<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Background</bold>: Process mapping (a patient-centred method) and recording the medical, nursing and administrative staff’s views involved in the provision of care help us understand patients’ experience regarding the constraints, delays and bottlenecks of healthcare service processes and identify areas of improvement.<bold>Patients and Methods</bold>: Time information and data were collected through time and motion study with regard to the path patients with breast cancer follow in two public hospitals (sample of 86 patients) and a semi-structured questionnaire was administered to medical, nursing and administrative staff (sample of 14 employees).<bold>Results</bold>: The amount of time required in total for the prescription process was increased up to seve7 times compared to the beneficial amount of time, and the longest delays in patients’ waiting time were observed with regard to the process of chemotherapy (more than 2 hours and 40 minutes, in some cases). About 92.3% of the staff of the two hospitals prioritized the malfunctioning of theCcentralIinformationSsystem as the most important factor and more than 75% of the study participants mentioned that several administrative and technical aspects have a negative and significant effect on the time required to prescribe the necessary medicines for the treatment of patients.<bold>Conclusions</bold>: The lack of understanding of the hospital’s processes and spatial infrastructure by most patients, the lack of an electronic patient record system and central information system are highlighted as the main issues that contribute decisively to the increase in the non-beneficial time that patients with breast cances have to spend nowadays in hospitals of the NHS in Greece.</abstract>

Associate Professor, Faculty of Nursing, National and Kapodistrian University of Athens, Center for Health Services Management and Evaluation

PhD, Faculty of Nursing, National and Kapodistrian University of Athens, Center for Health Services Management and Evaluation

Associate Professor, Faculty of Nursing, National and Kapodistrian University of Athens

PhDc, Faculty of Nursing, National and Kapodistrian University of Athens, Center for Health Services Management and Evaluation

PhD, Former Director of Aghios Savvas Cancer Hospital

MD, HIPPOKRATEION General Hospital of Athens, Department of Health Management, National School of Public Health, Athens

MD, Director of the A’ Oncology Department, Aghios Savvas Cancer Hospital

Professor Emeritus, Faculty of Nursing, National and Kapodistrian University of Athens, Center for Health Services Management and Evaluation

Living with breast cancer: Patients’ journey within the Greek National Health System

<abstract xmlns="http://www.w3.org/1999/xhtml">Background: Despite the documentation of addressing healthcare disparities in detection and treatment of cancer and health outcomes for cancer patients, the inequalities persist. Cancer patients of several vulnerable groups suffer disproportionally the effect of economic crisis on health and healthcare.Patients &amp; Methods: A cross sectional survey was carried out between July and October 2014 in order to assess the cancer patients’ barriers to healthcare access. A total of 426 cancer patients, members of cancer patient organization participated in the study. Data were collected by using an online, self reported questionnaire evaluating three main areas: healthcare access (7 items), economic status and financial burden of the disease (17 items) and the alteration on several aspects related to the disease (8 items) from 2009 to 2014.Results: Approximately 31% of cancer patients reported that they faced barriers to healthcare access for cancer treatment during the last 12 months. The main barriers included long waiting time for a medical appointment (51%) and inability to visit a private physician due to the incapability to pay the out of pocket cost (44%). One in four patient encountered obstacles in medication access which resulted to treatment delay (46%), worsened health status (96%) and increased out of pocket costs (39%).Conclusions: Results suggest that there are vulnerable groups among cancer patients in Greece who suffer disproportionally more the impact of economic crisis on health and healthcare. Healthcare reforms and targeted interventions should be implemented in order to effectively address the inequities in access for cancer patients.</abstract>

Healthcare access for cancer patients in the era of economic crisis. Results from the HOPE III study

