Cancer : the hospital opens on the city, the care support also

Published the 17.10.2017 to 18h36

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cancerambulatoireSoins support

The image of the patient with cancer in a wheelchair in a hospital, the arm infused to receive his chemotherapy, is dated. The treatment at the hospital and the supported heavy are still the burden of many patients, but one trend stands out : the chemotherapy and oral support in the city (ambulatory care). It was the thread of the congress of the AFSOS, the French Association for Cancer Care Support.

50% of the chemotherapy by the oral route in 2020

With the advent of chemotherapy by the oral route, at various stages of the treatment, oncologists can now limit the stay of the sick. The outpatient surgery can help some patients out of the hospital just after their operation. The progress of the radiotherapy, also, you can now limit the damage done to the healthy areas, and thus an easier recovery.

Chemotherapy, also, is in progress. Oral treatments are increasingly taking place. Today, tablets and oral solutions represent about one-quarter of the treatments, which patients can take at home. By 2020, nearly 50% of anticancer chemotherapies will be oral therapies. The innovation in the field of cancer benefit in ambulatory care.

A system that is win-win

This development has a double interest. Of interest to patients, first of all, who can stay at home more often, avoid the transport going and return no earlier than after the invasive treatments. By spending less time in the hospital, they also limit their risk of infections with hospital germs, the so-called ” nosocomial infections “.

The benefit is also important for the health Insurance. Most of the chemotherapy is oral, this means for less hospital stays, less equipment and personnel to finance, and less transport will be reimbursed.

“It is a win-win,” explains Dr. Jean-Jacques Zambrowski, health economist, who was interviewed by the editorial staff. “There are not many in health. It delivers clear, better quality, better security and better support “.

(Report made at the 9th congress of the AFSOS, in Paris, on 12 and 13 October)

Better manage the side effects

All of this is necessarily interesting, but if all of the conditions of careful monitoring of the patient and coordinate care between the physicians of the city and the cancer center. It is chemotherapy as it is some care of support, that is to say, all treatments associated with chemotherapy, radiotherapy and surgery, and allow that this treatment is not an ordeal.

In some cases, it is even possible to improve the survival of patients, as demonstrated by a study presented in June at the american congress of oncology, ASCO, and discussed again at the congress of the AFSOS, in Paris, these last days. In placing at the disposal of patients treated for cancer in the city, an application that allows them to enter into relationship with each other and self-reporting the side effects felt, and the doctors are warned more quickly, more early and can better manage them and avoid complications

“E-health is probably going to be one of the tools that will help drive the care to ambulatory care,” explains Dr. Fabrice Denis, oncologist-radiotherapist at le Mans. An option that also makes service for physicians-oncologists. Maintaining a link with their patients, it is possible to consider reducing the number of consultations and the work load for the services.

(Report made at the 9th congress of the AFSOS, in Paris, on 12 and 13 October)

Supportive care in outpatient

The organization of cancer care support is impacted as well as the specific care by the revolution of ambulatory care. The organization of oncology, up to this very (too much), hospital-centered needs to follow this evolution in order to continue to ensure optimal care of patients outside of health facilities.

The development of day hospitals ” ?care support? ” support issues at all stages of the disease, supported by the territorial networks or cancer, the platforms of follow-up at home, through therapeutic education, initiatives, and devices are emerging that will need to be accompanied and harmonised on the national territory.

Whether we like it or not, the development of outpatient care is required, and the AFSOS is committed to taking account of the needs of the sick, left to reorganize the institutions of care in oncology.