Inmate cancer patients – highlighting the importance of a holistic approach to oncological care

Tolia, Maria and Symvoulakis, Emmanouil K and Kamposioras, Konstantinos and Mauri, Davide and Skoutari, Angeliki and Volkos, Panagiotis and Schizas, Dimitrios and Spanos, Athanasios and Kokakis, Ioannis and Tsoukalas, Nikolaos and Charalampakis, Nikolaos and Cuccia, Francesco and Alongi, Filippo and de Mello, Ramon Andrade and Antoniou, Katerina M and Hyphantis, Thomas and Nixon, Ioanna and Matthaios, Dimitris and Nikolaou, Michail and de Lorenzo, Francesco and Apostolidis, Kathi (2021) Inmate cancer patients – highlighting the importance of a holistic approach to oncological care. Journal of BUON, 26 (6). pp. 2688-2703. ISSN 2241-6293 (https://jbuon.com/archive/26-6-2688.pdf)

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Abstract

Purpose: Inmate oncologic patients' rates increased drastically worldwide. Elderly, limited exercise, unhealthy diet, hepatitis, HIV+ status, tobacco and alcohol use, constitute the main cancer risk factors. We present an outline of practical oncological management and ethical thinking, in the specific environment of a detention facility. Methods: PubMed, Cochrane Database of Controlled Trials, SCOPUS and grey literature were extensively searched upto October 2021. Ιncarcerated oncologic patients experiencevarious everyday challenges:their confinement in high securityfacilities, the lack of access to critical care and related ethicaldilemmas inherent to the context of a correctional facility. Results: The detention facilities may be inadequate in providing early cancer diagnosis and appropriate care mainlydue to a lack of specialized personnel, b) in-house or in external specialized cancer hospitals, care variability (e.g. admissions in small local or regional hospitals), c) delays inproviding access and d) gatekeeper systems. There is a paucity of administration of a) systemic therapy(chemotherapy, targeted drug therapy etc), b) radiotherapy, c)palliative care, and d) enrollment in clinical trials.  Conclusions: Correctional facilities must encourage teamwork between healthcare and correctional professionals inorder to improve the provided anticancer care.