Jean-Louis, I gather there’s quite a history to the word sense, nonsense, senseless, because it has been concluded in the past that it’s senseless to have such a late diagnosis in head and neck cancer. People have been talking about senseless, you had a campaign in the past with actors in it, well right now you have the Make Sense campaign. Could you tell me why have you got the Make Sense campaign associated with head and neck cancer?
Clearly the diagnosis was too late; we worked on awareness on head and neck cancer and awareness about the presenting symptoms. So that was the first part of the Make Sense campaign. We had a survey in Europe, across seven countries in Europe, on more than 1,700 individuals from the general population asking them are you aware of head and neck cancer. Less than one in four were aware of this. So when we asked about which symptoms could be revealing head and neck cancer very few gave a good answer. So we said we have to improve the awareness about head and neck cancer, what head and neck cancers are, which symptoms may reveal a head and neck cancer. So that was the first part of the Make Sense campaign last year.
And how much of a benefit could there potentially be by getting more awareness going and perhaps diagnosing earlier?
I think that the presenting symptoms of head and neck cancer are very common; it could be like laryngitis or pharyngitis or otitis so most of the time the people are not very anxious about this symptom. When they consult the general practitioner the general practitioner may, at the beginning, consider that it’s a benign inflammatory disease and to treat with anti-inflammatory drugs or with antibiotics and it’s a loss of time before the diagnosis. So we say we have to improve awareness in the general population but also in the medical population, in healthcare providers including pharmacists, dentists and nurses etc., not only general practitioners. That was our target so we decided to have different forces within the Make Sense campaign: one was to raise awareness in the general population; one was to raise awareness in healthcare providers; one was to raise awareness in politicians and one to improve the emotional support of the patients.
So could you give me some examples of what you have, in fact, been able to do to improve this communication?
Last year we had the first Make Sense campaign and the major goal of this campaign was to improve awareness in the general population as well as in healthcare providers. So we designed a brochure, a leaflet, that was distributed throughout Europe explaining in a very easy to understand way what head and neck cancers are: oral cavity, pharynx, larynx, nasal cavities; the risk factors: tobacco, alcohol and, to a lesser extent, viruses and in particular the papilloma virus and after the presenting symptoms: difficulty in swallowing, change in voice, otalgia, lump in the neck or bleeding. We said should you have one of these symptoms for three weeks, yes, at that time you need a medical examination. That was the leaflet – One for Three.
Now you targeted these to clinicians and to primary care clinicians and also patients.
It was for the primary care specialists and also for the general population so it was distributed everywhere.
So what would you like cancer doctors to do about all of this because clearly there needs to be a closer meeting of the primary care physicians with the cancer doctors?
What we wanted to do with the healthcare provider is to remind them that, for example, an otalgia occurring in a smoker and a drinker could be an otitis but could be also a revealing symptom of a pharyngeal cancer for example. Because, of course, during their life the general practitioner has to treat much more otitis than cancer of the head and neck so there is a confusion in their feeling of what could be an otalgia.
Is there a way that cancer specialists could help the primary care doctors to reach these suspicions more easily?
We have to improve the awareness and after to improve the communication between head and neck specialists and general practitioners. So it’s a continuum in the way of the collaboration between paramedics, medics, including general practitioners, and specialists of the head and neck, dentists and pharmacists.
So what is the take-home message that you would like to leave everybody with?
The take home message is that the earlier the diagnosis, the better the outcome in terms of survival, in terms of cure and in terms of functional results and cosmetic results.