An increase in the number of oncological diagnoses is expected in Ukraine in the post-war period, which will be caused by insufficient diagnosis during the war.
This opinion was expressed by the participants of the round table held at the Interfax-Ukraine agency on Wednesday and dedicated to the problem of wartime oncology.
“Today, the influence of stress on the onset of cancer has not been proven, but during the war, all chronic diseases, including cancer, are definitely exacerbated. Therefore, we expect an acceleration in the development of cancer. Interruption in treatment and diagnosis leads to the worsening of the situation. The statistics of oncological diseases after our victory, I think, for many will be a big “surprise” in a negative way,” said Kostiantyn Kopchak, the deputy medical director of the Dobrobut network, said.
According to the forecasts of the deputy director for inpatient work of the Kyiv City Clinical Oncology Center, Tamara Hrushynska, the sad statistics on the incidence of oncology will be visible in 1.5 years.
“Some patients did not have the opportunity to receive the necessary medical care during active hostilities, for example, when there was only one family doctor in the whole city or people did not have the opportunity to get to the clinic. I think the sad statistics will appear in a year and a half. We will see that the number of oncological diseases will increase much, unfortunately,” she said.
She noted the number of patients in the Kyiv Oncology Center has not decreased, people traveled from different regions and received help.
For his part, Ivan Klymniuk, the head of the oncology department of the ADONIS clinic, said that almost the entire country had dropped out of the early diagnosis system for at least six months.
“People focused on survival and safety, they did not think about screening and diagnosis. We will see the echoes of the war in the field of oncology a little later, there will be many neglected forms. If earlier the patient could be diagnosed at the first-second stage, which makes it possible to stop the process, then now we will face the fact that cancer will be detected at the third-fourth stage,” he said.
At the same time, he stressed that now all representatives of the oncological service of Ukraine have consolidated and are providing assistance to patients.
The growth of neglected forms of oncological pathologies is also expected by the head of the parliamentary subcommittee on the prevention and control of oncological diseases of the committee of the nation’s health, medical care and medical insurance, Valeriy Zub.
“This is logical, because there were interruptions in treatment, untimely diagnosis and the inability to go to a medical facility. We predict and, unfortunately, we already see: the number of neglected forms of cancer has been growing in most cancer centers even in recent months,” he states.
Zub considers it necessary to reconfigure the work of the oncology service, since it will be necessary to carry out more complicated surgical interventions and apply more complex chemotherapy regimens.
According to him, the working group created in the Ministry of Health will develop proposals for adjusting the development of the oncological service, taking into account the current situation.
“The task is not to return the oncological service to the form in which it was before, but to make it better, in particular making regional oncology centers better,” he said.
Ukrainian citizens preferred receiving treatment for oncology and cardiac diseases abroad in 2019, just as a year earlier. Foreign specialists point at poor quality of medical documents which patients bring from the post-Soviet countries.
International medical tourism operators voiced such conclusions to Interfax-Ukraine after having analyzed the medical tourist flow to foreign clinics.
According to the Ukrainian Association of Medical Tourism (UAMT), around 160,000 patients left Ukraine for treatment in 2018. Germany, Israel and Turkey were the most popular destinations for medical tourism from Ukraine. During the same time, around 65,000 foreign patients came for treatment to Ukrainian clinics.
Director of the medical tourism agency DeutschMedic GmbH Anna Weegen (Essen, Germany) said that in 2019 almost a half of foreign patients of German clinics were diagnosed with cancer: breast cancer took the lead, esophagus, stomach and colorectal cancer ranked second, lung cancer ranked third. Around one third of foreign patients addressed German clinics for treatment of cardiac diseases and for replacement of arthroplasty.
“High-technology operations are in demand, including robot-assisted surgery and combined therapy for life-threatening diseases,” she said.
Weegen praised the visa-free regime which allows patients to receive medical aid in Germany promptly.
“That is what helped us in 2019 rapidly provide some patients with serious diseases with aid and organize transportation of their relatives,” she said.
Weegen also said that in general the cost of healthcare services in Germany for foreign patients did not change in 2019 for both check-ups and in-patient treatment as it is regulated in Germany in line with the DRG (Diagnosis Related Group) system.
At the same time, an increase in the cost of some kinds of treatment in Germany was caused by the active introduction of new expensive medicines, in particular drugs for targeted therapy for oncology diseases or materials for minimally invasive heart valve surgeries.
Weegen added that in 2019 German clinics and medical tourism operators still received poor quality medical documents from patients.
“We often receive odd handwritten medical reports and poor quality medical images,” she said.
In turn, expert for organization of treatment in Germany Dmitry Ladizhenski (Berlin) also said that the cost of treatment for foreign patients “have been remaining mainly at the same level for many years despite the fact that the price list based on the DRG is regularly updated.” The DRG pricing system significantly facilitates the healthcare budgeting and mutual payments between the government, insurance companies and hospitals.
Ladizhenski also said that the number of patients from Ukraine has increased, which is related, first of all, to the cancelation of visas between the EU and Ukraine.
“Up to 80% are oncology patients,” he said.
In turn, Director General of the foundation Proturmed Mariusz Arent (Gdansk, Poland) said that the number of Ukrainian patients in Polish clinics tripled, to around 10,000 people, in 2019. However, this became possible mainly due to an increase in the number of Ukrainian migrants in Poland.
Arent noted that, according to the Institute of Research and Development of Medical Tourism (Poland), the total number of medical tourists in Poland was around 182,000 people in 2018. He added that Ukrainian patients travel to Poland for treatment of oncology, orthopedic surgery, cardiac diseases and rehabilitation after injuries.
According to Arent, the cost of treatment in Poland for foreign patients did not change in 2019, although in general prices in Polish private clinics usually exceed Ukrainians’ budgets.
Board Member of the Lublin Medicine Cluster Management Marzena Strok-Sadło (Poland) reported that, in 2018 only, 15 providers of medical services (12 private clinics and three state hospitals in Lublin) received 5,787 foreign patients, the majority of whom arrived from the UK and Ukraine.
She added that foreign patients traveled to Lublin mainly for treatment of gynecology, oncology, orthopedic, ophthalmology diseases and for obstetric care. In addition, Polish stomatology, rehabilitation, aesthetic medicine and plastic surgery services are popular among foreign patients. Ukrainians also often visit SPA resorts in Poland. As to the price policy, the expert said that the cost of medical services in Poland rose by 5-6% in 2019.
In turn, Board Chairman of the Turkish Association of Medical Tourism Emin Çakmak (Turkey) said that in general Turkey receives around $10 billion from medical tourists from 165 countries. Around 1 million foreign medical tourists annually visit Turkey, around 45,000 of them were Ukrainians in 2019. The number of Ukrainian patients in Turkey annually grows by 10-15%. The majority of Ukrainian patients travel to Turkey for treatment of oncology diseases and for pediatric rehabilitation.
“Turkey is becoming the most preferred destination for Ukrainian medical tourists. Turkish clinics actively organize their work for this growing flow, for example many hospitals hire Ukrainian citizens who help Ukrainian patients to communicate with Turkish doctors,” he said.
