Roma, 10 nov. (askanews) – Hello everyone and welcome to Askanews’ EU Verified series.
In February 2021, the European Commission presented its long-awaited flagship initiative – Europe’s Beating Cancer Plan featuring four pillars: prevention, diagnosis and treatment, and quality of life of cancer patients.
The European Parliament gave a one year mandate to the BECA Committee, a Special Committee on Beating Cancer, to work on its own draft Report. Askanews is hosting a series of interviews to hear straight from the BECA Members what their priorities and commitments are and how their Report will fit in with the European Agenda.
I am Lorenzo Peiroleri editor at Askanews and I have the honour to host our fifth interview with our guest, Shadow Rapporteur in the BECA Committee, Member of the European Parliament’s European Conservatives and Reformists Group, Pietro Fiocchi from Italy. Welcome.
Q. So let’s jump in – You’re at the deliberation stage of the report – amendments have been tabled and now you are discussing with your colleagues the key points to support for the final report. What are the main priorities for your political group?
A.Generally speaking, the Commission report and the report produced by the rapporteur, Dr. Trillet-Lenoir, were already excellent proposals, but there are a number of points on which we are trying to exert pressure for change, and I will list four quickly: The first is the issue of the future and alternatives to traditional smoking. The Commission’s approach is very aggressive in terms of lumping traditional smoking together with the alternatives, such as e-cigarettes and vaping, when there is scientific proof showing a much lower cancer rate as a result of the use of alternative solutions. The other is the imposition of high taxes, which we do not believe in very much, partly because history teaches us that when something is restricted too much, even worse or even criminal behaviour emerges, with second-rate parallel imports. Then we have another very delicate point, which is that of alcohol consumption, which, as part of prevention, is perfect, but there is currently a battle in the Commission between a total ban and the moderate use of alcohol, especially as regards our Mediterranean nations and the Mediterranean diet, such as a glass of wine with a meal. We are fighting on this issue so that we do not have absolute bans, which are impossible to implement, or in any case crazy tax increases to curb consumption. The Commission also emphasises that this should be done by educating young people in particular, even starting in the eighth grade, because that is where very negative behaviour such as binge drinking develops among young people, who are the ones who should be intercepted immediately. Then there are other issues. One is that of screening, because there is data from European countries where there are screening programmes for particular types of cancer that show really positive effects in terms of reducing cancer rates. It would be good to apply it to the whole of Europe, and on this issue, among other things, there is a parallel battle to free the movement of patients in Europe. Because now there are a number of very important bureaucratic and fiscal obstacles. Lastly, of course, the patient’s quality of life, because often in many regions of Italy, as well as in other European countries, heavy chemotherapy is given and the patient is then sent home with nothing to do, whereas it is essential to continue treatment at home, with rehabilitation, nutrition, psychological support and everything else needed, because it has been seen that this leads to a significant improvement in the percentage of deaths from cancer, but above all in the quality of life, which is fundamental for the patient.
Q. One of the issues raised relates to how the Union can potentially help to reduce the current unequal access to treatment, care, and recovery among citizens in the EU. You and your colleagues have discussed palliative care and differentiated approaches and techniques to screening, not just nationally but based on sex. In your opinion, how big is this issue, and do you have the impression that it is worse for Cancer than for other diseases?
A. There is undoubtedly a purely practical and economic issue here, in the sense that cancer is undoubtedly the number one killer in Europe, and the Commission’s data also indicate that it is possible, through both screening and prevention, to reduce the number of cancer cases in Europe by as much as 40 per cent. Leaving aside the human tragedy of those who get cancer, from an economic point of view we are talking about billions and billions of euros, so from this point of view there is an incentive to say let us invest more in screening and prevention because it is money that comes back, as well as significantly increasing the quality of life of European citizens. Of course, we need to look at this in more detail when it comes to different types of cancer, which obviously have different procedures for men and women, and also at regional level, depending on the different European regions. Then there is another battle, which is my battle because my region is particularly affected: the fight against radon, which is a naturally occurring radioactive gas that comes out of the ground and accumulates in cellars and increases the percentage of lung cancer by 50%. Radon is particularly present in Italy in northern Lombardy and Valtellina, in the province of Sondrio. But it is also very prevalent in Lazio and parts of Campania. Intervening in Radon would reduce lung cancer significantly in these regions. But also in the Czech Republic, Finland and Spain. So we need to focus on both prevention and screening.
Q. Another issue you addressed is Radon gas why is it rarely debated compared to other topics?
A. In reality, the battle against radon has been going on in the United States for over fifty years and is relatively inexpensive, both in terms of monitoring and analysing the various houses and in terms of ‘corrective actions. Little work has been done in Europe on public buildings and factories, a little on schools, but almost nothing has been done on private homes. Among other things, and this is absurd, there are a whole series of plans with tax incentives for better house insulation, and unfortunately, in the case of radon, this even worsens the problem because the concentration increases. It is also necessary to have an overall picture that looks at all these parameters in order to defeat the influence of this gas on the incidence of lung cancer.
Q. You have proposed several specific references to the need for additional funding for research, especially for childhood cancers. Can you tell us how you envisage where this funding would come from and how it could be structured?
A. At the moment about 6 billion euros of European funds are allocated to cancer research and, in my opinion, this is not enough because if we really look at the costs of cancer in Europe, they are billions of euros a year. So the availability needs to be studied as well. In my opinion, if the Impact Assessment is presented in the proper manner, the necessary funds will be found and pushed. Then, once we have entered into this discussion, we will obviously have to understand where we are going to use this money, and there is a strong push, for example, in research into all the leading nano-medicines and a whole series of screening and treatment technologies that are much less invasive and much more successful than traditional therapies, which are very widespread at the moment. And this would really be an opportunity to take a step forward, and hopefully there will also be important centres of excellence in Italy, one in particular in the Milan area in the former Expo site.
