Is a law enough to provide a better prognosis for Brazilian melanoma patients or education is still a gap?

Abstract

According to Brazilian Law 12.732/12 ("60-day law"), cancer patients have 60 days after diagnosis for beginning treatment at the Unified Health System (SUS). The study aimed to evaluate the achievement and effectiveness of the '60-day law' for melanoma patients in a SUS cancer reference unit. A retrospective study analysed 58 medical charts from patients with the initial diagnosis performed before and after the "60-day law". The Law does not change the time interval between diagnosis and the beginning of treatment, and after the Law, patients presented a worse overall survival (p < 0.001). In conclusion, the '60-day law' was not effective.

Impact of the SARS-CoV-2 on the journey of high-risk colon cancer patients within the scope of the Unified Health System in Brazil

“…In Brazil, one of the strategies to minimize the delay in access to oncological treatment and increase the chance of cure was the sanction of the “Law of the 60 days” (Law 12.732/12), which dictates that a patient diagnosed with cancer has priority to be treated in the Unified Health System (SUS) within 60 days from the time of diagnosis [ 34 ]. Although, we observed in this study’s sample that the time to begin treatment exceeded the 60 days required by the law, both before and during the pandemic, a result corroborated by the study of Marcelino et al, carried out in Brazil [ 23 ].…”

“…Late-stage tumors can also be related to the journey of the oncological patient, from clinical suspicion to diagnosis, which is influenced by many factors, such as difficulty in recognizing symptoms, the difficulty of accessing health services, low educational level, also lack of patient commitment [ 22 ]. Moreover, other obstacles hinder the optimal management of cancer patients at SUS regarding the bureaucracies inherent to the public system, culminating in advanced disease [ 23 ].…”

Cancer patients admitted in the emergency department: A single‐centre observational study

“…In this context, ED becomes an essential part of all stages of monitoring the oncological patient. The ED professionals need a much broader‐than‐usual knowledge base in oncology, including treatments' complications, diagnosis of the disease and the management of cancer patients' emotional needs (Marcelino et al, 2022; O'Dwyer et al, 2016). In some scenarios, the patient is diagnosed with cancer in an ED unit because it was the first manifestation of the disease (Keeble et al, 2014).…”

“…The high number of late-stage presentations for diagnosis might be related to the cultural barriers and also patients' lack of education. If they were aware of cancer's signs and symptoms and acted upon them, patients might have more chances to reach the health system with potentially curable diseases(Marcelino et al, 2022). The large number of cancer diagnoses performed in the ED allows us to infer that, in public health, the ED can facilitate access to medical care when the patient has acute symptoms, which contrasts with the delay ated about 1200 patients with nonspecific complaints in an ED and reported 31% mortality in a 30-day follow-up for cancer patients(Karakoumis et al, 2015).…”