<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Background:</bold> Innovation is one of the most difficult words to define, especially when it comes to health technology. The aim of this article is to get a better understanding of the multi-dimensional facet of innovation, how this is valued by different stakeholders and the way forward in order to create innovative interventions for the sake of the patients and the society.<bold>Methods:</bold> A literature search was performed using mainly the PubMed database and reports from various organisations (EFPIA, etc.).<bold>Results:</bold> In the past, innovation in the pharmaceutical industry was the result of the findings of basic science translated into clinical compounds, ending up in marketed drugs. This model is not valid anymore since significant changes reshaped the drivers of innovations and the key players. Rising costs, increased competition, new scientific and technological developments, well-informed patients created a much more challenging environment where coordinated and committed collaboration seemed to be the only way to overcome these obstacles and reach innovation in order to discover, develop and deliver medicines to patients.<bold>Conclusions:</bold> Innovation initiatives have already proved their value by providing solutions to the major challenges the industry faces. It is now clear that a healthy biomedical ecosystem is determined by all stakeholders-academia, nonprofit/for-profit research institutions, government agencies, pharma/biotech industry and patients. Innovation initiatives provide the platform needed in which all stakeholders can meet and share their knowledge in order to deliver through innovation improved outcomes for patients while shaping an efficient and sustainable healthcare system.</abstract>

The Various Shapes of Innovation

<abstract xmlns="http://www.w3.org/1999/xhtml"><italic>Background:</italic> Targeted agents were introduced over past years because of better understanding of oncogenetic mechanisms in metastatic renal cell carcinoma (mRCC). These agents include tyrosine kinase inhibitors (TKIs) such as sorafenib, sunitinib, pazopanib and axitinib.<italic>Methods:</italic> Review of recorded data from patients’ files with mRCC were analysed during the period from August 2008 to December 2014. Those patients were treated by sunitinib as first-line therapy. The data included patients characteristics such as age, sex, ECOG performance status (ECOG PS), number and sites of metastasis and pathological type. Also, we reviewed response to sunitinib therapy, its adverse events and progression-free survival (PFS).<italic>Results:</italic> This study included 26 patients; median age was 56 years with male predominance (76.9%) and 61.5% of patients were of ECOG PS0. Lymph nodes were the most common site of metastasis (38.5%) and 46.2% presented with ≥3 sites of disease. Clear cell pathology was reported in 96.2%. No grade IV adverse events to sunitinib reactions were observed. Thrombocytopenia was the most predominant haematological reaction (46%) followed by neutropenia (38.6%), whilst fatigue was the most reported non-haematological one (50%) followed by diarrhoea (42.3%). Partial response (PR) was found in 30.8% and stable disease (SD) in 46.2%. One-year PFS was 57.7% with median PFS time of 12 months.<italic>Conclusion:</italic> This study proved effectiveness and safety of sunitinib as first-line treatment for mRCC. However, this is a retrospective study and relatively small numbers of patients were included, so prospective studies with larger number of patients are needed for further evaluation.</abstract>

Clinical Oncology and Nuclear Medicine department, Faculty of Medicine, Mansoura University, Egypt

Medical Oncology department, Faculty of Medicine, Mansoura University, Egypt

Metastatic Renal Cell Carcinoma: Sunitinib as First-Line Treatment; Results of a Retrospective Study

<abstract xmlns="http://www.w3.org/1999/xhtml">Cancer is becoming a major public health issue as patients enjoy longer survivals than ever before due to the introduction innovative but expensive drugs in the clinic. In addition, the ageing of the population in Greece is expected to increase the absolute incidence of cancer. The National Health System should rapidly and efficiently adapt to the new challenges, including increased pharmaceutical costs. Resources ought to be allocated rationally and efficiently while maintaining adequate coverage for the insured population. Economising due to large-scale operations should be pursued by the governmental single payor (EOPYY), so that affordable coverage remains feasible. Establishment of mechanisms to deal with new and very costly drugs should be put in place. The major changes in anchor oncologic hospitals are needed in order to play a role as regional leaders in oncologic care, including merging of similar divisions, subspecialisation of services and promotion of clinical research. These major centres could coordinate a host of satellite oncology services in other urban hospitals and in the provinces. In addition, joint operations in training and patient care should be pursued with major private centres, without mutual mistrust or obsolete inflexibilities. The current financial crisis represents an excellent opportunity for revisioning and restructuring oncologic care in Greece, taking into account the societal needs and based on flexibility and efficiency.</abstract>

Reorganisation of Oncologic Care in Greece: A Proposal

AHEAD OF PRINT

Volume 14 (2023): Issue 1 (December 2023)

Volume 13 (2022): Issue 3 (December 2022)

Volume 13 (2022): Issue 2 (December 2022) 6TH HELLENIC CONGRESS OF ONCOLOGY

Volume 13 (2022): Issue 1 (December 2022)

