world cancer report - iarc
world cancer report - iarc
world cancer report - iarc
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TELEMEDICINE<br />
The prospects for telemedicine in <strong>cancer</strong><br />
treatment primarily involve information<br />
distribution for quality assurance and<br />
sharing of medical technology resources.<br />
The Internet provides a powerful platform<br />
for information and knowledge distribution<br />
<strong>world</strong>wide. Routine use of telemedicine<br />
is currently limited to developed<br />
countries. The impact of telemedicine in<br />
developing countries remains limited<br />
since Internet access is often restricted.<br />
In developed countries, sharing of medical<br />
technology resources among health<br />
care institutions is likely to increase<br />
markedly with the development of<br />
advanced Internet-based services. These<br />
may include remote diagnosis, telemedical<br />
services such as remote image processing<br />
(including 3D or virtual reality for<br />
diagnosis or training), remote therapy<br />
planning (e.g. in radiation therapy) and<br />
expert system counterchecks (e.g. to<br />
monitor treatment courses) which may<br />
improve treatment outcome at affordable<br />
costs.<br />
REFERENCES<br />
1. Vetto J, ed. (1999) Current Practice and Therapy in<br />
Surgical Oncology, Hagerstown, MD, Lippincott Williams &<br />
Wilkins Publishers.<br />
2. Feig BW, Berger DH, Fuhrman GM, eds (1998) The M.D.<br />
Anderson Surgical Oncology Handbook, Hagerstown, MD,<br />
Lippincott Williams & Wilkins Publishers.<br />
3. Mion F, Grozel L, Boillot O, Paliard P, Berger F (1996)<br />
Adult cirrhotic liver explants: pre<strong>cancer</strong>ous lesions and undetected<br />
small hepatocellular carcinomas. Gastroenterology,<br />
111: 1587-1592.<br />
4. Bremers AJ, Rutgers EJ, van de Velde CJ (1999) Cancer<br />
surgery: the last 25 years. Cancer Treat Rev, 25: 333-353.<br />
5. Fisher B (1999) From Halsted to prevention and beyond:<br />
276 Cancer management<br />
Today, with modern network capacities no<br />
longer limiting electronic medical data transfer,<br />
the management of huge quantities of<br />
information and quality assurance are the<br />
major challenges in advanced medical informatics.<br />
Although much effort has been<br />
directed towards the development of electronic<br />
patient records, no truly authoritative<br />
standard has thus far evolved (European<br />
Committee for Standar- dization, Technical<br />
Committee for Health Informatics,<br />
http://www.centc251.org/).<br />
In developed countries, most hospitals rely<br />
on electronic data processing as the means<br />
of delivering services. Individual medical<br />
departments often employ their own digital<br />
information systems. In most instances,<br />
these applications will have been implemented<br />
over many years without reference<br />
to sharing, and communication, even within<br />
the hospital information system, may not<br />
be practicable due to proprietary communication<br />
standards. In effect, within a single<br />
health care institution, relevant patient<br />
information is distributed in numerous<br />
information systems without proper<br />
exchange capabilities. Attempts have been<br />
advances in the management of breast <strong>cancer</strong> during the<br />
twentieth century. Eur J Cancer, 35: 1963-1973.<br />
6. Berry DP, Maddern GJ (2000) Other in situ ablative<br />
techniques for unresectable liver tumours. Asian J Surg, 23:<br />
22-31.<br />
7. Luck AJ, Maddern GJ (1999) Intraoperative abdominal<br />
ultrasonography. Br J Surg, 86: 5-16.<br />
8. Partensky C, Maddern GJ (1999) Pancreatectomy after<br />
neoadjuvant chemoradiation for potentially resectable<br />
exocrine adenocarcinoma of the pancreas. In: Mornex F,<br />
Mazeron, JJ, Droz, JP, Marty, M eds, Concomitant<br />
Chemoradiation: Current Status and Future, Paris, Elsevier.<br />
made to utilize Web technology to create<br />
integration platforms, with HL 7 as the<br />
communication standard (Health Level 7,<br />
http:// www.HL7.org). However, disadvantages<br />
apply with respect to data handling,<br />
security and speed of performance.<br />
An alternative, as integration middleware,<br />
may be CORBA (Object Management<br />
Group, http://www.omg.org/) but commercial<br />
applications still have to prove<br />
their value in clinical routine.<br />
Only broad distribution of electronic infrastructures<br />
in health care will allow the<br />
integration of beneficial telemedical services<br />
into medical practice. In developed<br />
countries, the evolution of electronic<br />
patient records promises extensive<br />
advantages in terms of quality assurance<br />
and cost-effectiveness of patient treatment.<br />
In developing countries, ubiquitous<br />
access to Internet information sources<br />
will help tremendously in the distribution<br />
of medical standards and knowledge<br />
(Ricke J and Bartelink H, Eur J Cancer 36,<br />
827-834, 2000; Wootton R ed., European<br />
telemedicine 1998/99. Kensington publications,<br />
London 1999).<br />
WEBSITES<br />
Society of Surgical Oncology (USA):<br />
http://www.surgonc.org<br />
European Society for Surgical Oncology:<br />
http://www.esso-surgeonline.be/<br />
World Federation of Surgical Oncology Society:<br />
http://www.wfsos.com/<br />
On-line Medical Dictionary (CancerWeb):<br />
http://<strong>cancer</strong>web.ncl.ac.uk/omd/