LAHORE - Cancer is one of the oldest diseases in human history, a burden that we have been trying to manage formany generations. The earliest evidence of cancer can be found in Egypt, dating back to 3000 BC but it was not until 1900s that the field of oncology started developing and people began to raise a voice to unite against cancer.Over time, high-income countries have had their share of failures and successes against cancer and they have come a long way in shaping the history of cancer treatment. On the other hand, in addition to the problems faced by the high-incomecountries, cancer in the low- and middle income countries face a different array of problems—making an already complex disease even more challenging.
According to the World Health Organization (WHO), the toll of cancer is greater in low- and middle-income countries, where people develop chronic diseases “at younger ages, suffer longer – often with preventable complications – and die sooner than those in high-income countries.” According to an estimate, by 2040, the global burden is expected to grow to 27.5 million new cancer cases and 16.3 million cancer deaths. In Pakistan, it is estimated that there are around 180,000 new cases in a year and over 117,000 deaths from cancer.The magnitude of the problem demands that we make afocused and dedicated effort to fight cancer in LMICs.
CHALLENGES IN LOW- AND MIDDLE-INCOME COUNTRIES
One of the major barriers for cancer patients in poverty stricken regionsis theproblem of “access” —they do not have enough funds to see a doctor because either reaching a hospital requires travel expenses or they cannot afford the costs of diagnostic tests and doctors fee; leading to late diagnosis of the disease, causing avoidable loss of life. Due to a lack of awareness and stigma, they are more likely to ignore certain signs and symptoms until it is too late. Moreover, cancer patients from underserved areas often do not have access to nutritious food leading to malnourishment, which makes cancer treatments, such as chemotherapy, difficult to tolerate. Having your chances limited due to your economic background adds to the tragedy of suffering from cancer. Lastly, a crucial aspect of battling any disease, especially cancer, is the patient’s fighting spirit and mental well-being. The burden of poverty adds to the burden of disease and weighs down on the patient and their family psychologically.
SKMCH&RC EASING THE BURDEN OF CANCER
In Pakistan, the Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC), Lahore, opened in 1994 as the nation’s first specialist cancer hospital.The Hospital’s mission statement reflects remarkable foresight—itsums up how it hopes to address the above discussed issues: “To act as a model institution to alleviate the suffering of patients with cancer through the application of modern methods of curative and palliative therapy irrespective of their ability to pay, the education of health care professionals and the public and perform research into the causes and treatment of cancer”.Over the past twenty-eight years, SKMCH&RC has continued to provide quality treatment to underprivileged cancer patients—over 75% of whom receive financially supported treatment each year. TheShaukat Khanum healthcare system admits patients for treatment based on clinical guidelines, irrespective of their socio-economic background.It has established walk-in clinics providing cancer-screening facilities in Lahore, Peshawar, and Karachito allow easy access to cancer patientsand to fast-track cancer diagnosis.If patients are unable to cover the cost of treatment, and majority of cancer patients in our country form this group, they are assessed for financial support and are provided the care they deserve, free of charge.
Prevention and early detection are important tools as part of any strategy to effectively fight cancer. SKMCH&RCconductscancer awareness campaigns for various types of cancers, focusing on commonest cancers that are preventable or have a high cure rate if detected early, namely tobacco-use related cancers and breast cancer. The Hospital organises awareness sessions in colleges and poster competitions in schools to raise cancer awareness amongst youth at an early age.
PROVIDING EQUITABLE ACCESS TO HOLISTIC CARE
Cancer management requires a holistic and multi-disciplinary approach. Equity demands that we make efforts to provide not only similar treatment to all patients but also provide them what they need to achieve similar outcomes of treatment. For example, the problem of malnourishment is massive and can affect cancer treatment outcomes. The Hospital works to help such patients who have been admitted to the Hospital by providing them meals as advised by nutritionists, irrespective of the patients’ paying power.For patients who are eligible for hundred percent financial support, their food expenses are fully covered during hospital admission. Lastly, SKMCH&RC has ancillary health care section that is dedicated to help the psychological wellbeing of patients.