Supporting oncology professionals through education
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The content on this site is intended for healthcare professionals only
UICC’s 2008 meeting may prove an instigator for great success in the global struggle against cancer. Where many cancer conferences cover mainly the latest science, legislation, and progress in their country or economic block, the UICC congress had a greater emphasis on implementing scientific progress in worldwide political fields; incorporating global policy.
Representatives from the World Health Organisation (WHO), met researchers, doctors, nurses, policy makers and media from around the world, including less-developed countries, to tackle the problems caused by cancer, not just in the rich countries, but also in those where it is often dismissed as untreatable due to financial restrictions and lack of infrastructure.
The emphasis was very much on shifting global political will into taking relatively easy, realistically affordable steps to prevent millions of people from dying.
A recurring theme from the conference was the life-saving potential of the cervical cancer vaccine, this week being given to school girls across the UK for the first time. Each year about 500,000 women worldwide are diagnosed with cervical cancer and more than 250,000 die from it, with about 80% of those deaths in developing countries. The number of cases is expected to increase drastically over the coming years in developing countries. This is a situation which needs to be addressed urgently according to Professor Francesc Xavier Bosch of the Catalan Institute of Oncology, Barcelona - lead author of a report announced at the conference summarising the potential for cervical cancer control in Asia-Pacific, Latin America and the Caribbean.
Daisy Mafubelu, Assistant Director-General of Family and Community Health at the World Health Organisation, said that the vaccine - which immunises against 70% of the cancer-causing human papilloma virus strands – is a “useful tool in the comprehensive approach to cancer prevention in developing countries”. But that it was important that “the issue of affordability of the HPV vaccine in the developing world is addressed”.
This sentiment was echoed by Dr Ketayun Dinshaw, Director of the Tata Memorial Centre, Mumbai, India, who noted that the current price tag of $150 per dose was not even vaguely realistic for countries such as India. She also highlighted cultural problems with vaccinating young girls against a sexually transmitted disease, where families shun vaccination due to the stigma associated with such diseases.
The person responsible for discovering the link between HPV and cervical cancer, Dr Haruld zur Hausen of the German Cancer Research Centre in Heidelberg, Germany, also pointed out that HPV was responsible for not only 99% of cervical cancers, but also around 50% of genital cancers as a whole and many incidences of oral pharynx cancer. He further noted that with 27 million women now vaccinated the vaccine was as safe as any he knew and arguments for screening instead were weak as this only showed tumours, rather than preventing them.
Though frequently stressed as a cause of cancer, many speakers at the World Cancer Congress thought that this issue was being given nowhere near the amount of government or media interest it deserved.
With 5 million tobacco deaths per year, and 1.6 billion smokers by 2030, preventing tobacco abuse in its myriad forms, not just smoking, is likely to be one of the simplest, cheapest, and most effective ways to save lives. The recent WHO Framework Convention on Tobacco Control was signed by 168 countries and is currently having its various protocols and laws worked out. But until then, according to the WHO’s Dr Judith Mackay, the best method to save lives is to increase taxes on tobacco, preventing children from starting, then followed up by legislation.
Speaking to ecancer, Professor David Hill, Director of The Cancer Council Victoria, Australia, made much of the World Cancer Declaration, which he said had seen a very wide participation from across the cancer sector, formulating a comprehensive list of priorities into a “roadmap for action and for advocacy”.
“Being a non-government member-based organisation we think that advocacy, in the sense of identifying the policy changes that stand in the way of good cancer control, is an important strategy. It’s something other non-government organisations can’t do as well and indeed government organisations can’t do.”
Reflecting on the conference he highlighted the pushes for cervical cancer vaccination and tobacco control, but also Sunday’s session on prostate cancer, which he noted was seen as a ”rich western problem” but was a problem for poorer countries too; for example being the most common male cancer in Africa.
On a personal note he added that one of his own priorities would be pain control: “There is an unacceptably high number of people in all countries, but particularly in poorer countries, dying in pain from cancer without access to morphine; a very cheap drug . There are all sorts of attitudinal, regulatory, training and access barriers to the use of these drugs that consign people with cancer to dying in pain. It doesn’t require huge resources to deliver this pain relief. We need to concentrate, not only on plans for the long term, but for things that can be done to alleviate suffering right now.”
The evenings of the World Cancer Congress saw the entirely original concept of a cancer film festival, held in central Geneva. The festival’s aim was to “raise awareness of the complex realities of cancer globally, to shatter taboos and myths surrounding the disease, and to challenge stigma.”
“The success of Reel Lives was truly remarkable,” commented Isabel Mortara, UICC Executive Director. “All finalists brought adversity and courage to the big screen in their own unique way. We congratulate all entries to the festival; they championed the idea of celebrating the art of life through their battle with cancer.”
Award winners were chosen from an impressive line-up of 33 finalists from 16 countries. More than 250 films were entered into the competition.
The Grand Prize winning film ‘Chrigu’ told the story of a young man whose great plans for the future were shattered when, at the age of 21, an advanced-stage tumour was discovered in his neck. Swiss director Jan Gassmann followed Christian Ziörjen (Chrigu)’s fight to live, creating a moving and surprising portrait of his best friend in the process.
Runners up were "The Truth about Cancer" (USA) for best reportage, The Art of Living (India) for best personal story, The Children of Avenir (Morocco) for best educational or organisational film, and "Hookah" (Israel) for the best public service announcement.
The concluding summit, with its World Cancer Declaration, featured a stimulating speech from Margaret Chang, Director-General of the WHO, for the first time declaring access to cancer care a human right and adding that “the time is right to make cancer control a development priority”. Read the full report here.
Other highlights of the World Cancer Congress closing ceremony included an award to Raul Pitarque and Javier Bou, who won the prize for a symbol to designate smoke-free environments for children. Pitarque and Bou are tobacco activists in Argentina, and their simple but evocative design was judged to be widely useable, communicating effectively across cultures.
The all encompassing nature of this year’s World Cancer Congress, with 250 delegates from poorer countries funded by the UICC so that their countries could be represented, will hopefully prove a shot in the arm for cancer advocacy on the global political scene.
Though many proposed initiatives and protocols will be expensive to implement, many available options to control cancer rest, in the whole, with a shift in political will alone. The importance of high level advocacy can not be underestimated in the struggle to save millions of lives worldwide. The hope is that governments will listen, and get onboard with the fight against a disease that kills more people worldwide than malaria, aids and TB combined.