Europe must do more to stamp out lung cancer stigma

DISCLAIMER: All opinions in this column reflect the views of the author(s), not of EURACTIV.COM Ltd.

Significant inroads have been made into cancer treatment, through technology and pharmaceuticals. But barriers remain. [Shutterstock]

Lung cancer is the leading cause of cancer death in the EU and 267,700 people die from it each year across Europe. MEPs and cancer activists call for more to be done to tackle the burden of this disease on the individuals diagnosed, their families and our society.

Lung Cancer Europe (LuCE) is a non-profit pan-European organisation, launched in 2013. One of the main aims is to raise awareness about problems regarding access to treatment and care in Europe. A full list of the signatories to this opinion piece can be found below.

Lung cancer costs the member states €18.8 billion each year, 15% of our overall total cancer related costs. It leads to the greatest loss in productivity of all cancers, and this is all before we consider loss of earnings, impact on caregivers, the cost of co-morbidities and so much more.

Given the significant burden, and the opportunities presented by a greater understanding of genetics and the ability to produce more targeted therapies, so much more can and should be done to support people living with lung cancer.

Working with Lung Cancer Europe, we have committed to taking every opportunity available to us to support the 312,000 Europeans diagnosed with lung cancer each year, of which shamefully only 13% will survive more than five years.

We are committed to working with the European institutions, national governments, economists, regulators, the pharmaceutical industry, healthcare organisations, the media and society, to ensure lung cancer is being prioritised in legislation and regulations.

We are taking the lead in Brussels to help all involved parties tackle this burden and serve the thousands of individuals across Europe each year that find themselves facing a lung cancer diagnosis.

The genomic revolution has marked the beginning of a new era for lung cancer diagnosis and treatment. Current and future diagnostics, surgery techniques, and treatments have and will continue to advance significantly.

But barriers exist in the form of high regulatory hurdles for new medicines, more suited to older less-targeted treatments; high costs of new treatments; and lack of timely in-country approvals, which despite the 180-day timeframe for in-country approvals post EMA authorisation, vary significantly between countries.

More needs to be done in the development of targeted therapies that can overcome the high-levels of resistance seen in even the most recent advances in lung cancer treatment, while providing safe and effective options for the broad spectrum of lung cancer sub-types.

Around 80-90% people living with lung cancer are smokers. Despite the known association, one in four adults across Europe still smoke, and as the pattern of tobacco use across Europe changes, the incidence of lung cancer in women is on the rise.

Other risk factors include environmental pollution, occupational carcinogens and genetics.

Due to its association with smoking, public perception of lung cancer is that it is a self-inflicted disease. This creates a stigma which can isolate patients, and act as a barrier to seeking timely help, diagnosis and treatment, which could ultimately save lives.

Despite all the advances in treatment and care, five-year survival rates remain low in Europe, where 70% of lung cancers are diagnosed in the later stages of disease, and in these instances, curative treatment is not possible for 90% cases.

Screening programs may help to detect lung cancer earlier and reduce the mortality rates, but there are currently no screening guidelines that provide a benchmark for member states.

Focusing specifically on the patient journey means that quality of life also matters. Lung cancer has a significant impact on both the individuals diagnosed and their families. The high levels of co-morbidities, the side effects of treatment, the fear, sadness and anxiety associated with having a lung cancer diagnosis are all very real, but often lack the required attention from the care team made available to them.

Improving patient lives requires a patient-centric approach from a multidisciplinary team, enabling access to treatments against side effects, palliative services, rehabilitation resources, and psychosocial support.

Caregivers are also another important part of the care model, as the social, financial and emotional burden of looking after someone living with lung cancer, or any long-term condition, can also pose significant health and socioeconomic risks to these individuals.

Guidance should include reference to the use of multidisciplinary teams, which offer accelerated referral to specialist doctors and nurses, lung cancer coordinators, early palliative care, rehabilitation, emotional and social support for patients and their caregivers, in a patient-centric, personalised approach to care. 

Further we call upon all stakeholders to support:

  • Combating stigma by raising awareness of the signs, symptoms and risk factors, and encourage preventative or early help-seeking behaviour;
  • The promotion of effective prevention policies, which encourage smoking cessation, reduce exposure to carcinogens and control;
  • More efficient research and development by promoting policies to harmonise and centralise data collection on lung cancer across Europe;
  • Access to new medicines, by directing funds and promoting policies that incentivise research and development, and streamline regulatory processes and approval times.

In all, more must be done to encourage access, to increase awareness, ensure improved diagnostic tools, safe and effective treatments, and surgical procedures. Spending on lung cancer doesn’t automatically translate into improved outcomes, but more effective management of available resources to provide patient-centric care, does.

This is why we believe in the implementation of uniform national lung cancer plans that include guidance on early detection, diagnosis, referral and treatment.

Signatories of this opinion piece:

Henrik Aasved, Lung Cancer Europe member;

Tommy Bjork, Lung Cancer Europe board member;

Biljana Borzan, MEP, S&D group, (SDP, Croatia);

Deirdre Clune, MEP, EPP, (Fine Gael, Ireland);

Maria Pilar Garrido, Oncologist and President of SEOM (Spanish Association of  Medical Oncology);

Nathalie Griesbeck, MEP, ALDE, (MoDEM, France);

Regine Deniel Ihelen, Treasurer of Lung Cancer Europe;

Miroslav Mikolasik, MEP, EPP, (Christian Democrats, Slovakia);

Alojz Peterle, MEP, EPP (Christian Democrats, Slovenia);

Sirpa Pietikäinen, MEP, EPP, (National Coaltion, Finland);

Christel Schaldemose, MEP, S&D group (Socialdemokratiet, Denmark);

Dubravka Šuica, MEP, EPP, (HDZ, Croatia);

Ewelina Szmytke, Vice-President of Lung Cancer Europe;

Charles Tannock, MEP, ECR, (Conservatives, UK);

Stefania Vallone, President of Lung Cancer Europe;

Diego Villalon, Lung Cancer Europe member;

Glenis Willmott, MEP, S&D group, (Labour, UK);

Wendy Yared, Director of the European Cancer League Association;

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