Challenges in global cancer control

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Published: 18 Jun 2019
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Prof Mary Gospodarowicz - University Health Network, Toronto, Canada

Prof Mary Gospodarowicz speaks to ecancer at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting about global cancer care and control.

She discusses the current challenges in this area, which range from inadequate access to diagnostic, prevention and treatment services to combining treatment modalities.

To address these concerns, Prof Gospodarowicz believes work should be invested in identifying gaps in different treatment areas to allow for a multi-disciplinary approach and improved patient care. Collaborations between global organisations will also ensure this effect is perpetuated on a global scale.

Global cancer control is a huge topic, knowing that we have a tsunami of cancer coming with increased life expectancy, aging of the population, population growth and just simply the fact that we can do much more about cancer right now. The long term survival in cancer patients has doubled over the last forty years so most people survive. Most treatments are much more effective so patients can have more than one line of treatment and the cost of cancer care and the complexity of cancer care is growing.

We know that there are huge gaps in access to cancer services, both to diagnostic services, to prevention services as well as to treatment. We also know that cancer is a team sport, it requires engagement of all the diagnostic services and all the treatment modalities. So, very few patients are treated with just one treatment modality. Yet when we plan for cancer control and when we do gap analysis we only look at one treatment modality or trying to solve one problem.

We need to work together. There is a certainly a need to do a piece of work to look at the gaps in access to specific treatment modalities. There has been a lot of work on access to cancer medication, cancer drugs. There was a Lancet commission on access to surgery, and specifically then cancer surgery, and the problems that result from lack of access to this treatment. When I was President of UICC we did a huge piece of work on access to radiotherapy globally and we actually priced how much money would it cost to scale up access so that anybody in the world who needed radiotherapy would receive it in a timely manner. We then calculated what would be the benefit of such a scale-up. But we made a lot of assumptions – we made assumptions that patients have access to timely diagnostic services; we made assumptions that they have access to surgery and chemotherapy in order to benefit also from radiotherapy. I think at some point in time we must work together and look at the gaps in all cancer modalities and how we scale up access to appropriate cancer treatment that is multidisciplinary. So the surgery, medical oncology and radiation and supportive care people really need to start working together to make sure that we make progress so for the patient the differences between different disciplines are not seen, they’re blinded. The patient wants just their cancer cured and wants to benefit from treatment and the challenge is for us to start working together more.

Just as we need to work together between the disciplines we need to work together between the organisations. I understand that every organisation wants to be the best and have the biggest possible impact but the fact is we can’t do it alone. So we need more of the global collaboration, global cooperation, and in order to cooperate everybody has to be able to give up a little bit of their own turf in order to make better progress globally.