23 September 2009

Cancer threatens poorer nations

Cancer is a big killer in developing countries and a "tsunami" of the disease threatens to overwhelm the nations worst equipped to cope, experts said recently.


Cancer is a big killer in developing countries and a "tsunami" of the disease threatens to overwhelm the nations worst equipped to cope, experts said recently.

While only about 5% of global resources for cancer are spent in developing countries, the burden of the disease is far greater there, they said, with 60% of last year's 7.6 million cancer deaths occurring in poorer nations.

Women-specific cancers like breast and cervical cancer, which account for more than a quarter of all female deaths worldwide, could be dramatically cut in low and middle-income nations by improving awareness and detection, they said.

"There are tens of millions of people living with cancer or at risk of cancer in low and middle-income countries who do not benefit from all these advances," said Anne Reeler, who launched a report on cancer in poorer countries at the ECCO-ESMO European cancer congress in Berlin.

Basic treatment lacking
Reeler noted that while experts gathered in Berlin to discuss ground-breaking and often highly expensive medical advances that may help cancer sufferers in the rich world, poorer nations have almost no access to even the most basic treatments.

"In Ethiopia, for instance, what we often find is that by the time women come to a clinic they literally have a tumour protruding through the breast," she said. "They've spent two years going to see traditional healers and using holy water, and when they come to clinics it's too late to do anything for them.

"So awareness - getting rid of the myth that cancer kills and you can do nothing about it - is really important."

Double the cases in 20 years
Oncology experts expect a doubling of cancer cases across the world in the next 20 years and estimate that more than half of the 12.4 million new cases in 2008 occurred in low and middle income countries, a pattern predicted to continue.

David Kerr, a contributor to the report by an international cancer working group called CanTreat, and a professor of cancer medicine at Britain's Oxford University, said this was "wake-up call" for those concerned about the developing world.

"If there is a coming tsunami of cancer, and there surely is, then now is when we need to start working together to develop new models of cancer care so that we are prepared for it in the developing world," he said.

"We are facing a huge increase in cancer burden, and that burden will fall predominantly in those countries which are least well-equipped to deal with it - no infrastructure, no training, no docs, no nurses, no gadgets, no nothing."

Improve access to meds, diagnostics
The CanTreat experts said in their report that changing lifestyles, ageing populations, urbanisation and infections all played a part in the rise in cancer.

The CanTreat report called on governments in developed nations to work with pharmaceutical and healthcare industries on new ideas for improving access to cancer medicines and diagnostics, including deals to cut drug prices.

The experts also urged health authorities in low and middle-income countries to improve education to encourage women to recognise possible signs of the disease and act quickly and without fear of stigma if they suspect they are ill.

CanTreat authors compared the current threat to that posed by Aids in developing countries and by cancer in richer nations several decades ago.

"Cancer in developing countries now is like cancer in rich countries 30 years ago - there was little that could be done, and people were dying stigmatised," said Joseph Saba, another CanTreat member. "The difference is that now we know what to do. Then we didn't." - (Kate Kelland/Reuters Health, September 2009)

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