The New York Center for Migration estimates that 36,000 foreign mothers are born annually on American soil, and the navy has set off especially when Trump announced a plan to abolish the law. The president of the commission for the preparation and monitoring of the National Plan for the fight against malignant diseases and the president of the Croatian Oncology Society, prof. Eduard Vrdoljak talks to 2019 Calendar Marathi Printable Word PDF File about what is being adopted by the National Plan, which was done by hundreds of experts, and should improve diagnostics and treatment, and reduce mortality from cancer in Croatia. Every year in Croatia, more than 20,000 people are suffering from cancer, and their lives are dying 14,000. The plan is currently in the public debate, and should soon be faced by the government.
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The survival of cancer depends primarily on its type and degree of excellence. We have tumors that are associated with very low survival rates, and in large part they are preventable by primary prevention measures, such as lung cancer and smoking. We also have tumors in our country with low rates of five years of survival, for example colon cancer (50 per cent in five years), and mortality could be reduced by a significant 25 per cent total implementation of the early diagnosis of colorectal cancer. Nevertheless, only 18 percent of us have been called for review and the occult bleeding in the stool.
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I have deliberately started this way, pointing to the importance of primary and secondary prevention measures, health education and the role of the patient himself in his oncological health. If you are on the example of a patient with a suspected cancer, it will show that the application of the National Plan should look like his path through the health system ? How would he be guaranteed to receive timely service and greater chances of survival? The National Cancer Plan, through 20 chapters, dealt with all aspects of oncological care for cancer patients. The path of an imaginary patient would look like this – a suspected cancer patient appears to the general practitioner who examines him and confirms or refuses the suspicion of cancer.
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If suspicion proves to be justified, the patient refers to a diagnostic treatment that must be done using optimal diagnostic tests within three weeks. Before applying any oncology therapy, including surgery, except in the case of urgency, the patient will be presented to a multidisciplinary oncology team that will define the goal and strategy of treatment, give appointments for additional searches, define the date of possible surgery and the necessary pathological tests, the type of systemic oncology therapy and the term of possible radiotherapy.
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The patient will receive an oncologist who specializes in this type of tumor, who will be responsible for his treatment and coordination of all planned parts of the therapy. In this way, through legally implemented multidisciplinarity, each patient in Croatia will have significantly higher chances for optimal therapy, less chance of wrong treatment, and easier, safer and faster path through diagnostic and therapeutic procedure. The plan introduces a multidisciplinary approach, that is, about each patient care of the team of doctors of various specialties. What changes in the patient’s approach to the current treatment?
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So far, we have had declarative multidisciplinarity in our country. When I say “declarative” I think that we have teams in hospitals, but they were incomplete, irregular, did not cover all patients, they were not timely and did not have the rights or the power they needed to be assigned – the decisions of the team must be respected. The National Plan Against Cancer envisages the introduction of a legal obligation to present a pre-team presentation, with HZZO not paying for treatment services if the patient is not presented to the team. Clearly, it is a prerequisite for defining team members for individual cancers, to allow them time for preparation and participation, administrative support, etc.
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We also plan “virtual teams” because we do not have the appropriate number of specialized experts in all environments, especially for specific diseases. In conclusion, in relation to the previous declarative, we plan a true, complete and successful multidisciplinarity. The Plan mentions the establishment of the Croatian Oncology Network, which should link oncology institutions in Croatia and thereby raise the level of care. What will be crucial for a clinic or an oncology department to become part of the network? What are the criteria for selecting a health institution in the network?
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All oncology institutions will become part of a common oncology network. The National Oncology Network is the backbone of our cancer plan. By combining all oncological capacities, uniforming, standardizing diagnostic and therapeutic procedures, optimizing the use of oncology capacities, diagnostic and therapeutic, and continually measuring the outcome of treatment, we will, in my opinion, make more than any measure to correct the appearance of survival of our patients.
According to some data, Croatia has twice as high cancer mortality than the western country, and the National the cancer plan should save between 5,000 and 7,000 lives annually and stop an increase in the number of patients and deaths? Fortunately, Croatia does not have a twice higher cancer mortality than Western Europe. Differences in 2019 Calendar Marathi Printable Word PDF File probability of survival depend on sex (higher for men) and type of tumor. However, in summary, cancer mortality in our country in relative terms is higher by 30% than in Western democracies.