World Cancer Day: Time to Declare a Revolutionary War on all Fronts

World Cancer Day: Time to Declare a Revolutionary War on all Fronts

Abdul Rahman Jazieh, MD, MPH

@jaziehoncology
Jan 14, 2012

As much as we loathe wars, we should realize that we are in the midst of a global one that kills more people than all world wars, regional wars, or civil wars. The numbers of victims claimed by this war’s far-reaching effects and collateral damages are striking evidence of its massive destructive impact.

As we approach World Cancer Day, on February 4, 2012, we know that one out of two American men and one out of three American women will be affected by cancer during their lifetime, and that one-fourth of deaths are due to cancer. We are told that more than seven million people die from cancer worldwide annually, and a much larger number are afflicted by the disease. Unfortunately, all predictions indicate that this number will only increase if we continue doing what we have been doing. It is time to declare war in an unconventional way, in a revolutionary way to annihilate the danger that humanity is facing, to save lives, and to minimize suffering. The characteristics of this new revolutionary global war against cancer should include:

  1. Forming a united front, including the public, organizations, and governments at the local, regional, and international levels: The enemy is very strong and far-reaching, therefore, it will be difficult for any individual government or organization to face it alone. It requires collaborative efforts built on individual responsibilities and involvement. We are all responsible for avoiding known risk factors, seeking timely medical help, and participating in cancer-control activities. Organizations should help in initiating or adopting cancer-control policies and initiatives, and governments should provide the infrastructure, support, and services that help in cancer-control efforts.

    Sounds easier said than done! True! But I believe it is much easier to implement this idea today than in the past because of the improvement in communication, social media, globalization, and other factors that can assure the wide involvement of individuals and organizations. Existing infrastructures such as the United Nations (UN), World Health Organization (WHO), and International Union Against Cancer (UICC) can synchronize global efforts.

  2. Developing a clear vision--get rid of ambivalence and have a strong resolution to fight cancer: It is critical to call things with their right names, “point fingers,” and ask others to determine their position in this war. For example, tobacco is known to cause cancer; about one-third of cancers are attributed to tobacco products, in addition to other health risks from tobacco. I cannot think of any marketed product that kills more people than tobacco. Even firearms are not as dangerous as tobacco products, as evidenced by the number of people who are killed by firearms compared to cancer. In addition, firearms are not easily accessible and are much more regulated than tobacco. Yet we find tobacco companies flourishing worldwide. There are even politicians who defend the interests of these companies! If one steps back and thinks about it, it is mind boggling! We celebrated the achievement of taxing tobacco companies to do more research in cancer, and yet we let them continue to sell cancer-producing products; we turn on another tap while the big hole in our water tank is still open. Can someone explain this?

  3. Defining roles and responsibilities: There should be a clear delineation of responsibilities, starting from individuals to international organizations. At the risk of making some people uncomfortable, I will ask this question: Is smoking cigarettes a personal decision and freedom of choice? The answers will come from both sides of the aisle. Let us start with the affirmative answer, “yes, this is a personal choice.” Then the next question will be: should the person carry some of the burden that they puts on society when they get the disease as a result of this behavior “choice”? I am not saying that patients with smoking-related cancers should be discriminated against in any fashion, but there should be some thoughts about the current smokers and the consequences of their behavior. It is about adults being responsible for their actions. The roles of organizations depend on the nature of their work or business. For example, companies that produce cancer-causing agents should think about their actions. Companies that produce cancer-fighting agents should invest more in cancer control and prevention sectors. The United Nations should play a more visible and orchestrated role in this war.

  4. Improving resource allocation: This is true for developing countries as well as developed ones. The developed countries should address issues of access to equitable care and better cancer-control plans for their citizens; but they should also share the responsibilities of helping the less fortunate countries in fighting this disease. As for the developing countries, they should face the challenge of resources in more creative ways. A fashionable approach, which is noble and commendable, is to develop guidelines for cancer care in countries with limited resources. What about guidelines for “redirecting” resources, i.e., proper utilization of resources as there is no country with limitless resources? Many countries have no infrastructure to provide simple cancer screening or care, yet they find resources to buy expensive weapons to fight other kinds of wars or spend money on less important items.

I know that this commentary may generate questions, objections, criticism, or an indifferent shrug of shoulders. I also know that we can do better than what we have been doing if we all put our minds together. “Together, it is possible,” as the UICC has stated. Let us make World Cancer Day on February 4, 2012, a beginning of a new era of hope, a hope that can be brought about by a revolution that does not just generate new ideas, but also finds new ways to achieve good “old” ideas.

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Comments

Nagwa Abdel Rahman Ibrahim, PharmD, PhD

Feb, 09 2012 7:42 AM

Thanks Dr. Jazieh for bringing these points up.  I concur for the vast magnitude of each in order to declare cancer revolutionary war in year 2012. At certain stage it is essential to call things with their right names mainly in such a critical situation with the consequence of tobacco products. Your expression “we turn on another tap while the big hole in our water tank is still open” is very realistic. Researchers are working hard through pharmacogenetics, pharmacogenomics,…. to know the hidden causes of different types of cancer trying to reach a personalized treatment. While in smoking- related cancers the front cause is known to all. But, none was able to start with it!   


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