Identifying the main developments in oncology to more effectively orient the care offered by the French comprehensive cancer centres (Fcccs) and stay one step ahead in patient care: these are the objectives of prospective studies conducted by Unicancer, used to understand new trends, major changes and adaptations in oncology by 2025.
The future of oncology: connected patients and care
In the next few years, oncology will evolve to involve less invasive, more sophisticated care, requiring less patient presence in the hospital, the development of telemedicine, patient empowerment and progression of e-health.
French cancer centres are taking the lead in anticipating these developments in the care of cancer patients, for their benefit and that of French cancer research as a whole.
Reinforced role of patients: better informed, better connected, empowered
Patients are increasingly proactive in their treatment journey and want to position themselves as “partners”. They inform the nursing teams of any changes in their symptoms via smartphone applications, very useful for adjusting their treatments.
What adaptations are needed for healthcare Centres?
- Training professionals to adapt to new patient requirements, better informing patients about chronic diseases and making them a genuine healthcare partner.
- Providing general but also personalised information to patients and healthcare workers.
- Working with patients associations to collect and process information arriving directly from patients.
- Implementing tools for measuring patient-reported outcome measures (PROMs), throughout their treatment
Patients as stakeholders in their cancer journey
“Connected” health for more efficient delivery of care
Facilities are going to have to “get on board” with the new technologies that are emerging to support the developments in clinical decision-making backed by big data analyses, automating their management (management of flows, prescription support, etc.). They are also going to have to use new tools to coordinate and monitor patient treatment and care.
What adaptations for healthcare facilities?
- Integrating big data platforms with analysis tools in research protocols, to be able to support clinical decision-making.
- Developing telemedicine with remote consultation by expert specialists, remote monitoring, etc.
- Accelerating automation of processes with automated management tools specifically.
Interaction between healthcare players
The role of healthcare facilities treating cancer will be shaken up in years to come. Private practices will become major hubs. Healthcare facilities will be brought to play the role of “healthcare pathway coordinators” and should develop their partnerships with public facilities currently reorganising into networks.
What adaptations for healthcare facilities?
- Developing management and pathway models.
- Offering more services to patients with coordination of care and services and the creation of links between treatment structures.
- Adjusting territorial partnership strategies by rolling out management tools especially (i.e. Customer relations management).
More targeted, less invasive radiotherapy
Radiotherapy is a changing discipline, as much in terms of the increasingly cutting edge techniques used as in terms of treatment protocols. It is at the heart of current trends towards de-escalation of cancer treatment.
What adaptations for healthcare facilities?
- Enabling patients to benefit from more targeted, fewer and more effective treatments.
- Increasingly use the most cutting edge methods:
- new methods: intensity-modulated radiation therapy (IMRT), respiratory synchronisation, stereotaxis,
- Training of paramedical staff,
- Extending the duration of sessions by taking account of preparation time and quality controls.
Outpatient surgery: standard practices in oncology in 2025
Outpatient surgery will continue to develop over the next ten years. Patients will no longer sleep at the hospital and undergo surgery during the day using less aggressive surgery, more effective organisation and follow-up at home or at one-off consultations in the hospital or even in a private practice. This trend will continue with significant decreases in length of stay after major surgery, in favour of enhanced recovery after surgery (ERAS) programmes.
What adaptations for healthcare facilities?
- Increasing surgical beds with special outpatient surgery units.
- Developing the missions of paramedical staff, pre- and post-operative telephone follow-up.
- Developing professional coordination between hospitals and private practice.
Care pathway and quality of life
Development of targeted therapies, immunotherapy and oral therapies
By 2025, the proportion of oral drug treatments is set to exceed the current 25% to reach 50%, and intravenous chemotherapy in breast cancer, to decrease by 25%. With oral treatments, it will be increasingly possible for patients to be treated at home.
What adaptations for healthcare facilities?
- Better quality consultations.
- Increasing the number of medical oncologists.
- Developing partnerships with private practice structures: pharmacists, general practitioners, etc.
Onco’Link – Oral therapies experimentation
Characterisation of tumours, better understanding them to better treat them
Patient tumour DNA is increasingly analysed to understand the key genetic mutations of those tumours, which make it possible to offer patients “personalised’ treatments as they are fighting these genetic mutations (where there are any), and this throughout the disease.
What adaptations for healthcare facilities?
- Equipping facilities with high-speed with high-speed sequencers and imaging equipment.
- Implementing molecular multidisciplinary team meetings.
- Encourage the creation of new professions.
- Increasing tumour genetic analysis.
Development of therapeutic interventional radiology
Interventional radiology is a major area for innovation, at the crossroads between imaging and surgery, technology and science. It meets a high societal demand for offering effective and less aggressive treatments. Interventional radiology will make it possible to replace certain types of surgery by less invasive procedures.
What adaptations for healthcare facilities?
- Obtaining more funding, currently a significant obstacle to development of practices.
- Creating operating rooms dedicated to interventional radiology.
Integration of supportive care throughout the healthcare pathway
Supportive care, far from being secondary, provides essential support for patients with cancer and it is set to develop in the coming years. By 2025 it will be considered essential to all patients treated for cancer, with a proven impact on health results (fewer non-scheduled hospitalisations, fewer relapses, etc.).
What adaptations for healthcare facilities?
- Harmonising supportive care offered to patients.
- Increasing and extending funding coverage.
