Belgium: Six hospitals collaborate on ‘extra layer of care’ for young cancer patients

A network comprised of six hospitals located across Belgium is aiming to carry out age-specific care dedicated to adolescents and young adults (AYAs) diagnosed with cancer, that is young adults between the ages of 16 and 35 years.

Belgium’s RIZIV insurance committee has given its endorsement to collaborate with those six hospitals as of 1 December.

Minister of Social Affairs and Health Frank Vandenbroucke emphasised the significance of providing comprehensive support to young individuals with cancer.

“Our aim is to offer high-quality, age-specific care to improve their quality of life during and after treatment,” Vandenbroucke stated.

Six hospitals – UZ Leuven, UZ Gent, UZA (Antwerp), CHU Liège Sart-Tilman, Institut Jules Bordet, and Cliniques Universitaires Saint-Luc in Brussels – will now collaborate on this initiative.

In Belgium, these hospitals experience the largest number of AYA diagnoses every year. The collaboration aims to establish a national care pathway to ultimately provide standardised AYA care.

Each AYA team is composed of a multidisciplinary team of experts in the field of cancer care, consisting of at least four disciplines: a specialist doctor, a specialised nurse, a social worker, and a psychologist.

A start-up budget of 600,000 euros has been provided for 2023. From 2024, 1.2 million euros will be released annually for the agreements with the various hospitals. ​

AYA care at UZLeuven

Speaking to Euractiv, Kleo Dubois, project officer of the AYA project at UZLeuven, said “age-specific care is important to meet the needs of AYA [..] both medically and psychosocially.”

UZLeuven has been providing AYA care since 2017. From her experience, she highlighted how, in the medical field, cancer diagnosis is often delayed. “The pathologies are very diverse, whereby the chance of survival has improved but not as much as in other groups of patients, and there is also less access to clinical trials.”

At UZLeuven, ​​“adolescents and young adults are already offered regular care, but their specific needs are not always taken into account in the past […] the hospital is committed since 2017, together with Leuven Cancer Institute, to raising awareness and training healthcare providers, by collaborating between different disciplines and departments,” she added.

Dubois emphasised the need for multidisciplinary teams to cater to this group. “Sufficient expertise is required that can be applied and optimised [..] In the children’s department; young people between 16 and 18 years old do not feel sufficiently autonomous, while young adults in the adult department often feel treated like older patients.”

Dubois said: “We see AYA care as an ‘extra layer of care’ on top of regular care to meet their specific needs.”

Not only is treatment placed as a high priority area, but specific attention is also given to the initial diagnosis as well as ongoing treatment during this stage of life, particularly focusing on their wider support system.

“These stages have a significant impact on AYA’s physical, emotional and psychosocial well-being, at a time in their lives when they are in full development in various domains [ ..] this makes psychosocial support absolutely necessary.”

Boosting access to clinical trials for young patients 

​​At the EU level, Euractiv asked Childhood Cancer International – Europe (CCI) to comment on the Belgian agreement.

Delphine Heenen, CCI Europe regional committee member and head of European affairs said: “In Belgium, around 2,300 adolescents and young adults are diagnosed with cancer every year [..] they are at a crucial stage in their life, where she agrees “high-quality psychosocial support” is needed.

Belgium’s current treatment situation is no different to that in many parts of Europe, where “children with cancer are treated in paediatric oncology departments, and young patients, from the age of 16, can be treated in an adult oncology department”, she noted.

“This has two serious consequences: On the one hand, their chances of survival are sometimes worse than if they were treated in a specialised ward, and on the other, the psychosocial support they receive is not appropriate to their age or needs.”

This needs to be addressed through a better policy and better organisation of care for AYAs across the EU, she said, adding that there is a need for a firmer focus on research in Europe and internationally to offer young patients the best chances of survival.

“More EU-wide collaborations could improve research and knowledge development on AYA-specific cancer types and improve information and access to clinical studies, which are essential to improve clinical outcomes for AYA cancer patients.”

The Belgian initiative aims to provide further improvements in AYA care in the coming years.

Dubois said expanding the team to collaborate with other hospitals allows ways to “continue to work on optimising AYA care, sharing this in the hospital and beyond,” this includes “better access to clinical trials” by bringing awareness and helping AYAs to make informed decisions to participate.

[By Caoimhe Kelly – Edited by Vasiliki Angouridi/Zoran Radosavljevic | Euractiv.com]

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