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Cancer treatment: Innovative substances improve prognoses and quality of life

A paradigm shift in target-orientated cancer treatment
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(Vienna, 31-January 2017) Over the past years, medical research has made immense progress in cancer treatments. New treatments are being approved almost on a quarterly basis, and the scope of application for innovative immunotherapies is being expanded to include further types of tumor. In this way, the life expectancy of patients can be substantially extended and their quality of life significantly improved. Experts speak of a “Revolution in Oncology”. This was emphasized on Tuesday during a Press Conference at the MedUni Vienna / AKH Vienna just a few days prior to World Cancer Day (4.2.).

Huge developments have recently taken place in many areas of tumor treatment. For example, a paradigm shift is currently taking place in the treatment of tumors of the urogenital tract – these tumors are now substantially easier to treat. “Depending on the type of tumor, long-term survival is possible today even in advanced stages, which would formerly have led to the death of a patient within a very short time”, reports Manuela Schmidinger from the Department of Medicine I and the Division of Oncology, Program Director for Metastasized Renal Cell Carcinomas, MedUni Vienna/AKH Vienna.

The latest example is the bladder carcinoma, the ninth most frequent tumor occurring in humans. Until now, the primary treatment for metastasis spread has been chemotherapy treatments with platinum, yet many patients prove insufficiently fit for treatment from the start. Should this treatment fail, hardly any effective further options have been available up to now. For this reason, the metastasized urothelial carcinoma has so far been linked with poor prognoses. 

After more than 30 years without major advancements in treatment, the development of the immunotherapeutic drug Atezolizumab has provided a breakthrough. The monoclonal antibody working against the protein PD-L1 bonds directly with the PD-L1expressed on tumor cells and tumor infiltrating immune cells, and blocks its interactions with the PD-1 and B7.1 receptors. In this way, it is probable that T-cells are activated. "In Europe, Atezolizumab has not yet been approved" says Schmidinger. Due to the positive study data resulting from a phase II study, however, the US American FDA (Food and Drug Administration) has already taken the first steps and has issued the accelerated certification of Atezolizumab. Schmidinger is optimistic that the prognosis for urological tumors will thus be dramatically improved. “By combining the best strategies, the future of urological treatments is becoming substantially more promising. Here immunotherapy in conjunction with both established, target-orientated treatments and with radiotherapy can achieve positive, in part synergetic effects”.

The Comprehensive Cancer Center (CCC) at the MedUni Vienna and the AKH Vienna
The CCC of the Medical University Vienna and the Vienna General Hospital, managed by Christoph Zielinski, who is the Chairman of the University Department I and Director of the Department of Oncology, plays a central role in the continuous improvements in cancer treatment. The CCC, which was founded in 2010, networks all vocational groups from the MedUni Vienna and the AKH Vienna who are involved in the treatment of cancer patients, who conduct research into cancer diseases and who are active in teaching or training in this field. The main pillars of this network are amongst other things the Tumorboards. “These represent the basis for interprofessional treatment recommendations in Oncology and are the key to the individual, optimally-coordinated care of every individual patient including the knowledge from all sources from disciplines concerned with the respective disease”, explains Zielinski.

Furthermore, so-called “Units” have been set up which are intended to build a bridge between the clinical care of patients with certain types of cancer, the clinical research and the basic research. In addition, a platform has been established for ”Molecular Diagnostics and Treatment in Oncology”. This platform bundles the expertise for individualized treatment and promotes research efforts in the field. 

Support in vocational life
In spite of their tumor diseases, patients can now live substantially longer than was the case ten or twenty years ago. Modern molecular diagnostics will further increase the chances of long-term survival. “And with this – in addition to the fact that survival is possible – a new aspect is increasingly drawing attention: the quality of life and how to live everyday life with cancer”, emphasized Paul Sevelda, Chairman of the Department for Gynecology and Obstetrics in Vienna-Hietzing Hospital and the President of the Österreichischen Krebshilfe (Austrian Cancer Aid Association) on Tuesday.

Many people suffering from cancer are fully involved in vocational life at the time of diagnosis. During their treatment, however, most of them are no longer in a position to continue their activities as before. In the initial period of the disease, it is both necessary and understandable that the medical treatment, the progression and the efficacy of the treatment should be the focus of attention in the interests of the patient. However, subsequent breaks from vocational life are generally unavoidable. Those affected experience existential and vocational insecurity during this phase. “In the Krebshilfe Advisory Centers, we have recorded a substantial increase in the necessity of special consultation on the subject of ‘Cancer and vocation’, says Sevelda.

Many patients would like to resume their vocational activities following their treatment, but are not yet able to work at full capacity. Until now, they were practically forced to remain on sick leave until they were 100 percent ready for vocational life again. However, many cancer patients also went to work at full capacity although they felt only 50 percent capable of working, and thus overstrained themselves. The Österreichische Krebshilfe has therefore requested the Federal Government to integrate the possibility of “Part-time sick leave” into the Government program. After seven years of tough negotiations, the part-time vocational reintegration was adopted into law at the end of 2016, and will come into force on July 01, 2017. Then it will be possible to agree with an employer on the reduction of weekly normal working hours for a duration of one to six months – with one possibility of extension (up to three months). Patients – if they are employed under private contracts and were employed prior to their illness for at least three months – have the opportunity to return to the work process stepwise, thus gradually adapting to the requirements placed upon them in everyday working life. 

Krebstag (Cancer Day) at Vienna Town Hall: February 14, 2017
The “Leben mit Krebs” (Living with Cancer) Association will once again be inviting guests on February 14, 2017 for Krebstag (Cancer Day) in the Vienna Town Hall. From 10:00-15:00 hrs, renowned speakers will be providing a comprehensive program of lectures including a panel discussion on the topic of “Krebs 2020” (Cancer 2020) free of charge. “The wide spectrum of treatment options for cancer diseases of the chest, lungs, skin, prostate, intestines, kidneys, bone marrow and lymphatic system are the subject of this program. But also related subjects such as nutrition and rehabilitation for cancer will be addressed”, explains Gabriela Kornek, President of the AKH Vienna.
Further information: http://www.leben-mit-krebs.at

In collaboration with the Ministry for Social Affairs and the Ministry for Health, the Krebshilfe has collected further information related to the subject “Cancer and vocation” and the prerequisites and details of the new “Part-time vocational reintegration law” in a new brochure of the same name. From the beginning of March, this brochure will be available to order free of charge under http://www.krebshilfe.net.