Metastatic Breast Cancer (MBC) in Europe

Guest contribution by MEP Alberto Cirio.

One woman in eight will develop breast cancer. Almost one in three women diagnosed with early breast cancer will develop metastatic breast cancer (source). Only in Italy, 30 000 women are suffering from metastatic breast cancer (MBC), and it seems that the figure is increasing. The good news is that, according to the Italian Observatory on Rare Diseases, the survival rate of women with breast cancer after five years from the diagnosis is now around 87%, but this is not enough. We have to increase the survival rate also for metastatic breast cancer. Science has done its part and hopefully will keep up. Policy is supposed to support it, though unfortunately you cannot eliminate such a problem with a pen line – it requires a continuous effort among multiple actors. In addition, different policy levels have different responsibilities, and a good step forward would be good coordination among them.
As a Member of the European Parliament at the first mandate, I have been experiencing a sense of frustration for what the EU can do. Specifically in health policy, the whole European construction is built upon a Treaty that explicitly attributes this competence to the national authorities, and leaves us with supplementary possibilities as well as with the exchange of best practices. However, this still means there are plenty of measures to be taken at EU level to improve the lives of MBC patients.
For example, one important contribution the EU can bring is through research. The EU can provide for measures to help Member States gather data about the MBC burden, but also it can streamline the financial support for MBC related programmes. Much can be done in this field, and the figures show that Metastatic Breast Cancer must be considered among policy makers’ priorities. A recent survey of GFK-Eurisko for Europa Donna on Italian women aged on average 54- (30% of them are younger than 45) shows many insights into the daily hurdles faced by patients. Increasing their quality of life, with the help of innovation, increases the survival rate, translating to giving back to society mothers, wives, workers that can still contribute to the health and wealth of the people around them. Statistics now register cases of women who live over 20 years after such a diagnosis. This means that a woman under 45 can easily become a grandmother, reach retirement age, and keep enjoying life as much as everyone else. This objective is worth being pursued, although a change of mentality is needed.
Another example would be through measures to improve the support offered to MBC patients to overcome the various challenges brought in by the disease. These patients need help with daily tasks, as well as psychological and financial support. I would like to mention the crucial roles of the European Commission Initiative in Breast Cancer (ECIBC) and the European Pillar of Social Rights – two very important ongoing initiatives that should address MBC specifically and could provide the Member States with an appropriate framework to improve the lives of MBC patients. Moreover, society itself needs to learn, and educate itself to have a different, more supportive attitude towards these patients. Even when the disease has become chronic, MBC patients can keep working and can keep having a life. What should be the normal perception of such women is worth, unfortunately, a targeted policy action – albeit not a legislative one.
As mentioned before, education is key in changing mentalities, misconceptions and fear to talk about one’s disease. I come from the countryside, and in my area already talking about breast cancer creates embarrassment and shame. It will not be easy but it is mandatory that we spread the knowledge about the means of prevention, the importance of early screening schemes, watching out for symptoms, so it becomes clear that breast cancer and specifically metastatic breast cancer is a disease that deserves attention at both the individual and society levels.
In addition, the caregivers should be recognised for their efforts and accompanied in a role they do not choose. I am not referring exclusively to the hard skills, but also to the psychological support that children and family members in general need when a dear one receives such a diagnosis. According to recent research in Italy, 65% of caregivers declare being worried (against 51% of patients), 44% declare being scared (against 28% of patients), and only 2% declare taking it easy (against 30% of patients).
My hometown has around 30 000 inhabitants, the same number of women that suffer from MBC in my country. I therefore have a concrete idea of how important it is to prevent new women from joining this group, to improve the quality of life of these people, and to deploy policy tools to allow sick women to keep being part of a society that badly needs them. Last year, I supported the launch of a multi-stakeholder group policy roadmap in MBC. This document provides for specific policy recommendations to improve the outcomes for MBC patients at EU level, but also in specific countries including Italy. I look forward to seeing the steps done, through these tools, to achieve such an important objective across Europe and beyond.

Alberto Cirio is an Italian MEP (EPP-Forza Italia) elected in 2014. Born in Turin in 1972, he graduated in law and has a long experience in tourism and food. He has been President of the International Fair of the White Truffle of Alba between 2003 and 2010, Minister for Tourism, Sport and Education of the Region Piemonte and coordinator of the Piemonte Expo 2015 directorate. He is a member of the ENVI and AGRI Committees of the European Parliament, and the co-Chairman of the Economic Committee of the Euronest parliamentary assembly.

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