Teleoncology improves the quality of life in breast cancer patients

The increasing popularity of technology and devices in recent years has led to their application in healthcare settings, providing healthcare practitioners with new alternatives for the monitoring and treatment of patients suffering from a wide variety of diseases and ailments. 

E-health, the tech-based digital healthcare revolution, is being used to manage and monitor healthcare. It is helping optimize expenditure, service and care in many cases, and contributing to ensuring the sustainability of the healthcare system.

In relation to this, a final project carried out as part of the UOC's Master's Degree in E-Health has assessed the effectiveness of telemonitoring and telemonitoring devices in the treatment of breast cancer. "The main aim of using these innovative e-health systems is to improve cancer patients' and their families' quality of life," said Laura Pérez Fernández, who carried out this review of the literature under the supervision of nurse and researcher Hilda Maria Rodrigues Moleda Constant.

According to data from the European Cancer Information System (ECIS), over 34,000 new cases of breast cancer, the most common type of tumour in women, were diagnosed in Spain in 2020. "In about 30% of women diagnosed with cancer in Spain, the tumour started in the breast," said Pérez.

The study shows that telemonitoring – through the use of devices or wearables, such as electronic bracelets, apps, messages and telephone or video calls – is a useful tool for the treatment of breast cancer. "Using these electronic devices results in a continuous and objective assessment of the patient's functional recovery by measuring their physical activity," said Pérez. 

Improved quality of life

Breast cancer patients' quality of life is improved by the convenience, efficiency and low cost of these devices, which have already been validated and proven to work. Furthermore, in more complex situations such as in the pandemic, they also provide greater safety for both patients and healthcare staff. "Optimizing telemedicine in the field of oncology, particularly as regards access to audiovisual features that can improve communication between oncologists and their patients, should be a priority," said Pérez. 

The study also notes that there are age and regional differences between patients in the use of electronic devices. For example, teleoncology is used differently in less developed countries, where patients are usually younger, from the way it is used in developed countries, where telemonitoring is generally used by older patients with the help of electronic bracelets or apps. "In addition, it proves the value of telemedicine for other patient populations, which range from those who do not need direct practical therapy to those who are unable to go to traditional clinics because they live in rural or remote areas," said Pérez. 

It is estimated that Spain spends €19.3 billion per year on cancer. Over half of this is paid for by the public health service, and 45% by patients' families. According to the report "Impacto económico y social del cáncer en España" ["Economic and social impact of cancer in Spain"] presented in 2020 by the Spanish Association Against Cancer (AECC), the cost of treatment in the specific case of breast cancer is estimated to be over €58,000 per patient for localized tumours and over €210,000 in cases of metastasis.

Benefits of teleoncology

According to this review of the literature, the application of e-health systems to oncology leads to better control of the symptoms arising both from the disease itself and from the chemotherapy used to treat it. And this in turn results in fewer visits to healthcare facilities. "This type of system leads to fewer and shorter hospital stays and fewer visits to the emergency services linked to the morbidity resulting from the treatment," said Pérez. 

However, although telemedicine and telemonitoring have many benefits, they also suffer from some limitations, such as technological differences between countries. For example, variations between different regions' infrastructures can lead to differences in the ability to implement the technology, as well as to different costs for the same services. "Digital inequalities between regions thus have an impact on equality, inclusion, the ability to exercise the right to health and even democratic stability," she said. 

Furthermore, in addition to the use of various portable devices in oncology settings, wearables for telemonitoring purposes provide greater opportunities for measuring variables and are easy for patients to use in order to track their own activity status. The information fed back by these devices could therefore play a significant role in patient motivation and might even contribute to the early detection of severe symptoms or of worsening patient condition. 

For example, home telecare is particularly suitable for telemonitoring the toxicity associated with chemotherapy or where direct therapy is not required, particularly if patients have difficulty travelling to hospital for physical or geographical reasons.

"Cancer patients tend to become quite 'addicted' to hospital care, and this burden on the healthcare services is compounded by higher costs, procedures and test duplication, and telecare can help with this," said Pérez, also noting that information and communication technologies (ICTs) enable psycho-oncologists to help patients who are unable to travel, have awkward schedules, want to remain anonymous or do not want to ask for time off work.

In view of this, she believes that new telemonitoring strategies and monitoring systems that help increase cancer patients' treatment adherence and reduce some of the costs associated with this illness must be developed and implemented. In addition, more consistent models and standards in relation to teleoncology devices must be designed and established. "In view of Spain's high breast cancer rates, teleoncology should be deployed in response to this disease and to support its treatment in a widespread manner, as a number of hospitals in the country are already doing. However, telemedicine requires more investment, regulation and training for both medical staff and patients," concluded Pérez.