Volume 12 (2021): Issue 3 (December 2021)

Volume 12 (2021): Issue 2 (December 2021) Supplementary Issue: 27th Hellenic Conference of Clinical Oncology

Volume 12 (2021): Issue 1 (May 2021)

Volume 11 (2020): Issue 3 (December 2020)

Volume 11 (2020): Issue 2 (July 2020)

Volume 11 (2020): Issue 1 (March 2020)

Volume 10 (2019): Issue 2 (December 2019)

Volume 10 (2019): Issue 1 (April 2019)

Volume 9 (2018): Issue 1 (December 2018)

Volume 8 (2017): Issue 1 (June 2017)

Volume 7 (2016): Issue 2 (June 2016)

Volume 7 (2016): Issue 1 (March 2016)

Volume 6 (2015): Issue 4 (December 2015)

Volume 6 (2015): Issue 3 (September 2015)

Volume 6 (2015): Issue 2 (June 2015)

Volume 6 (2015): Issue 1 (March 2015)

Volume 5 (2014): Issue 2 (December 2014)

Volume 5 (2014): Issue 1 (July 2014)

Forum of Clinical Oncology

 Why subscribe and read  We would like to present to you the Forum of Clinical Oncology (FCO), the official scientific journal of the Hellenic Society of Medical Oncology.In the Hellenic Society of Medical Oncology we want FCO to serve as a forum, for us all, to communicate clinical and research achievements in English; to share thoughts, opinions, facts, problems and solutions.We envision the journal to be the means, by which our efforts in the fight against cancer will become known to a wider audience, thus establishing our presence in the global setting. FCO publishes original and translational research articles relevant to diagnosis and treatment of cancer, state-of-the-art reviews, case reports, research articles, statements of opinion and comments, all related to clinical practice and basic research. A large number of eminent Greek and Foreign colleagues who participate in the National and International Editorial Boards, with their continuum direction and support, guarantee the high quality of the work published in FCO. In every issue published there will be something new, enjoyable and exciting to be read.  Why submit  We would like to welcome you to the Forum of Clinical Oncology (FCO), the official scientific journal of the Hellenic Society of Medical Oncology.In the Hellenic Society of Medical Oncology we share the view that there are many issues we deal with in our everyday clinical and research practice that are common to our colleagues geographically closer to us, in the Balkans and the Mediterranean basin, but also to those in other parts of the world. That led us to dare "the great leap forward": to broaden the scope of our Greek scientific journal for oncology, published in Greek for the last 10 years, and develop Forum of Clinical Oncology a web based open access journal in English.  FCO will serve as a forum for us all to communicate clinical and research achievements. One of the innovations of the journal is its online management from submission of an article to its publication. Online is more efficient: submitting, reviewing, proofreading, filing and indexing. However, the most important benefit of all is easy universal access.  English has become the common language amongst scientists from around the globe. This is the reason why we chose English as the official language of the journal. Many Greek colleagues have already published work in English in distinguished journals or have studied or worked abroad. We believe that the language change will not be an impediment for our Greek colleagues to present their work in FCO, whereas on the other hand it will allow our colleagues from other countries to participate.  The Forum of Clinical Oncology publishes original and translational research articles relevant to diagnosis and treatment of cancer, state-of-the-art reviews, case reports, research articles, statements of opinion and comments, all related to clinical practice and basic research.  We share the view that there should be no barriers to knowledge and thus, we decided Forum of Clinical Oncology to be an open-access journal, i.e., any work submitted to the journal and accepted for publication shall be made immediately available to the scientific community and the general public, via the journal's website and printed version. Authors are requested to adjust accordingly the information regarding their work they wish to make public. It is the desire of the editorial team to make this journal an interactive educational tool to acquire knowledge and it is addressed to scientists working with oncology.  Please join us in our effort and submit your work to the FCO.  Archiving  Sciendo archives the contents of this journal in Portico - digital long-term preservation service of scholarly books, journals and collections.  Plagiarism Policy  The editorial board is participating in a growing community of Similarity Check System's users in order to ensure that the content published is original and trustworthy. Similarity Check is a medium that allows for comprehensive manuscripts screening, aimed to eliminate plagiarism and provide a high standard and quality peer-review process. 