More and more people know a person who has gone to Europe or the United States for cancer treatment. Isn’t Finland the leading country in cancer treatment anymore?
– Finnish society has succeeded in providing good care equally to everyone. Whether we give the best possible is a different matter, the chief physician of the private cancer hospital Docrates Juha Kononen states.
Treatments must be optimized, as they are given from common funds. According to Kononen, the threshold for introducing new or experimental treatments is also high for this reason.
– The availability of new forms of treatment is also affected by the fact that Finland is a small country whose entire population roughly corresponds to one large American city. For-profit companies are not in a hurry to enter our market to apply for an official license, especially if the implementation of the treatment requires equipment with complex operation and operating mechanisms.
That’s why in recent years there have been cases where Finns seek cancer treatment abroad with their own money.
There are certain types of cancer for which sufferers are more likely than others to seek help from abroad. The price tag can be steep.
The development of medicines is slow
Cancer treatments are constantly developing both in terms of treatments and diagnostics. Currently, the most important forms of cancer treatment are cancer surgery, radiotherapy, chemotherapy and hormonal treatments. Various immunological treatments and so-called precision medicines are also widely used today.
According to Juha Kononen, the development of new medicines is slow. In Finland, up to a decade can pass between the first clinical trials and market entry.
In the world, the situation is different. For example, in the United States, cancer drugs that come to Europe only later are approved much faster.
– The development of new drugs and treatment methods is easier among larger populations. It is also easier to develop demanding surgery, such as pancreatic surgery, in countries with large volumes, such as Germany. The technical success of surgeries is more likely when learning is accumulated continuously and abundantly.
Germany has a 2005 ruling by the Constitutional Court that allows patients access to experimental treatments if the disease is life-threatening, no alternative treatments are available, and there are indications that the treatment could be beneficial. This has enabled the operation of clinics specializing in experimental treatments.
– It is difficult for a layman to know how to evaluate the benefits and harms of experimental treatments. For example, with regard to dendritic cell therapy and various cancer vaccines, evidence of the benefits is still limited, Kononen states.
New forms of treatment from your own pocket
At Docratee, we look for individual treatment for the patient that is best suited to the patient’s situation.
– When the patient comes to us, we carefully map his situation and explain the treatment options according to both domestic and international recommendations. Fortunately, cancer that has sent metastases can usually be treated for a long time. During the course of the disease, situations change and it may happen that at some stage of the disease we have to offer treatment that is not yet available in the public sector, says Kononen.
He points out that every Docratee customer is out of the patients treated with tax funds, and thus reduces the treatment pressure on the public sector.
– On the public side, certain treatment lines are usually drawn, and experimental treatments are not necessarily started at all. When the patient pays for his treatment himself, we also openly discuss experimental and newer treatments, and evaluate whether it is worth trying them.
If Docratee’s own treatment methods have been tried, and the patient does not get help from them, the eyes are turned to the world.
– We first find out all the international forms of treatment for which there is good scientific evidence and recommendations. In the case of rare cancers, we also look to see if a drug trial could be found for the patient in which he could participate. The third option is experimental research, which is based on at least some scientific evidence, says Kononen.
The leading physician of the HUS Cancer Center Johanna Mattson says that there is no statistical data on Finns applying for foreign cancer treatments.
-According to my assessment, applications abroad are low in relation to the number of cancer patients. You may be more likely to seek treatment abroad if it is a rare cancer, the prognosis of the disease is worse, or there are few treatment options.
New treatments on the horizon
Sometimes Docratee refers patients to drug research centers operating in Europe, where meritorious work is done. They give, for example, CAR-T cell therapy, which is not yet available in Finland for solid tumors.
Finding out about international and experimental cancer treatments is everyday for Docratee.
– If we make a random sample of ten of our patients with advanced cancer, we will be able to offer treatment in-house for six of them. For four, we have no treatment to offer, but we are looking into alternatives for them from abroad. Sometimes it’s a slim consolation, but better than nothing.
Most people seek help from abroad for difficult-to-treat cancers, such as advanced cancers of the pancreas, biliary tract, liver, and gastrointestinal tract, as well as brain tumors.
The price of cancer treatments paid for by the patient can range from tens of thousands to even hundreds of thousands of euros. The costs depend on the examinations, treatments, operations, equipment and medicines used.
-A special group consists of patients for whom proton beam therapy is a so-called valid treatment. In their case, a referral abroad for treatment can be made from the public side, and there are no additional costs for the patient, Kononen states.
Kononen is quite optimistic about the future of cancer treatments.
– Just 10 years ago, the life expectancy of certain types of lung cancer was half a year, while now it is already more than five years. Spots of light can also be seen in the treatment of difficult pancreatic and brain cancers.
According to Kononen, a lot of interesting new things are coming, such as new diverse antibody drugs that can recognize, activate or inhibit the function of several cell types at the same time and contain a drug load that is toxic to cancer cells. Their development is biological engineering.
– Interesting development steps are currently being taken in immunotherapy. In the future, cancer treatment will be even more about attracting the body’s own immune defenses to attack cancer.
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