Editorial

The government has just launched a €10 million national cancer plan, which lays stress on prevention and the early detection of cancers that every year claim the lives of about 800 people.

This is, of course, welcome and commendable but, in order to ensure what is being proposed can be implemented, there are some considerations to be made.

Costs would, of course, come to mind first. The country already has to foot a huge health care bill, which, some argue, is unsustainable. Is the proposed cancer plan feasible and how will it be funded?

And will sex education and sexually transmitted disease prevention go hand in hand with the proposed national cervical cancer vaccination scheme? It has to for otherwise youth risk harbouring a false sense of security because casual sex leads not only to the human papilloma virus (that predisposes to cervical cancer) but also many other microorganisms, including the HIV virus. It is envisaged that the initial phase will attempt to vaccinate young girls before their sexually active years while a more organised cervical cancer screening programme will be launched in 2014, targeting women aged over 20.

A colorectal screening drive also forms part of the project, testing individuals aged between 60 and 64 years with a faecal occult blood test.

The plan also aims to fast-track possible cancer cases, speeding up access to diagnostic tests and surgery through the introduction of predefined protocols and guidelines, including dedicated slots for the medical imaging of cancer diagnosis as well as dedicated appointment specialist slots and surgery for urgent diagnostic cases in order to ensure this is carried out within one week of the initial patient consultation.

It is also envisaged that the national formulary for free medicines will continue to expand to include more – and costlier – cancer medications, with a projected €64 million to be spent on all medications by 2011.

A PET/CT scan that will help to pinpoint cancer will be installed at Mater Dei Hospital next year through an agreement with the Swiss government. This will cost another €2.8 million.

The proposed national cancer plan will attempt to increase psychological and spiritual support for patients and include training for doctors in communication skills, as in passing on bad news.

Cancer research is also included in the plan as well as strategies that will address environmental and lifestyle causes that predispose to cancer such as smoking and alcohol consumption as well as scrutiny of air quality and renewable energy and, in general, measures that promote healthy lifestyles.

Doctors are, however, somewhat sceptical with regard to the feasibility of the plan’s implementation in view of the lack of space and human resources at government hospitals. For example, the faecal occult blood test mentioned above will generate 300 new cases of diagnostic endoscopies annually, a test that already has a month-long waiting list.

Doctors are also on record bemoaning the lack of available statistics on morbidity and outcome following treatment, which are vital for auditing and would allow the system to detect specific facets of care that could be improved.

The plan rightly lays stress on prevention and, as the Prime Minister said at the launch, the efforts in this regard must go beyond the health care system.

One thing is clear, if the national cancer plan is to prove successful ­- and success means lives can be saved - there needs to be an all-round effort in terms of top-notch planning, adequate funding, deployment of all available/necessary resources and an all-out fight against wastage and abuse.