From deciding which drugs to prescribe to making travel plans to attend a congress, there’s a lot that the medical community can do to limit the environmental impact of oncology. To mark World Environment Day on June 5, the ESMO Daily Reporter, the official newspaper of the European Society for Medical Oncology, discussed this topic with Mathilde Jalving, MD, PhD. She is the chair of the Society’s Climate Change Task Force and a medical oncologist at the University Medical Center Groningen in the Netherlands.
The One Health approach emphasizes the close connection between the health of people, animals, and the environment. With this approach in mind, the ESMO experts thought about ways they could make a positive change and contribute to bringing about a halt, or at least a slowdown, in the current trends.
Seeking Sustainability
Jalving was asked what sustainability means in the oncology landscape. “In general, sustainability means that our current human activities should not negatively affect future generations. In oncology, this term implies that professionals should be aware not only of the potential effects that their choices in daily practice may have on the environment but also of the direct impact the climate crisis has on how cancer develops and is treated.” The good news is that the scientific community is becoming more and more interested in sustainability. Indeed, numerous studies are evaluating the impact of climate change on health and cancer in particular.
A review published in The Lancet Oncology cites several of the effects that climate change is having on major cancers, from environmental exposures to ultraviolet radiation, air pollution, disruptions in the food and water supply, environmental toxins, and infectious agents. But there are also less obvious, albeit equally important, aspects to consider. For example, extreme climatic events often make it impossible to provide adequate care, which leads to disruptions in national health systems.
What can healthcare professionals do in their daily clinical activity to increase sustainability and to respect the environment? “Obviously, our primary focus is to take care of our patients and deliver high-quality care. However, within these boundaries, we can take simple individual actions to give a good example,” said Jalving.
These actions extend to the oncology community as a whole. Jalving gave the following examples:
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Think about the drug being prescribed. Intravenous administration of therapies produces more plastic waste than does giving the same drugs orally, owing to the use of infusion materials.
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When traveling, choose less-polluting modes of transportation (eg, it’s better to take a train than a plane).
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Reduce unnecessary patient travel by replacing some in-person appointments with phone calls or online meetings.
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Consider treatment deescalation, which results in a wiser administration of medication and reduces potential waste.
Dedicated Task Force
“Although there is a growing awareness that our professional choices have an impact on the environment, guidelines that may advise our practice towards sustainability have not been developed so far,” said Jalving. She and the other experts on the ESMO Climate Change Task Force are focused on the main objective that was set when the team was launched in 2019: to make the Society’s activities more sustainable. One of the ways they do this is by evaluating potential strategies to reduce the carbon emissions of ESMO events. “The first activity of the Task Force was to estimate the greenhouse gas emissions associated with attendance at the ESMO Congress. We found that on average, each attendee generated about 1500 kg of carbon. This kicked off a series of actions toward making the Society and its events more sustainable, including the promotion of train travel, the digitization of ESMO scientific journals, waste reduction at events, attention to reducing air conditioning and gadgets, and providing more sustainable food choices.”
Another action came about when the pandemic arose in 2020. The Task Force, in collaboration with the ESMO Young Oncologists Committee, organized Train to ESMO, a virtual journey that encourages an environmentally friendly alternative to attending congresses and networking.
This article was translated from Univadis Italy, which is part of the Medscape Professional Network.
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