Q. Turning to something you have been very vocal about and that you mentioned a few weeks ago at the initial consideration of amendments – the inclusion of harm reduction strategies in the Cancer Plan. Do you think there is support for this to be included in the Parliament report, as it has been highlighted as a missed opportunity that it was not addressed in the Commission plan?
A. One that is certainly extremely positive is education, even in the very first years of school. The other one, which I don’t believe in, are strong limitations and tax impositions to limit access to alcohol and cigarettes. And not only alcohol and cigarettes, because there is also talk of a sugar tax to make soft drinks with sugar in them more expensive. And there is even talk of a fat tax, to make meat, or junk food, less affordable. On the one hand, I can understand why one should have a slight tax distinction and restrictions between healthier and less healthy foods. On the other hand, I can understand having a similar taxation in all the states, to avoid the smoking, alcohol tourism that we know very well, especially in Northern Europe. However, we must be careful, because otherwise there is a risk of going back to the 1980s, when there were smugglers bringing cigarettes from Albania, and the poorest part of the population in particular would return to harmful behaviour that is even worse in terms of various diseases, including cancer. Because the very poor would no longer be able to buy alcohol and cigarettes and start sniffing glue and petrol, for example. So it really is a sensitive issue, an issue that certainly needs to be addressed because the data on child obesity in Europe, for example, is growing, and alcohol consumption in Europe is high. We need to be very pragmatic because the important thing is to have a plan to achieve a 10 or 5 per cent reduction in these phenomena, rather than wanting to achieve 100 per cent and then achieving nothing. That is kind of the theme that we are not trying to push.
Q. The draft report for the Special Committee has no mentions of harm reduction at all, and does not distinguish between cigarettes or devices for vaping. What is your position?
A. There are scientific studies showing a very strong reduction in cases of oral and lung cancer in users of alternative products, especially heated tobacco, so for me it would be one of the tools par excellence. Also, because there is scientific proof showing that it is not a gateway to smoking – in 99 per cent of cases smokers switch from traditional smoking to alternatives. That is why it is important.
Q. More broadly on lifestyle choices, an approach suggested by the rapporteur is to use labelling – specifically the Nutri-Score model – on food and alcohol. What is your opinion?
A. I am quite cynical in the sense that in the Environment Committee we talk a lot about labelling on everything, including CO2 emissions of the food production cycle and a whole series of other things. So there is a risk of putting so much information on the product that in the end it is of no use because consumers don’t read it. Unless you go shopping with an environmental engineer, a chemist and a lawyer. That seems absurd to me. Surely a general indication, this food is bad for you, this food is good for you, would be desirable. The problem is that all the methods that make this distinction even from a scientific point of view are based on quantity. So we’re back to square one.Q. The risk is to create confusion in consumers that hear different opinions on the same argument. For example on alcohol some studies show that it causes cancer, while others point to how a reasonable use can be beneficial. It can make it difficult to establish consensus about what the “truth” is. In your opinion what approach should consumers have?
A. It certainly starts with the concept that everything is bad for you if consumed in the wrong quantities. And this is fundamental. Regarding alcohol consumption, there are plenty of studies that say that as part of the Mediterranean diet, a glass of wine with a meal is perfectly fine. This is demonstrated by the fact that life
I think you have to base it on the scientific evidence, but then you have to apply common sense and try to figure out what are the ways to achieve a lower percentage in the reduction of harmful consumption.
Q. One additional question I wanted to ask you which is more about the structure and how to take this plan forward. There have been discussions about how health is ultimately a member state competence and whilst there should be collaboration there might potentially not be a real European Health Union. Can you explain how this would function? And does this fit with the idea of increasing cross-border data sharing to ensure free circulation of patients?
A. In my opinion, a European database is essential, especially for rare diseases and pediatric cancers, in order to have the possibility to treat these types of diseases in centers of excellence, which, being rare diseases, are only one or two in Europe. This really increases the chances of survival, where maybe in your hospital, in your city, you are finished and you have no hope.
Q. The BECA report has to look at cancer from many different sides, including trying to balance prevention, treatment and research. If you should rank them in terms of importance, how would you list the following:
Research
Environmental pollution
Prevention & Lifestyle choices
Treatment
A. The environmental part is probably the most important one, but it is not specifically addressed by the BECA Report, as it is already covered in other directives and strategies that are emerging in Europe. Certainly not particularly related to cancer, but in general, we are seeing an increase in allergies and diseases that were not so widespread only thirty years ago. So the impact of the state of the air we breathe and the water we drink is certainly fundamental in reducing the number of pathologies, some of them even cancerous. From another point of view, we obviously need to make a qualitative leap in technology, especially with regard to technologies that target the cancerous cell, instead of taking that crazy beating of chemotherapy, which is extremely invasive. And then a whole series of other tools for the early diagnosis of these cancers, which we obviously want to stop in the early stages and not in the fourth stage when there is very little we can do. And the experience of breast cancer, which we have in Italy and throughout Europe, shows how successful such a model is in terms of patient survival, treatment and quality of life.
Thank you to our viewers, and see you at our next interview with another member of the Beca Committee. For updates on the European Cancer Plan, please visit our AskaEurope section on Askanews.it
