A recent report from The Lancet Breast Cancer Commission highlights a concerning reality: many individuals with breast cancer are not receiving the treatment they need. Despite significant advances in breast cancer research and treatment over the past three decades, which have reduced mortality rates by over 40% in some high-income countries, disparities in care persist. These inequalities mean many groups are "systematically left behind, ignored, and forgotten."
Addressing Inequities in Metastatic Breast Cancer Care: A Global Call to Action
One of the most affected groups is those living with metastatic breast cancer. This population faces considerable disadvantages, partly because rates of metastatic breast cancer are not systematically recorded, and their specific needs often go unmet. The Lancet Breast Cancer Commission has emphasised the necessity of establishing systematic recording of cancer rates and enhancing prevention strategies and personalised treatments. The global burden of breast cancer is set to rise dramatically, with predictions indicating three million new cases annually by 2040 and one million deaths. People in low- and middle-income countries will be disproportionately affected. To tackle these gaps and inequities, the researchers advocate for "global collaboration, communication, and empowerment," presenting their commission as a "forward-looking and optimistic road map" to address urgent challenges in breast cancer care and reduce breast cancer rates.
Unveiling Hidden Costs: The Urgent Need to Address Inequities in Breast Cancer Care
A striking finding of the commission is the lack of data on metastatic breast cancer rates, even though 20-30% of early breast cancer cases relapse. The physical, psychological, social, and financial costs of breast cancer are immense but often under-recognized, as current global health metrics fail to capture them adequately. Professor Charlotte Coles from the University of Cambridge acknowledges the success of modern medicine in improving breast cancer survival rates but stresses the importance of addressing the inequities that leave many patients behind. She hopes that by highlighting these disparities and hidden costs, healthcare professionals and policymakers can work together with patients and the public to address them effectively.
Shedding Light on Struggles: Insights from a UK Pilot Study on Breast Cancer Burden
In response to these findings, a UK-based pilot study was launched to provide a snapshot of the economic burden and care needs of people affected by breast cancer. The survey of 606 people living with breast cancer and their carers revealed that nearly all participants experienced physical or well-being issues related to their condition, such as losing a job during treatment or experiencing sexual dysfunction. Financial difficulties were also common, with 27% of patients with early breast cancer and 35% with metastatic breast cancer reporting money problems. Many struggled to cover travel costs for treatment.
Unveiling the True Toll: Addressing the Hidden Costs of Breast Cancer Care
The need for palliative care is evident, with estimates indicating that in 2020, approximately 120 million days were spent with serious health-related suffering by people who died from cancer, and a further 520 million days were endured by patients living with the disease. Dr. Carlos Barrios from the Oncology Research Center at Hospital São Lucas in Brazil noted that even in countries with well-developed healthcare systems, breast cancer patients often receive inadequate support and care. In countries with less affordable healthcare, these costs are more severe, frequently leading to catastrophic spending and impoverishment. The Commission calls for developing new tools to estimate the hidden costs of breast cancer and improving communication between healthcare workers and patients. This would enhance patients' quality of life and guide policymakers to invest in breast cancer prevention and interventions that alleviate suffering, such as early detection, cost-effective therapy, optimal management, and financial protection.
Researchers estimate that up to a quarter of breast cancer cases in high-income countries could be prevented by modifying risk factors, such as reducing alcohol consumption and managing weight. Systematic approaches to identify those at increased risk and equitable access to personalised prevention strategies, including affordable and effective medications and early detection programmes, are essential. Professor Benjamin Anderson from the University of Washington concluded that ensuring access to evidence-based prevention and care, regardless of an individual's location or financial status, would yield significant benefits for patients, families, and healthcare systems aiming for universal health coverage.
Source: The Lancet Breast Cancer Commission
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