Cancer is not just a ‘sickness of the rich’

Common is the belief that cancer is a “sickness of rich people.” More specifically, that cancer is an ailment that only people in developed countries need to worry about.

But Dr. Cecilia Llave, a gynecologic-oncologist and project director of the Cancer Prevention Clinic, a joint project of Chevron Philippines, UP-PGH and the Cancer Institute Foundation, believes otherwise.

She cites a 2008 report of the International Agency for Research on Cancer (IARC) that said that in 1970 or 40 years ago, developing countries accounted for only 15 percent of new cancer cases in the world. By 2008, however, 50 percent of new cancer cases were found in developing countries, and if the trend continues, 70 percent of new cancer cases in the world will be in developing countries by the year 2030.

Indeed, says Llave, cancer currently kills more people worldwide than any other disease. A 2006 WHO-funded study found that cancer, not infectious diseases, is the world’s number one killer. In 2002, the most common infectious diseases—TB, malaria and HIV/AIDS—altogether killed 5.3 million people worldwide. The different forms of cancer, however, “well exceeded this (figure), accounting for some 7.2 million deaths.”

Add to this the fact that more people around the world are falling ill (and dying) of cancer. The IARC predicts that from 12.9 million people worldwide afflicted with cancer in 2009, cancer cases might well reach a total of 16.8 million by 2020 (eight years from now).

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THE SITUATION isn’t any rosier in the Philippines. In 2010, 82,468 individuals were diagnosed with cancer (Philippine Cancer Facts and Estimates), a number that doesn’t include Filipinos who had previously been diagnosed with the disease. In that same year, nearly 52,000 Filipinos died of the disease—or complications arising from it.

Staggering as those figures may be, Llave says the current statistics may even be an underestimation. “The uncertainty is rooted in the fact that Philippine data were derived from only two cancer registries—one in Metro Manila and another that covers Metro Manila and Rizal province,” writes Llave. Not captured in the official statistics is the number of cancer cases in the rest of the country, particularly areas in the Visayas and Mindanao, among the country’s poorest regions.

“Experts have long conceded that poverty has much influence on cancer incidence and fatalities,” adds Llave.  “They observed that cancer is likely to arise and progress to death in areas where the facilities and know-how for the prevention, early detection and treatment of cancer are unavailable, inaccessible or unaffordable.”

She further points out that “lack of funds” has been the usual excuse offered by governments of developing countries facing a growing cancer burden. “Several scientists, however, pointed out in the journal The Lancet less than two years ago that money should not be a problem.”

The world spent $305 billion in 2009 to “study, prevent and treat cancer,” Llave pointed out, citing the study. But only 5 percent of this amount was spent on and in developing countries. The rest of the money (95 percent) went to rich and developed countries “which accounted for only 15 percent of the world population. “This great imbalance in the use of global anti-cancer resources can be resolved with the use of innovative global and regional financing mechanisms,” writes Llave.

“Fighting cancer, particularly in developing countries, need not be expensive… Countries with limited resources and with little or no specialized anti-cancer services can overcome the burden of cancer through the deployment of trained primary and secondary caregivers, low-cost screening and treatment technologies, and through special emphasis on cancer prevention,” points out Llave.

The World Cancer Declaration calls to the attention of government leaders and health policy makers 11 objectives to be achieved by 2020 to significantly reduce the global burden of cancer.

In the Philippines, “the first organized move to increase public awareness (of) the burden of cancer and on the World Cancer Declaration” will be on Feb. 3 in a forum called “Moving as One, A Global Call to Action: Preventing Cancer to Save Lives,” to be held at the Diamond Hotel. The Feb. 3 gathering will also serve as a prelude to the Philippine observance of World Cancer Day on Feb. 4.

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THE EVENT, being held under the auspices of the Union for International Cancer Control (UICC), brings together Filipino and international experts in the prevention, early detection and treatment of cancer. It is hoped that the event “will create an opportunity for networking among concerned groups, the sharing of best practices, and the affirmation that fighting cancer is not a local and government concern but also a global and multi-sectoral priority.”

Organizers of the “Global Call to Action” also expect it to be an “initial mapping exercise of public and private organizations working or interested in cancer prevention and control in order to identify the strengths, synergies as well as gaps. Ultimately, the goal of the event is to bring together a group of leaders who will champion cancer prevention and control in the Philippines.”

Too often, says Llave in a recent conversation, cancer patients and their families look on a diagnosis as a “death sentence,” despairing of ever finding the money for a cure. “But expensive treatment is not the only answer,” says the doctor. “If we could only popularize prevention, like exercise and a healthy diet, going for regular tests and early diagnosis and developing accessible and alternative treatment, we could bring down the number of people dying from cancer.”