By Maher Saifo, MD
In the late 1970s, the Syrian government established a national cancer institute in Damascus, which is the only center to offer cancer diagnoses and treatments for Syrian patients without charge. The Ministry of Higher Education and Damascus University, until the war, provided Syrian oncologists who work for this center with many sponsored scholarships in Western countries, including my delegation to Roswell Park Cancer Institute.
This war, which is associated with poor socioeconomic status and deterioration of medical services, affects not only the cancer care but also the academic process and research establishment at Damascus University.
Patients with cancer used to come from the whole country to our center. The majority of Syrians rely on road and automobile transportation, as there are no convenient air network facilities. In addition to the unaffordable transportation expenses, the roadway is highly unsafe and full of threats: explosions, kidnapping, and snipers. Furthermore, many patients who lost their families have no one to accompany them on the long journey to our cancer center. Indeed, this war has caused hundreds of thousands of deaths and injuries, and we must include in that count those patients with cancer who could have been saved if only they were able to receive treatment. Before the war we saw 1,400 patients per day and over 1,000 new patients per month in our center; now, with the war ongoing, we see only 300 patients per day.
Progress in oncology care was halted by the war. The arrest of services resulted in a worsening of care to patients, leading to an observed decreased cure rate. We face major challenges in the care of our patients:
- There is a lack of chemotherapeutic agents; patients who are candidates for adjuvant therapy and those with potentially curable cancers receive only the cytotoxic drugs available at the present moment.
- Interrupted electrical power supplies cause major disruptions to treatment, especially radiation therapy, including the linear accelerators and the brachytherapy machines.
- The cobalt therapy units do not work without source replacement.
- Insufficient diagnostic equipment results in inaccurate evaluation and staging; for instance, radionuclides (tracers) are barely available for the nuclear scans.
Increased incidence and advanced stages of cancer due to the war pollutants is yet to be demonstrated, but we expect that these outcomes are likely.
Dr. Saifo received his medical degree from Damascus University, where he completed his residency and fellowship in medical oncology. He obtained his clinical and research postdoctorate degree in oncology at Roswell Park Cancer Institute. He was appointed to faculty at Damascus University, Albairouni University Cancer Center where he currently serves as an assistant professor on the GI and Lung Service. He has been an ASCO member since 2009. Dr. Saifo said of his background, “My interest in cancer began in 1996 when my lovely young sister was diagnosed with breast cancer. She was 23 years old and an engineering student. Her 5 years of suffering still inspire me to fight against our real enemy, cancer.”