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Home » Oncology » Multidisciplinary approach to cancer survivorship can help more patients

Professor Aoife Lowery

Consultant Surgeon at Galway University Hospital and Associate Professor
in the Discipline of Surgery, University of Galway

As cancer patients are often able to live longer with modern interventions, a multidisciplinary team in Galway are addressing survivorship, recovery and treatment to ensure the best possible quality of life.

The prognosis for breast cancer patients in Ireland has improved significantly since the introduction of the breast cancer screening programme and improved therapies, including radiation and targeted treatments. The overall prognosis is now 85% — an improvement of 5% in the last 10 years.

Cancer survivorship and tackling treatment issues 

“Most patients diagnosed through the breast cancer screening programme will be diagnosed in the early stages, and we would consider their disease to be curable. There is a five-year survival rate for early-stage breast cancer (stage 1) of 98%,” explains Professor Aoife Lowery, a Consultant Surgeon at Galway University Hospital and Professor in the Discipline of Surgery and clinical lead at the clinical research facility at the newly launched Institute for Clinical Trials at University of Galway.

Professor Lowery is heading research — supported by the Irish Cancer Society Women’s Health Initiative and the National Breast Cancer Research Institute — focused on evaluating pathways for identifying, managing and overcoming side effects of cancer therapies.

Improved chances of survival mean patients face challenges, not just of diagnosis and disease, but of the effects of the treatment they go through. “We are trying to address survivorship issues,” she explains. “This means understanding the burden of cancer diagnosis and cancer treatment. There’s a broad range of issues that patients can face. A lot of them are related to quality of life and the symptoms, side effects and consequences of cancer treatment.” 

We involve patients in our research from
the beginning, as they are the ones
who have experienced cancer.

Addressing issues through multidisciplinary study 

The advantage of the multidisciplinary approach is that people from various disciplines with different perspectives and expertise come together to address a problem. This includes support from dieticians, physiotherapists, translational scientists and bioengineers.

“For example, thanks to funding from DTIF, I am working with a group of bioengineers and anatomists, scientists and a start-up company developing devices that prevent or reduce the toxic side effects of chemotherapy. As doctors, we often view these challenges from a treating clinician’s perspective. An engineer may see it totally differently — bringing those perceptions together is the best way of coming to an innovative solution,” explains Professor Lowery. 

The research is based on the survivors’ experiences. “We involve patients in our research from the beginning, as they are the ones who have experienced cancer and cancer treatment,” she says. “This is the best way to ensure we are doing research that is relevant to them. Similarly, there may be issues clinicians see as an unavoidable side effect of effective cancer treatment that can be hugely challenging to patients.

Improving the care pathway for cancer patients 

The University of Galway Women’s Health Initiative team is leveraging expertise in both cancer care and cardiology to develop a care pathway for cancer patients who are at increased risk of developing heart disease during cancer treatment.

“Cardiovascular disease is one of the main killers of women in Ireland,” says Professor Lowery.” We know cancer treatments can have consequences for the heart, so we are developing a specialised care pathway to identify the magnitude of the risk to our female breast cancer patients. This is being done by conducting blood tests, imaging tests and evaluating patients’ quality of life.” 

Measuring impact on patient care and outcomes 

The research examines the best way to support patients from diagnosis through to survivorship. Professor Lowery concludes: “At University of Galway, we recently launched Ireland’s first Institute for Clinical Trials. The ability to deliver clinical trials is already having an impact because patients who are in the trials are benefiting from the interventions. Also, having an active cancer research environment improves care.

“We need to continue to generate evidence that dedicated multidisciplinary survivorship pathways do improve quality of life. We would then like policymakers to fund this important component of clinical cancer care.” 

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