By Jose Angel Sanchez, MD
I saw the tears falling from his eyes when this 30-year-old man asked me, “Could my mother be cured?”
I said, “No, your mother will die from this disease.”
“How come?” he said, crying.
“Her stomach cancer has spread and has multiple metastatic lesions. Her liver and kidneys are not working well. Her physical and nutritional conditions are very poor. She will die soon; exactly when, I cannot tell.” I stand up and hold him, thinking, was there anything else that I could do?
This is a common case in metastatic gastric cancer. A 62-year-old woman will die because her diagnosis was too late. In Honduras, 70% to 80% of cancer cases are diagnosed in advanced stages, with mortality rates approaching 70%. The most common cancers, cervical, gastric, breast, and prostate—which could be cured if diagnosed early—usually present to the few oncologists in the country in advanced stages.
And the question in my mind is why?
Easy question but difficult answer: poverty, fear, lack of information, misconceptions, taboos on the patient side. Poor infrastructure, deficit in the number of nurses, doctors, and technician experts in the field, lack of tumor registry, and poor policies will make the diagnosis of cancer in early stages a difficult task in low-resource countries.
Can we increase the chances to make early diagnoses in patients with cancer? Yes, we can, I can, but how? By educating the public, students, nurses, general practitioners, and pathologists, and working together with national and international institutions, medical societies, universities, and governments. Only together can we defeat cancer.
Dr. Sanchez is a member of ASCO’s International Affairs Committee and a hematologic oncologist at Hospital Escuela, University of Honduras.