Contents
Around the program of prevention in people genetically at risk of developing the disease, incl. A lot of emotions aroused in the case of breast cancer thanks to Katarzyna Piekarska, KO MP. The author of the program, an internationally recognized specialist in the field of clinical genetics, Prof. Jan Lubiński. In his opinion, emotions are justified and the program needs to be changed. What kind? He answers in a conversation with Medonet.
- In Poland, there are about 3 million people with a high genetic predisposition to develop cancer, less than 30. is covered by the program
- This is certainly not enough and it needs to be changed – says prof. Lubinski
- If a patient with a hereditary cancer disease calls the facility and hears that there is no chance to make an appointment, it is understandable that she reacts emotionally – she emphasizes
- We need a small group of specialists – mainly program implementers – to work on the program, because when it breaks down on officials, many important matters are lost on the way – adds the professor
- Without this program, there is no chance for specialist care – summarizes the expert
- More information can be found on the Onet homepage
Are the emotions around the program justified?
Prof. Jan Lubiński is the creator of the prevention program, incl. in breast cancer. The program was launched in 1998. The program got loud when Katarzyna Piekarska, KO MP, wrote in social media a few days ago that she had been diagnosed with breast cancer. She accused the health ministry of taking away free examinations from women. The Minister of Health, Adam Niedzielski, assured that nothing like that was happening, and that the program was only “redefined”.
According to prof. Jan Lubiński, the author of the program, which has been running for almost 25 years, is an unnecessary “blowing the topic”, although the emotions themselves are justified.
– If such a carrier of the BRCA1 gene mutation, i.e. genetically burdened with breast cancer, calls the facility and asks for tests, and hears that there is no chance for a visit, it is no wonder that she reacts very emotionally – said Prof. Lubiński, head of the Department of Oncology and the Department of Genetics and Pathomorphology at the Faculty of Medicine, Biotechnology and Laboratory Medicine, Pomeranian Medical University in Szczecin.
At the same time, the specialist in the field of clinical genetics emphasized that there are about 3 million such patients with a high genetic predisposition to developing cancers of the breast, ovary, colon, endometrial cancer and several rare diseases, e.g. retinoblastoma in Poland. The risk of disease in them ranges from 30%. up to 60-70 percent as is the case in carriers of the BRCA1 gene mutation.
In short, the program is to allow people hereditary at high risk of breast, ovarian and colon cancer to be detected, properly diagnosed and under specialist care.
– This care is not the same as for the average Kowalski. Genetically burdened women must have their breasts MRI performed once a year. And patients, e.g. with a predisposition to Lynch syndrome, must have a colonoscopy every two years from the age of 25. – explained prof. Lubinski.
In addition, when a woman has a BRCA1 gene mutation, preventive treatments should be additionally carried out, as was the case with, for example, actress Angelina Jolie.
– Without this program, there is no chance for specialist care – summed up prof. Lubinski.
What tests are in the program?
Follow-up examinations of patients as part of this program include, inter alia, Magnetic resonance imaging, mammography, breast and vaginal ultrasound, CA 125 marker. In the case of colon risk, it is additionally colonoscopy, and in endometrial cancer, premenopausal hysteroscopy and prophylactic procedures – removal of the ovary, fallopian tube, removal and reconstruction of the breast.
– What will probably be born now is the extension of the program with elements in nutrition. We are one step away from introducing it to these people. It is a diet based on arsenic, selenium, zinc, copper, lead and manganese. If necessary, the diet would be supported by supplementation – said prof. Lubinski.
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Too few patients included in the program
The expert noted that in fact, after so many years of operation of the “Program of care for families of high, hereditary risk of developing selected malignant neoplasms”, it should, of course, be extended.
– Of these three million people, about one million patients should definitely be included in the program. Now less than 30 have a chance for such research. patients. This is certainly not enough and it needs to be changed – emphasized the expert.
In his opinion, a good solution, in accordance with the announcements of the Ministry of Health, will be that from September 1 this year. these benefits are to be financed by the National Health Fund, and not by the ministry. This pool will increase by an additional PLN 54 million.
– I’m sure there will be more funds. Thanks to this program, we will be able to cover more patients. It is a good move – he pointed out.
Many institutions had doubts about financing
Prof. Lubiński also pointed to a problem that could have caused media publicity. Well, the letter sent by the Ministry of Health to the operating clinics implementing the program was not precise and raised some doubts as to the further financing of the research.
– Also as the manager of such a facility, I called and received information that the intention was that the financing would be extended. Some institutions, waiting for explanations from officials, suspended admitting patients, hence this misunderstanding, which gained media attention – said prof. Lubinski.
Every cloud has a silver lining
According to prof. Lubiński, this example of a “stumble” that happened against the intentions of the parties can only make everyone aware of what may happen if there is no such research. At the same time, he added that changes to the program should be consulted primarily with specialists in the field of oncological genetics, i.e. with people who actually participate in the implementation of this program.
– I, for example, do not know about developmental defects, despite the fact that I am a geneticist. There are very narrow specializations here. I would like to avoid that the program will be decided by random people, which is often the case when it is consulted at the official level. Many things are lost then – pointed out the professor.
He also noted that in oncological genetic clinics, of which there are currently over 30 in Poland, certified doctors in the field of clinical genetics of cancer should work, and they are constantly educating themselves, because the progress in this area of medicine is very fast. They should be supervised by a group of experts, consisting mainly of people who implement the program. In addition, a pool of research that would be carried out under this program should be distinguished.
– It cannot be that at the moment the patient is enrolling for the examination and waiting for several months. It cannot be, in other words, a normal queue at the National Health Fund. The patient has to come in one day and several tests should be done – he explained.
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