Feb 09, 2012
An interview with International Affairs Committee member Abdul-Rahman Jazieh, MD, MPH
Dr. Jazieh (center) with colleagues at the King Abdulaziz Medical City.
AC: What is the current state of cancer care in Saudi Arabia?
Dr. Jazieh: According to the Cancer Incidence and Survival Report 2007 by the Saudi Cancer Registry (scr.org.sa), 12,309 cancer cases were diagnosed in Saudi Arabia in 2007 (Saudi Arabia’s population at the time was approximately 17 million). Breast cancer ranked first in incidence (13.8%), followed by colorectal (9.9%), non-Hodgkin lymphoma (NHL; 7.7%), thyroid (6.4%), leukemia (6.2%), liver (4.8%), and lung cancer (4.5%). The top five cancers in women were breast, thyroid, colorectal, NHL, and leukemia; in men, the top five cancers were colorectal, NHL, leukemia, lung, and liver. Female age-standardized incidence rate (ASR) was 84.7 per 100,000 compared to 282.8 per 100,000 for the United States. The ASR for males was 80 per 100,000 compared to 353.4 per 100,000 for the United States.
While ASR of cancer is lower in Saudi Arabia than in the United States, there are multiple indicators of an ominous future for cancer incidence in Saudi Arabia, likely closing the gap between Saudi and U.S. ASRs over the next two to three decades. The first reason for this potential cancer incidence increase is an aging population, which will bring the youth majority from the bottom of the population pyramid upward into the “cancer zone.” The second reason is the recent adoption of a typically sedentary lifestyle combined with a Western diet. “Supersized” and fatty meals are distributed by many American-style fast food restaurants; in Saudi Arabia, these restaurants are as common as in any metropolitan U.S. city. The third reason is the increasing number of smokers. Saudis are picking up this deadly habit in increasing numbers today, and as a result, the prevalence of lung and other tobacco-related cancers is expected to increase in 20 to 30 years.
The Kingdom of Saudi Arabia is proactively combating this expected increase in cancer incidence through multiple state-of-the-art facilities where treatment of all levels of care can be given with the highest international standards. Previously, state-of-the-art treatment could only be found in three major cities: Riyadh, Jeddah, and Dammam. Recently, however, cancer centers have opened in smaller cities, including Makkah, Madina, and Qaseem, with several more under way.
The Kingdom has also made a significant investment in the training of physicians. Most of the practicing oncologists in Saudi Arabia trained and qualified in North America. Furthermore, ambitious health sciences universities have emerged to educate medical, nursing, and other allied health science staff to offset the anticipated workforce shortage and meet future needs.
One other unique aspect of cancer care in Saudi Arabia is that patients are relieved of a great financial burden faced in other regions of the world, as Saudi law guarantees that all Saudi patients with cancer receive care free of charge. Charitable nongovernmental organizations assist with other costs that may not be covered by the government. Furthermore, there are multiple governmental and nongovernmentalinitiatives for cancer control, such as controlling tobacco and screening and early detection programs for certain cancers.
AC: What led you to pursue oncology as a career?
Dr. Jazieh: I developed an interest in oncology for two reasons. The first one was the shortage of oncology specialists in my country. The second reason was the potential to contribute to science and help large numbers of patients. With limited effective treatments for many cancers, I thought oncology offered me a great opportunity to learn and discover.
It is interesting how Arabs perceive and react to my chosen specialty. Some people are so afraid of cancer that they will not say the word “cancer” out loud. For example, when my mother is asked about my work, she replies: “He is specialized in ‘that disease.’” When people initiate a conversation with me about work and I tell them that I am a cancer doctor, a common reaction is for them to ask one of two questions: “Did they find a cure for that disease?” or “What causes it?” The word “cancer” is never mentioned.
AC: You were recently appointed as a member of ASCO’s International Affairs Committee (IAC). What are some of your goals and visions for your term?
Dr. Jazieh: My main goal for my term on the IAC is to enhance capacity-building in our region to improve cancer care. ASCO’s international vision makes this goal achievable. I would like to enlist ASCO’s assistance in training health care professionals in the region through various training mechanisms, including workshops, symposia, and a new Virtual Mentors program that is currently being explored. The objective of this program will be to assemble a cadre of senior physicians and scientists who will provide guidance and mentoring to junior professionals using virtual technology and social media networking.
I envision the Virtual Mentors program being implemented worldwide and benefitting not only professionals abroad, but also those in the United States.
AC: What do you see as the role for organizations like ASCO to support cancer research and cancer care in your country and region?
Dr. Jazieh: Programs such as the ASCO/ESMO Global Curriculum for Training in Medical Oncology, the ASCO in-service examination, the International Development and Education Award (IDEA), Long-Term International Fellowship (LIFe), and palliative care workshops are not widely known in the region. Increased awareness of these programs should be ASCO’s first step in supporting cancer research.