Is this what is Wrong with
Western Medicine?
Adult Stem Cell Foundation Medical Advisory Board
Oncologists Call for Radical Solution to
Global Cancer Problem - Oct 03, 2013
AMSTERDAM — A new report with contributions from more than 100
cancer specialists across the world highlights the huge differences in
cancer care between countries, and proposes a new way of financing
a solution to the global cancer problem — a public/private
"Radical solutions are urgently needed," concludes the State of
Oncology report, presented here at the European Cancer Congress
It would take an estimated $215 billion annually to equalize cancer
outcomes across all the resource settings, and there is no one source
of philanthropy that could afford that sort of investment, said lead
author Peter Boyle, PhD, president of the International Prevention
Research Institute in Lyon, France.
"We need a new effective public/private partnership, which
needs to be driven by the private sector, and needs commitment from
governments and nongovernment organizations," he said. It would
need the commitment of the pharmaceutical industry, as well as
industries involved in diagnosis, pathology, screening, and radiation,
and these companies would contribute not only funds, but also
equipment, training, and knowledge, he suggested.
"We have had a good response from industry," Dr. Boyle said during
a press briefing. "These things don't happen overnight," he said, but
he hopes that enough details will be in place to make an
announcement at the World Prevention Summit in Washington, DC,
in November 2014.
"Working to improve health must cease to be viewed as a
competition," the report authors write. "Public and private
organizations have an underlying suspicion of each other that must
be overcome in the interests of improving cancer care and outcomes
"The situation is dramatic and urgent, and it behooves all parties to
put this frequently deep-rooted suspicion behind them and develop
an effective collaboration to improve this key aspect of public health
throughout the world," they conclude.
The report was coauthored with Richard Sullivan, MD, PhD, from the
Kings Health Partners Integrated Cancer Centre in London, United
Kingdom; Christopher Zielinski, MD, director of the clinical division of
oncology at the Medical University of Vienna in Austria; and Otis
Brawley, MD, from the American Cancer Society. However, there
were more than 100 contributors to the book, each outlining the
situation in a particular country, Dr. Boyle commented.
Lack of Cancer Infrastructure
The aim is to allow every patient with cancer to have the most
appropriate treatment for their disease, Dr. Boyle declared.
That this is far from the case in many parts of the world is the main
focus of the report, which outlines the state of oncology in more than
50 countries, including those in Africa, Australasia, China, parts of
Europe (Bulgaria, Cyprus, Hungary, and Turkey), the Indian
subcontinent, and Latin America.
Dr. Boyle gave several examples from Africa, where many countries
do not have a single radiotherapy machine and others have only 1
machine per country, but the technology is old and there are
problems with electricity supplies. There is a lack of everything —
80% of cancer in Africa is treated without any pathology or histology
being available, which is like "taking a shot in the dark."
Another country that is particularly starved for cancer resources is
Nepal, where figures show the lack of expert physicians — there is
only 0.17 oncologist per 1 million of population, Dr. Boyle noted.
One of the consequences of a lack of cancer infrastructure is that
when cancers are diagnosed, they are at such an advanced stage
"that cure is impossible, and palliation is the only option," he said. But
this too has problems, as the international restrictions on opiumderived drugs make it impossible in some countries to use morphine
for the relief of pain in terminal cancer patients, and so these patients
are treated with paracetamol (acetaminophen), "which is
inappropriate," he added. The scope of this problem was outlined in a
global survey presented last year at the European Society of Medical
Oncology annual meeting.
"It is bad to have cancer, but it is worse to have cancer when you are
poor," the report concludes.
"The gap between rich and poor, between highly educated and less
educated, the north/south divide as we frequently refer to it, is already
substantial, and is set to continue to grow," Dr. Boyle said.
"We are making steady progress in all aspects of oncology, and we
are moving survival ahead," he commented. The report details how
survival rates in many cancers, including breast, prostate, and
colorectal, have vastly improved over recent decades, and also
outlines progress that has been made with targeted therapies, such
as imatinib (Gleevec) and related drugs in chronic myeloid leukemia
and gastrointestinal stromal tumors.
"The problem is not everyone in the world has got access to that
progress and can benefit from that progress," he commented.
"Many parts of the world are already unable to cope with the current
situation and are totally unprepared for the future growth of the
cancer problem," the report authors write.
The dominant contribution to the global cancer burden in the next 50
years will come from China, India, and Nigeria, but there will also be
increasing demands from countries such as Bangladesh, Indonesia,
Pakistan, and Vietnam, where rapid change is taking place, the report
The cancer problem will increase not only because of population
growth, but also because people are living longer and the risk for
cancer increases with age, and because of the increasing adoption of
Western-style lifestyles, which increases cancer risk, the authors
Menu of Actions
In addition to proposing a new financial model for producing funds to
tackle the problem, the report also outlines a menu of actions, to be
adapted in each country to its own particular needs and means.
First, prevention of all cancers that are preventable. The authors
criticize current efforts with their silo mentality of separating cancer
prevention from that of diabetes and cardiovascular disease. These
common chronic conditions, and others such as osteoporosis, have
many lifestyle habits in common and all of them could be tackled
together in one model of disease prevention, they say.
Top of the agenda should be avoiding tobacco and limiting alcohol
consumption, followed by avoidance of obesity and encouragement
of physical activity. Also under this action point are organized
screening programs and vaccination (e.g., against hepatitis B and
human papillomavirus).
Second, treatment resources should be available everywhere. This
includes having appropriate imaging and radiotherapy equipment,
surgery, laboratory and pathological services, as well as therapeutics.
Also, the report authors note that in many countries there is still a
stigma related to cancer, which needs to be eliminated so that
patients seek medical attention at an earlier stage of their disease,
when treatment is still possible.
Third, it is vital to have resources in place to provide curative therapy
for those cancers that are curable. This is a major challenge in lowincome countries, and is becoming increasingly important as more
targeted drugs become available. "If these curative therapies do not
become available in lower-income countries at the same time as in
higher-income regions, then the gap between rich and poor will widen
even further," the authors warn.
Fourth, the provision of palliative, supportive, and terminal care is an
essential part of cancer care, and yet it is missing in many of the
poorer regions of the world. This will require strong action, coupled
with significant training programs, and the need is urgent.
European Cancer Congress 2013 (ECCO-ESMO-ESTRO):
Abstract 1401. Presented September 29, 2013.
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Source: Adult Stem Cell Foundation Advisory Board

Lack of Cancer Infrastructure