Precise questions, for the present and the future of the Oncological radiotherapy. In front of the institutions, they are the experts of the scientific societies of radio-oncologists, medical oncologists and medical radiologists, together with patient associations, on the occasion of the general states of oncological radiotherapy, promoted by the Italian Association of Radiotherapy and Clinical Oncology (AIRO).
What is needed for the future? And what must be the space for this discipline, one of the three cornerstone (together with surgery and medical therapy) in the treatment of many tumor forms?
Radio-oncologists are needed
Oncological radiotherapy is among the most advanced therapies in the treatment of the tumor, able to offer highly effective, and often decisive treatments, but in Italy it is still underutilized compared to international standards. Although 60% of people with diagnosis of neoplasm requires radiotherapy treatments during the course of the disease, Only 30% access you in our countrythus depriving patients of an indispensable and potentially life -saving therapeutic opportunity.
How was this gap in terms of access? The role of employment dynamics cannot be underestimated, beyond the organizational situations. Radiotherapy suffers from one serious lack of professionalswith only 1,045 radio-oncologists distributed in a non-uniform way on the national territory, in about 200 radiotherapy centers. A deficiency determined by a Insufficient number of enrolled in specialization schools Compared to the available places – only 23 registered in 2024 compared to 170 seats – and by a small number of hours of teaching dedicated to radiotherapy in medical degree courses.
Hence the need, on the one hand, of enhance university educationintroducing mandatory courses of oncological radiotherapy in medical degree paths, to which a greater number of university training credits is attributed; on the other hand, of make the specialization school more attractiveby establishing scholarships dedicated to specializing in radiotherapy, to cope with the concrete threat that, constantly number of specialists, this specialist may almost disappear over the next decade. A very serious threat to the SSN and for Italian oncological patients, who could be deprived of the possibility of accessing these fundamental treatments and not infrequently life -saving.
“Oncological radiotherapy is a strategic discipline in the fight against cancer, but in Italy it is still underutilized And intense in therapeutic paths. Furthermore, the lack of adequate enhancement within the university courses causes one lack of specialistswith only 1,045 radio-oncologists active against a growing question. Only with a concrete intervention on these fronts will we be able to guarantee the avant -garde access to cancer patients throughout the national territory “
Report Stefano Pergolizzi, director of the complex operating unit of radiotherapy of the “G. Martino” University Hospital of Messina and elected president Airo.
The role of specialists
Communication in oncology is a therapy in therapy. More empathy, listening and ability to explain treatment clearly they can make a difference for patients in radiotherapy. And today, those who offer this sensitivity is no longer a minority: the radiotherapist women are 631 out of 1046 registered in Airo (Italian Association of Radiotherapy and Clinical Oncology), more than 60%. Their Communication approach It is a key factor for the quality of care and for the well -being of patients.
Explains Antonella Ciabattoni, secretary of the presidency of Airo (Italian Association of Radiotherapy and Clinical Oncology)
“Doctor women demonstrate particular attention to the relationship, favoring a more open dialogue with patients and this translates into one greater adhesion to therapies and in a reduction in the stress linked to the disease. In fact, women are attentive to relationships and oriented to the dynamics of the relationship for education and tradition, in addition to the wealth of choices, thoughts, personal emotions and innate curiosity, which pushes them to ask questions. And on the questions and answers to them the relationship is built, through a mix of competence, welcome, listening and closeness to the patient “.
Not only is the female presence growing, but Women are the protagonists also at the top of the discipline.
“Women in radiotherapy bring added value Not only in communication, but also in the research and innovation of the sector. Their contribution, together with that of colleagues men, enriches the sector with complementary perspectives. We must continue to promote this presence – continues Barbara Jereczek, Estro President (European Society for Radiotherapy and Oncology) – and encourage the new generations to take this path. The goal is enhance talent and competenceregardless of the genre, for the progress of radiotherapy and the well -being of patients “.
Numerous studies show that effective communication between doctor and patient in oncology improves adherence to treatments and involves a high degree of satisfaction (Empowerment), with the development of a stable therapeutic relationship according to a meta-analysis published on Jama, The doctor’s women adopt a verbal and non -verbal communicative style, more patient -oriented, with a greater emotional involvement and less technical language. Doctor women dedicate more time to interviews, favoring a greater understanding of treatment and implications.
How to optimize treatment paths
It should always be remembered that oncological treatments are based on the choices that, on a case -by -case basis, are made by the team that takes care of the person. Therefore the indications must be identified with particular specificity, also considering safety in any associations of surgical approaches. So the Safety profile evaluation Systemic therapies in combination with radiotherapy must be based on clear criteria and on an adequate data collection process, as highlighted by the most recent international recommendations. The definition of shared security parameters, with particular attention to the toxicity profile and at pharmacological interactions, It represents a fundamental step for a conscious employment of the association between drugs and radiotherapy, and therefore for a truly multidisciplinary and integrated management of all therapeutic weapons available today in the fight against cancer.
It will therefore be fundamental to elaborate in the next few months of care dedicated to the oncological pathologies in which the use of radiotherapy is more effective, to define the correct methods of association between radiotherapy and drugs, starting from scientific evidence already widely available in scientific literature and clinical practice, from which it emerges that from the association between drugs and radiotherapy, in various specific pathologies, no critical issues derive in terms of Additional toxicity.
Marco Krengli, Director of the Radiotherapy UOC of the Veneto Oncological Institute – IRCCS and Air President, highlighted:
“In Italy, radiotherapy is under the amount not for lack of technology or skills, but for lack of a structured path that regulates its use. Our goal is to work with the institutions to guarantee a fair access to this life -saving therapyand to ensure that radiotherapy is always considered on the oncological paths from the early decision -making phases. It is then essential to invest in the training of new specialists, making the teaching of radiotherapy increasingly attractive in the university and specialization path “.
Requests for the future
In short, different needs must be placed on the table. It is essential to enhance the training on radiotherapy, both in medical degree courses and within the specialization courses, for example by establishing dedicated scholarshipsto deal with the lack of radio-oncologists, which risks compromising the offer of radiotherapy over a decade. According to experts, it also has a lot strengthen the role of radio-oncologists In the multidisciplinary teams and promote their greater involvement in regional oncological networks, in the innovative drug committees and in all other decision -making joints dedicated to taking charge of patients and the governance of cancer pathologies, to encourage a real integrated approach to the management of these diseases.
Finally, it is basic to delineate precise therapeutic paths, which fully integrate drug care and radiotherapy, in the oncological pathologies in which the benefit of the association between drugs and radiotherapyand in which the absence of additional toxicity attributable to the irradiation of drugs is proven. All by remembering that taking charge of the oncological patient requires a multidisciplinary approach, in which even the radio-oncologist must play a crucial role, to define the best diagnostic-therapeutic process, and thus guarantee the optimal approach to each oncological pathology.
