Una bola de nieve está creciendo en los servicios sanitarios: los pacientes supervivientes de cáncer

Abstract

One of the consequences of diagnostic and therapeutic progress in cancer is the increased survival observed in the last few decades in Spain and elsewhere in Europe. New cancer cases are increasing steadily due to population aging, among other factors. Consequently, the number of long-term survivors can be expected to increase in the years to come. This increase will tax healthcare systems, which are already showing the limitations of the present model of follow-up. New scenarios should be assessed and proposed from both the management and clinical perspectives. Although there is insufficient scientific evidence to indicate the most effective way to organize the follow-up of these patients, several approaches are being proposed in other countries to improve the fit between health services provision and the specific needs of these patients. In Spain, these experiences are scarce. However, given the situation, which could be described as a snowball effect, the current model should be reviewed and new approaches discussed in order to provide a more effective response to this situation. This article aims to identify the priorities for cancer survivors from the healthcare point of view, to review organizational approaches in other countries, and to propose a framework, based on the integration of the different levels of health care, including primary care - the Cinderella of this situation - in order to assess various healthcare options for these patients in the Spanish healthcare context.

Características socio-demográficas y clínicas de jóvenes sobrevivientes de cáncer en la infancia y adolescencia

“…En nuestro medio, la Sociedad Argentina de Pediatría ha publicado que sólo un 15% de los adolescentes con necesidades especiales en el cuidado de su salud, de 13 a 17 años de edad, cuenta con un plan de transición estructurado (Breitman et al, 2011). En segundo lugar, en todos los países donde ha mejorado la sobrevida de quienes padecieron enfermedades oncológicas, la transferencia de pacientes pos-tratamiento oncológico, sean pediátricos o adultos, desde los servicios de oncología en los cuales se realizó el tratamiento y seguimiento inicial hacia servicios de atención primaria o de distintas especialidades, también constituye un gran desafío para los sistemas de salud (Ferro et al, 2011).…”

Oropharyngeal Cancer Survival: A Population-Based Study of Patients Diagnosed between 1978 and 2002

“…The continuous increase in the number of cancer survivors along with population ageing in Spain, with a consequent increase in the number of cases, translate into new challenges that have to be overcome by the health care system [18]. Nowadays in Spain, more than 50% of cancer patients are alive after five years of diagnosis and the trend is to increase this percentage [19].…”

“…Meanwhile, there is still much to know about these patients. Studies on cancer survival need to increase follow-up time and broaden perspectives, with the objective of knowing the physical, psychological, and social aspects associated with this illness [18, 30]. …”

Desarrollo del cuestionario español para medir necesidades no cubiertas de supervivientes de cáncer (CESC)

“…; además de barreras en la reintegración a la vida laboral (7)(8)(9) . A ello se añade que los pacientes deben aprender a convivir con la incertidumbre de una posible recaída, y con los controles y el seguimiento clínico que no siempre se administra de manera estandarizada (10,11) . Si bien es cierto que se han producido muchos avances en cuanto a la atención integral del paciente con cáncer, es necesario mejorar la atención a aquellas per-de los resultados del estudio cualitativo previo para conocer las necesidades de supervivientes de cáncer en España (14) .…”