“We have taken a big step backwards in the early diagnosis of cancers, particularly of the breast, uterus and colorectal. With the onset of the pandemic two years ago, all cancer screenings were effectively cancelled. All medical resources have been directed to Covid care. It was no longer possible to carry out preventive tests”. The collateral damage caused by the virus in the words of Paolo Veronesi, 60, an oncologist like his father Umberto who made a change in the fight against cancer: to be confronted with the weapons of clinical practice and the humanity of those who heal who, with this infallible method, he nurtures the patient’s self-confidence. For Veronesi, there is university teaching and above all the activity and role at the European Institute of Oncology (IEO), where he leads the breast care program. You have just traced the new horizons of the fight against disease in the book “Victoire sur le cancer. On the women’s side: all the treatments to overcome breast cancer”, published by Sonzogno. Next Thursday he will be the guest of “Monitor” live at 9 p.m. on Videolina. At the center of the episode, edited and directed by Simona De Francisci, is the theme of the inequalities triggered by the Covid which has caused so many “collateral victims”.
What happened after the terrible phase of total cancellation of screenings?
“In 2020, the projections took place in spurts. People were afraid. There was still no vaccine and hospitals were considered places of possible contagion. The women skipped a year of preventive exams. In 2020, no one had an ultrasound. In 2021, with vaccinations, hospitals have become safer spaces. Now we are trying to recover”.
What are the consequences?
“Today we see tumors on average in a more advanced state than we used to see in 2019. Before the virus, early diagnosis had improved. We had reached 60% adhesions with screening mammography. We are now below 50%. We have lost thousands of cases diagnosed early. These data do not tell us that there are no tumors, but that many cases will be diagnosed at a more advanced stage, with less chance of cure and requiring more invasive surgical and medical treatments”.
What other “collateral damage” has the Covid caused?
“In 2021, we had problems related to operating theaters and the management of surgical cases. Last year, 400,000 surgeries were missed in Italy due to the virus, although in the field of oncology we tried to save the interventions in which it was necessary to intervene quickly to avoid aggravation of the clinical picture. To this must be added the fact that intensive care is still, for the most part, occupied by Covid patients, the clear majority of whom do not have vax, to understand how far the situation is still very far from normal ”.
Can we make up for lost time?
“Now we are trying to catch up. Resources have arrived, more will be available in the coming months. It is clear that this will take time. The important thing is that confident people return to prevention. Breast cancer, the most common in Italy with 55,000 new cases per year, thanks to early diagnosis, becomes an enemy that can be overcome. In this way, the chances of success increase considerably”.
What does it mean to believe in prevention?
“It is important that people have confidence and do the screening spontaneously without waiting for an invitation from the health services. I observe the specific field of my activity, but the appeal concerns all oncological pathologies: All women, even the youngest, must not neglect prevention. Prevention can make the difference. We now have the opportunity to fight cancer effectively. For cases diagnosed by preclinical mammography and ultrasound, there is an excellent chance of recovery. It is very important to perform the fecal occult blood test. Everyone after the age of 50 should receive an invitation to do this very simple examination at the pharmacy”.
Is there a risk that two years of health emergency will alter the progress that oncology has made in recent decades?
“We are backing down in prevention but, fortunately, oncological and biomedical research into new therapies has not stopped. Last fall, at the congress of the European Society for Medical Oncology, studies and research were presented that cause us to be optimistic. They show the effectiveness of innovative drugs in patients with advanced breast cancer. The research of these two years has produced interesting results not only for the treatment of breast tumors. We are in a period of great revolution on the research front. We see the possibility of curing cancers at an advanced stage, situations which previously did not give much hope. I think that in the next few years it will be possible to see even more interesting results”.
Umberto Veronesi, his father.
“A great teacher, we worked together for thirty years, side by side, until he stopped working a few months before leaving us. Until the age of 90, he never stopped a day. The lesson he left me? Beyond the technique, the surgery and the diagnosis of breast cancer, it taught me to have a good relationship with patients. They loved it. He created with them a relationship of true friendship, esteem, respect and great trust. I try to put his ideas and values into practice. The patient’s trust in the doctor is the prerequisite for recovery. If a patient trusts the doctor, she gets better treatment, follows the instructions, does not seek alternative therapies which can be, as we have seen in the recent past, very dangerous”.
Trust is a recurring word in this interview.
“You have to have faith in medicine and science. It is necessary to contact the doctor immediately, at the first symptom, and it is necessary to refer to the centers of excellence for the diagnosis and treatment of cancer: the so-called “breast units” are active in all regions, certified by our health and recognized by the Ministry of Health”.
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