Shadowing a DoctorApril 28, 2014
Looking At Cancer As A Global Problem – Why Cancer Treatment Is So Complex In Developing Countries
The disparity in cancer care around the world is highlighted by this simple but alarming statistic – if you were diagnosed with leukaemia in the UK, you would have a 90% chance of survival. However, for those living in one of the poor, developing countries, being diagnosed with leukaemia is almost like receiving a death sentence. The odds are as high as 90% that you will die of the disease. This disproportion in cancer care between developed and undeveloped countries is simply unacceptable and there are ongoing efforts being made to understand why there should be such a difference and what can be done to make cancer care more accessible to everyone, irrespective of the underlying demographics.
The Global Oncology Initiative and Students for Global Oncology, two Harvard-based programs recently sponsored a symposium conducted by the Dana-Farber Cancer Institute. The focus of the symposium was to reiterate that cancer is a global problem and is not just something that occurs and should be treated in the developed world. Despite having the most advanced equipment and unlimited resources, cancer still poses a challenge in developed countries. Compare this against the lack of healthcare education and limited resources in the developing world, and it is easy to see why it poses an even bigger problem in poor Asian, African and South American countries.
Comparative studies done on breast cancer showed that breast cancer patients in Africa tended to be younger than breast cancer patients in developed countries, and they are more likely to die, partly because of late diagnosis and partly due to inadequate treatment. In developing countries, breast cancer is not usually diagnosed until it has reached Stage 4, when it has invaded the bones or organs and cannot be cured.
According to the 2012 report, a woman’s odds of survival would increase by 30% even if treatment could be delivered at stage 3, before it has spread to other parts of the body. However, early identification and the subsequent treatment costs for things like chemotherapy are at odds with the limited resources in these countries. Most poor nations just do not have sufficient essential radiology equipment for timely diagnosis.
The stigma of having cancer also plays a huge part in the late diagnosis for patients. The idea that cancer is a death sentence, that it is a curse and is caused by witchcraft is ingrained in some societies. All of these myths also result in patients being abandoned by a spouse or not getting permission to get married. A survey was done in nine countries and found that 25% of people believed that cancer patients brought it on themselves.
Breast cancer in particular is the single biggest killer in undeveloped nations. This is because, in most of these countries women do all the work at home and husbands are reluctant to lose their wives to months of treatment. Moreover, most men would also not think of them as a ‘proper’ woman if they were to lose a breast.
Additionally, in many countries chemotherapy is not covered by health insurance so people turn to cheaper ‘herbal’ cures, traditional medicines and witch doctors. Making problems worse is the lack of understanding that when cancer is left unattended, it does not simply go away. It gets worse.
The only solution to treating cancer as a global problem is to educate people, raise awareness and to make resources more readily available in these countries for early diagnosis and timely, appropriate treatment.