Treatments for metastatic breast cancer (MSC), which affects thousands of women each year in Europe, have progressed and can now dramatically extend a patient’s life, but policymakers are still not fully taking this into account, said an expert at EURACTIV.

“There is a lack of knowledge on the part of those who make the decisions”said Dr Fatima Cardoso, president of ABC global alliance, a multi-stakeholder platform specializing in CSM. While there is no cure for MSC, there are now treatments available that significantly extend lifespan, in some cases up to five years, Cardoso said.

Critics suggest that despite advances in innovation that may offer patients with MSC a better chance of stabilizing the disease and extending their lifespan, policymakers continue to move slowly towards adopting these. innovations.

It is estimated that more than 355,000 women in the EU were diagnosed with breast cancer in 2020. But no one can say precisely how many patients progress to MSC, as cancer registries are only interested in diagnoses and mortality, but not relapse.

For Ms. Cardoso, screening and early detection of breast cancer is essential in the fight against the disease. “However, we cannot forget that even when detected early and with the best treatments, 30% of breast cancers will become metastatic”, said the expert.

According to Elena Kountoura, a European lawmaker from the left-wing GUE-NGL party, the first months of 2020 were a huge setback for efforts against the CSM, as breast cancer screening and treatment programs were disrupted or even suspended. , due to limited access during successive confinements.

“The delay and disruption of these services has increased the risk for women to be diagnosed months later, at a more advanced stage.”she told EURACTIV.

Stigma and inequalities

The second element is the stigma attached to the disease.

According to Ms Cardoso, some countries are reluctant to “Spend our resources on people who are going to die”.

“I know, it sounds very strong, but unfortunately that’s what our patients are going through”, she added.

For her part, Greek MEP Ms Kountoura called on societies to move away from the distorted notion that women with metastatic cancer have nothing to expect.

“Right now, newer drugs and more effective treatments, as well as clinical trials, show great promise. It is no longer rare for a woman with metastatic cancer to live more than ten years with a stable disease. To this end, targeted action is needed, both at European and national level ”, she said.

Another problem is that of growing inequalities in Europe in terms of access to therapy, not only from one country to another, but also within the same country.

“It is very common in many countries to treat patients differently, depending on their medical coverage”, said Ms Cardoso.

Dr Fiorita Poulakaki, board member of Europa Donna, the European coalition against breast cancer, said patients face discrimination in terms of work, but also private insurance.

“The reimbursement of multiple medical expenses, including rehabilitation, is not always guaranteed, depending on the country, the type of insurance and so on”, she said.

To make a difference, adds Poulakaki, society’s attitude must first change. “Patients with MSC should be encouraged to move on with their lives and not be discriminated against of any kind. “

“Do as with COVID vaccines”

Earlier this year, the European Commission released a “Beating Cancer” plan based on four essential pillars: prevention, early diagnosis, treatment and follow-up care.

“The plan will support the creation of a new network of expertise, where cancers that are difficult to treat will be addressed and where metastatic diseases will be included”, a European Commission spokesperson told EURACTIV.

The file is currently under discussion in the European Parliament.

Patients and stakeholders have placed their hopes in the Commission’s plan, but Cardoso warned the plan barely touched on the CSM. However, she said he still represents “A great opportunity to end discrimination on advanced cancers, with the necessary changes in the plan”, she said.

Frances Fitzgerald, an Irish MEP from the Fine Gael Party (EPP), told EURACTIV that the public-private partnerships concluded at European level during the pandemic – between the pharmaceutical industry and the European institutions – point the way forward to boost the innovation in the fight against CSM, “As we did with vaccines”.

The Irish MEP said there is more and more innovation from pharmaceutical companies, but it is still very expensive.

“We must encourage research and development of products with the greatest therapeutic value and able to meet the needs of these patients”, she added.

Patients and caregivers are “Companions of suffering”.

The European Cancer Patient Coalition (ECPC) recognizes advances in survival through pharmaceutical innovation, but says the quality of life of breast cancer patients has not improved.

Charis Girvalaki, ECPC, told EURACTIV that patients with MSC will still have to come to terms with and learn to live with an incurable disease, which can induce great psychosocial distress in patients and their caregivers.

“We often say that cancer patients and caregivers are companions in suffering along the cancer journey”, she added.

As to how to better cope with this critical situation, she said EU-wide awareness campaigns should be stepped up and Brussels should develop breast cancer guidelines for women. patients and caregivers in plain language.

Finally, the expert said that it would also be essential to design and deliver appropriate palliative care services for patients with metastatic breast cancer as a central European policy implemented at national level, in order to reduce inequalities care in Europe.

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