Cancer Control in Developing Countries: Meeting the Challenge

Author(s): K. A. Dinshaw1
Affiliation(s): 1Radiation Oncology, Tata Memorial Hospital, Mumbai, India
Summary (max 100 words):

The world today is in a state of health transition with different countries in different stages depending on the age, structure and economy. Contemporary lifestyles, high risk behaviour, social pathology, serious environmental damage and economic upheavals have changed the evolving epidemiology to that of more non-communicable diseases. Cancer as a malady considered to be a disease of the developed and affluent countries will be a major cause of concern in 70% of all cancers in the developing world by 2020. The goals of cancer care, however, remain the same: to decrease mortality and morbidity of cancer in an appropriate cost effective manner by an interdisciplinary team. An effective and wholesome cancer programme has as its components prevention and early detection, diagnosis and treatment, rehabilitation palliation and terminal care. Research both basic and translational research and education and training are also important components of the cancer programme. Increasing the cost effectiveness of cancer care it is essential that evidence based medicine be used for employing new protocols and new technology. Prioritization and optimal use of available resources would be necessary. Wherever possible indigenous or innovative technology must be used adapted to the local conditions and needs. Evidence based medicine implies making use of the best existing evidence and promise to improve quality of patient care, help contain costs, promote cost effective therapy and quality of life.

Conclusion (max 400 words):

The goal of decreasing mortality can be met by decreasing the incidence of lifestyle related cancers; by increasing the efficacy. Cancer related morbidity can also be decreased by downstating, offering prompt and effective oncological treatment and ensuring the availability of palliative or home care facilities. The possibilities and opportunities of Tele Medicine and Telepathology are driven by health needs to a great extent in developing countries.

Lessons learned:

Cancer is important health issue and a major determinant of the human and economic wealth in a country. One of the critical challenges of setting up a fully functioning comprehensive cancer centre is the opportunity to manage a cohesive interdisciplinary team. The impetus to measure the outcome of our efforts in terms of their impact in reducing suffering and death from cancer despite its multifactional aetiology, multimodal therapy and different subjective and objective responses is so important. Just as the challenge of cancer is enormous in a developing country so is the opportunity to tackle it by a comprehensive Cancer Control Programme.

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