By Nagi S. El Saghir, MD, FACPChair, ASCO International Affairs Committee
Professor and Director, Breast Center of Excellence, Naef K. Basile Cancer Institute, American University of Beirut Medical Center
February 4, is an important day in the fight against cancer worldwide. It aims to raise awareness and education about cancer and press people and health authorities to take action against the disease. Hundreds of public campaigns and activities take place and continue throughout the year. Activities include posting lines, quotes, and articles on social media, raising awareness by writing or giving interviews in the press (community or national newspapers, magazines), radios, and televisions, organizing local community meetings and conferences at workplaces and medical centers, organizing counseling centers and hotlines, helping collect information on patients with cancer and their needs in the local community and country, producing local awareness videos and organizing fundraising events, small community fashion shows, wig donations, bra donations, organizing transport donations for patients, toys for children, participating in school and parent meetings, promoting healthy nutrition exhibits, and talking to health authorities about problems that patients with cancer have and suggesting ways to resolve them.
The Union for International Cancer Control (UICC) has issued a World Cancer Declaration that calls upon government leaders and health policy-makers to significantly reduce the global cancer burden, promote greater equity, and integrate cancer control into the world health and development agenda in order to produce major reductions in premature deaths from cancer, and improvements in quality of life and cancer survival rates.
UICC has set nine targets for action:
- Strengthen health systems for effective cancer control
- Measure cancer burden and impact of cancer plans in all countries
- Reduce exposure to cancer risk factors
- Universal coverage of HPV and HBV vaccination
- Reduce stigma and dispel myths about cancer
- Universal access to screening and early detection for cancer
- Improve access to services across the cancer care continuum
- Universal availability of pain control and distress management
- Improve education and training of health care professionals
Myth 1: “We don’t need to talk about cancer.” The truth is that people need to talk about cancer, not to be afraid, to participate in cancer screening campaigns and early detection. This would help cure and alleviate fear, anxiety, and discrimination.
Myth 2: “There are no symptoms or signs of cancer.” The truth is that there are warning signs about many cancers and the dissemination of their knowledge helps people benefit from early detection. People should be taught to recognize symptoms and signs of disease, particularly breast, cervical, skin, oral, and colorectal cancers, and some childhood cancers. For many of these diseases, early-stage detection produces better outcomes and cures.
Myth 3: “There nothing I can do about cancer.” People need to hear it again and again: that there is a lot they can do about cancer and about preventing cancer, either at the personal level, or at the community and policy level. People can be taught to live and promote healthy lifestyles to reduce cancers that are influenced by tobacco use, increased consumption of alcohol, unhealthy diet, obesity, and lack of physical activity. National policies and programs to promote healthy lifestyles are recommended. Healthy workplaces should be tobacco-free, offer healthy food options for their employees, and promote health awareness. People and policy-makers could reduce the risk of infection-related cancers by taking preventive action against hepatitis, HPV, and H. pylori and prevention of liver, cervical and stomach cancers. Vaccinations are recommended to prevent related cancers, but cost remains an issue in developing countries, particularly for HPV vaccination, which must be resolved by reducing costs and increasing access.
Myth 4: “I do not have the right to cancer care.” All people have the right to access proven and effective cancer treatments and services on equal terms, and without suffering hardship as a consequence. This is an important subject because disparities in cancer outcomes exist not only between the developed and developing world for most cancers, but even between different areas and communities within some developed countries. Inequities in power, resources, culture, and inadequate investment at a primary health care level restrict people in low-resource settings from accessing essential cancer services, e.g. cancer prevention and early detection programmes. People may not be able to afford expensive cancer medicines and treatments, which must often be paid by patients out-of-pocket, pushing many families further into poverty.
UICC recommends a global advocacy message that cancer is not just a health matter, but rather that all individuals have the right to effective, quality, affordable cancer services. We are also reminded that the Universal Declaration of Human Rights says “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being.” The lack of adequate palliative care and access to pain relief remains an important and unacceptable aspect of unequal access to care worldwide that needs to be addressed.
Lack of health insurance and other barriers prevent people from getting access to even basic health care. Universal health coverage to ensure that all people have access to health services without financial hardship is a critical component of sustainable development and poverty reduction, and a key element of any effort to reduce social inequities in cancer outcomes. According to the World Health Organization (WHO), universal coverage is the hallmark of a government’s commitment to improve the well-being of all its citizens.
The myths of 2014 World Cancer Day are relevant in all parts of the world, particularly in low-resources areas and countries. ASCO has focused on those issues for years, offering corresponding educational programs and actions through ASCO International.
Nagi S. El Saghir, MD, FACP, is the 2013-2014 Chair of the ASCO International Affairs Committee. He also serves as Professor and Director of the Breast Center of Excellence at the Naef K. Basile Cancer Institute, a part of the American University of Beirut Medical Center in Beirut, Lebanon.
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