy) that penetrates deeply into the body, killing tumour cells while minimising damage to healthy adjacent tissues. This will be a magnificent milestone for dealing with cancer in Malta and, thus, the sooner it is successfully introduced the better.