Prologue

A cancer diagnosis is a devastating and life changing experience.

While dealing with their own feelings of shock and being overwhelmed, the patient is also faced with the strain of telling family and friends and making decisions regarding treatment. At this point, the start of what is called by many the 'cancer journey' can be a bewildering experience. There is the health system to navigate, choices to be made regarding specialists and treatments, endless information to sort through and unfamiliar medical terms to learn. There are also a myriad of questions such as: Where do I obtain information on my type of cancer? Which information can I trust? How do I find a specialist which deals with my type of cancer and how experienced are they? Which treatments will be the most effective for me? Should I pursue complementary and/or alternative treatments, how effective are they and how do I find out about them? Where do I find the latest research findings on new treatments and how do I evaluate them?

More often than not the timeframe to find information and make decisions on treatment can be very short and needs to occur while the patient is struggling to come to terms with their own feelings and perhaps their own mortality.

This could be daunting enough for most people but the majority of people diagnosed with cancer will also face practical, emotional and psychological challenges in addition to their physical treatment. If you live in rural or remote Australia, a cancer diagnosis brings additional concerns of access to services, transportation to treatment and possibly large periods of time spent away from family and local support networks. If you are an Aboriginal or Torres Strait Islander, the remote locality issues can be compounded by cultural and linguistic differences.

Thanks to greater access to medical and health information on the Internet and through national preventative health campaigns, Australians are becoming better informed about health issues. There is also a growing trend that people want to take greater responsibility for their health and well being. As a result, when a disease like cancer is diagnosed, many patients wish to be active participants in their treatment plans. They want and need to feel a greater degree of influence and control.

In order to be active participants and to make informed decisions, patients want to understand the cancer treatment choices that are available to them. In addition to the range of conventional treatments, the use of complementary and alternative medicines and therapies is increasing as patients seek to extend their healthcare choices. This may result in a patient investigating and evaluating possible alternative treatments and therapies relevant to their condition, often with little assistance from the conventional medical practitioners who can be sceptical of their benefits. This scepticism may result in patients choosing not to inform their medical practitioners that they are investigating or using complementary or alternative therapies, some of which may have the potential to affect conventional treatments. However, increased usage of such therapies indicates that patients are voting with their feet.

Cancer control in Australia is largely a positive story with our survival rates being second only to the USA and the number of deaths falling each year. However, these improvements are not equal across the community with disproportionate rates of cancers in disadvantaged groups, including Indigenous Australians and those living in rural and remote areas.

Australia has an ageing population and consequently the incidence of cancer will increase. With earlier detection from enhanced screening and technological advances in treatment, the number of people living longer with cancer will also increase in the future. A number of recent reports, while acknowledging the gains made in recent years in the area of cancer survival, have argued that Australia must provide a national, integrated, evidence driven and consumer focussed approach to cancer care.

In this report the Committee examines key areas of multi-disciplinary and integrated service delivery and the use of complementary and alternative treatments. The report outlines ways in which Australia can continue to optimise choice and improve outcomes for cancer patients as they travel their cancer journey.

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