Outpatient care is becoming more and more important in the treatment of cancer. An opportunity for health insurance, but also for the sick.
The image of the cancer patient in a hospital chair with his arm infused for chemotherapy is dated. Hospital treatment and heavy care are still the burden of many patients, but a trend is emerging: oral chemotherapy and care in town (outpatient care). This was the common thread of the AFSOS congress, the Francophone Association for Supportive Oncological Care.
50% of oral chemotherapy in 2020
With the advent of oral chemotherapy, at several stages of treatment, oncologists can now limit patient stays. Ambulatory surgery already allows some patients to be discharged from the hospital immediately after their operation. Advances in radiotherapy, too, now make it possible to limit the damage done to healthy areas, and therefore easier recovery.
Chemotherapy is also on the rise. Oral treatments are taking up more and more space. Today, tablets and oral solutions account for about a quarter of the treatments that patients can take at home. In 2020, nearly 50 % of cancer chemotherapy will be oral treatments. Innovation in the field of cancer thus benefits outpatient care.
A win-win system
This development has a double interest. An interest in patients, first of all, who can stay at home more often, avoid tiring transportations and come home sooner after invasive treatments. By spending less time in the hospital, they also limit their risk of infections caused by hospital germs, the famous “nosocomial infections”.
The benefit is also important for the health insurance. More oral chemotherapy, for her, means fewer hospital stays, therefore less equipment and staff to finance, and less transport to reimburse.
“It’s a win-win system,” explains Dr. Jean-Jacques Zambrowski, health economist, interviewed by the editorial staff. “There aren’t many healthy. It brings clear progress, better quality, better security and better support ”.
(Report produced on 9e AFSOS congress, in Paris, October 12 and 13)
Better manage side effects
All of this is necessarily interesting, but on condition that all the conditions for careful monitoring of the patient are ensured and care is coordinated between the town doctors and the cancer center. It is with chemotherapy as it is with supportive care, that is to say all the treatments associated with chemotherapy, radiotherapy and surgery and which allow this treatment not to be an ordeal.
In some cases, it is even possible to improve patient survival, as demonstrated by a study presented in June to the American Congress of Cancerology, ASCO, and discussed again at the AFSOS Congress in Paris, the latter days. By providing patients treated for cancer in the city with an application that allows them to relate to each other and self-report any side effects they feel, doctors are warned faster, earlier and can do better. manage them and avoid complications
“E-health will probably be one of the tools that will promote outpatient care,” explains Dr. Fabrice Denis, oncologist-radiotherapist in Le Mans. An option that is also useful to oncologists. By keeping a link with their patients, it is possible to consider reducing the number of consultations and the workload for the services.
(Report produced on 9e AFSOS congress, in Paris, October 12 and 13)
Supportive outpatient care
The organization of supportive oncology care is impacted just as much as specific care by the revolution in ambulatory care. The organization of oncology until now very (too) hospital-centered must follow this evolution in order to continue to ensure optimal care of patients outside health establishments.
From the development of day hospitals for the management of problems at all stages of the disease, from support by territorial or cancer networks, to home monitoring platforms, through therapeutic education, initiatives and systems are emerging which will have to be supported and harmonized on national territory.
Whether we like it or not, the development of outpatient care is essential and AFSOS is committed to taking patients’ needs into account, even if it means reorganizing oncology care establishments.
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