The idea was born a little longer ago, but it came to fruition just ten years ago. Luxembourg has a National Cancer Institute (INC), a health agency responsible for supervising and organizing oncology in the country’s five hospital centers. “Similar institutions exist abroad, such as in France,” underlines Guy Berchem, president of the structure.
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An oncologist in the Grand Duchy since the 1990s, the doctor shared the ambition with other colleagues to see such an agency structured in Luxembourg. Ten years later, he takes a satisfied look at the work accomplished by the structure, particularly in the area of collaboration between the five hospital establishments in Luxembourg, but also university research work.
We did not reinvent the wheel, we rather looked at what existed and worked abroad in order to make it a melting pot in Luxembourg.
Guy Berchem
oncologist and president of the National Cancer Institute
“In particular, we have established guidelines for treating cancers within Luxembourg hospitals in order to standardize practices. We did not reinvent the wheel, we rather looked at what existed and worked abroad in order to make it melting pot in Luxembourg,” summarizes the oncologist specializing in the treatment of lung and neurological cancers.
With a particular difficulty which imposes itself on the country. “The absolute number of cancer cases sometimes causes cancers that are not rare elsewhere to become rare cases here. If we take cancer with 20 cases per year, that’s only five cases per hospital,” adds Nikolai Goncharenko, director of the National Cancer Institute.
Labels for hospital services
Among the practices put in place by the INC, we find the “RCP”, for multidisciplinary consultation meetings. “These are meetings which bring together several specialists to discuss complex cases,” explains Guy Berchem. These exchanges make it possible to seek the opinion of a foreign expert without requiring the patient to travel, which makes it possible to improve their care. “These meetings have become more democratic and have now become part of the routine of Luxembourg oncology.”
Luxembourg among the best in the OECD in terms of health
The National Cancer Institute has also set up a whole program to label hospital services. “This labeling is carried out by cancer in a hospital, or in a hospital network. It is carried out in partnership with the Deutsche Krebsgesellschaft, which has already approved the treatment of prostate cancer at the Robert Schuman Hospitals, breast cancer at the Luxembourg Hospital Center and lung cancer in these two hospitals,” explains Nikolai Goncharenko.
Dr Guy Berchem is an oncologist and also medical director of the CHL. © PHOTO: Gerry Huberty
In Luxembourg, and more broadly in Europe, this work in hospital networks, which allows resources to be pooled, is particularly encouraged and supported by various funds. But it comes up against a limit: that of medical data. “Administrative issues can block patient care. Despite the arrival of the shared care file, which notably allows easier access to the history of medical imaging and other analyses, patients are the subject of separate files in each establishment, which contain essential data,” indicates Guy Berchem, who pleads for simplification in this regard.
Towards the creation of a new structure
Beyond encouraging collaboration between hospitals, the certifications pushed by the INC also allow better access to innovation, for example by facilitating clinical studies, including those carried out by firms. But the institute’s ambition is to go even further. “The INC has been a non-profit organization since its creation, and it was recognized as being of public utility in 2024. In the next 10 years, we would like to evolve in the direction of a public establishment, and be able to collect donations to directly finance research,” underlines Nikolai Goncharenko.
We call on all healthcare professionals to join forces with us to further improve healthcare networks and their quality.
You
director of the National Cancer Institute
In their sights, the doctors reveal their desire to see a “Comprehensive Cancer Center” or CCC created in Luxembourg. “It is a structure which networks all the players, integrating both research and care to work transversally,” explains Guy Berchem. This center could work collaboratively within the framework of a European network since such structures already exist in France and Germany, and make it possible to offer the patient a personalized care pathway.
Of Ukrainian origin, Nikolai Goncharenko holds a doctorate in molecular biology which he completed with business studies carried out in Luxembourg. © PHOTO: Gerry Huberty
On this dimension, the doctor highlights the expected revolution in cancer treatments thanks to artificial intelligence. “Oncology relies on different areas, such as chemotherapy, immunotherapy, but also personalized therapies. It is in this last aspect that AI is very interesting because it allows us to move forward more quickly by specifically adapting the treatment to the patient. We expect a very rapid evolution at this level,” said the oncologist.
For even more collaboration
Within hospitals, the INC campaigned for the hiring of more “case managers”. These health professionals are intermediaries between the patient and the various therapists in order to guide them throughout their treatment. “It must be taken into account that the patient is in shock at the time of diagnosis. So all the information that you give him at that moment, he risks not remembering it,” recalls Guy Berchem. In the coming years, the Institute hopes to see this role become more democratic.
AI is already used in breast cancer screening in Luxembourg
More broadly, the president and director of the INC hope for even greater networking and collaboration between hospitals and the various players in Luxembourg oncology. “It would be the holy grail,” breathes Nikolai Goncharenko, who calls on professionals “to join forces with us to further improve healthcare networks and their quality.” A collaboration that the Institute intends to continue to nurture on a European scale by continuing its participation in various projects allowing in particular the financing of more infrastructure.
Today, the INC employs 13 employees and finances 30% of its activities through its participation in European projects. “But we may have to move again,” smiles the director of the INC when talking about the ambition of the structure. While waiting to see what the health agency will have accomplished in ten years, the two doctors send a message to patients: “Give your vision of your illness and keep as much hope as possible. Everything is evolving very quickly.”
