From the President: A Missing Element?

29 February 2024

A founding principle of the European Cancer Organisation is the use of a multi-disciplinary, multi-professional approach to improving cancer care. But are we really living up to that ideal?

ECO just launched the ambitious INTERACT-EUROPE 100 project so that healthcare providers from different specialties and professions can train together. This is designed to improve collaboration resulting in better patient care. But what is absent from this and so many other projects is any psycho-social component.

Far too often, incorporating psycho-social support in EU cancer projects feels like an afterthought, at best. I have spent my entire professional life in this field and I have seen firsthand the profound benefits it provides, and the mental and physical pain that can result when initiatives ignore this component.  

For the patient, cancer doesn't confine itself to one body part or one physical system. It has devastating consequences across biological, social, and psychological spheres. Indeed, every aspect of 'being'. And this needs to be addressed in every project we initiate.

Until the field of psycho-oncology was founded in 1977 by Dr Jimmie Holland at Memorial Sloan Kettering Cancer Center in New York, measuring anxiety, and depression, and fatigue was not fully appreciated – or straightforward. Today, however, there are objective scales to evaluate the patient experience and to validate whether psychological interventions are working. Psycho-oncology has become a full-fledged partner in evidence-based science.

So why is it so often overlooked in designing cancer care projects?

One reason is the so-called 'silos of care'. Unfortunately, this enduring challenge affects every medical specialty, even when different professionals are sitting around the same table. We are still learning the language, and the needs, and the techniques of the other specialties and the potential role each could play in the patient's care.

These professional silos have a direct impact on the patient's quality of life and make it difficult, sometimes impossible, to integrate psycho-social support into cancer care initiatives.  

Another reason psycho-social support is so often overlooked is because we do not listen   enough to the needs of our cancer patients. We fail to practice genuine patient-centred care.

We assume that since patients don't understand their disease, they don't understand its psychological impact. But that impact is real, and all too often we fail to ask them about it.  

When the INTERACT-EUROPE 100 was launched in Barcelona two weeks ago, there were plenty of presentations explaining the project and its various components. There was also an offer to expand the training to include additional disciplines and professions.

I sincerely hope they consider adding psycho-social professionals to this novel inter-specialty programme.  Indeed, I would ask all my colleagues working on new cancer care initiatives in Europe to explore the role of psycho-oncology in their efforts.  If patient-centred care is truly our goal, we cannot afford to do otherwise.

With gratitude and warm wishes,

Csaba

Prof. Csaba Degi

President