A global revolution in cancer medicine

Globally, cancer causes one in every six deaths, placing the “emperor of all maladies” at No. 2 on the list of most common killers, according to the WHO. While the U.S. cancer death rate is falling, researchers at New York’s prestigious Memorial Sloan Kettering Cancer Center expect that by 2030, about 75% of cancer deaths worldwide will occur in low- to middle-income nations — due to such factors as growing urbanization, longer life expectancy and population growth.

Finding cures for healthcare inequity

Like many of the world’s leading cancer hospital systems, Sloan Kettering operates its own program to address inequities in the global healthcare system. Established in 2011, it aims to reduce cancer deaths in these low- and middle-income countries, and specifically in sub-Saharan Africa.

The University of Texas’s renowned MD Anderson Cancer Center recently announced the expansion of its oncology initiatives in Brazil and Mozambique, begun in 2014.

In April, a hugely ambitious new global movement called Common Sense Oncology was launched by Charles Booth and Bishal Gyawali, mid-career oncologists at Queen’s University in Ontario, Canada. 

They brought together 30 specialists and patient advocates in Ontario to consider ways to bring more clarity, parity and common sense to cancer care worldwide.  

Participants hailed from 15 nations across six continents: Canada, the United States, Mexico, Brazil, Italy, the Netherlands, the U.K., Israel, Ghana, Rwanda, India, Japan, Nepal, Australia and New Zealand.

A world of healthcare for all 

Common Sense Oncology aims to refocus the attention of the cancer community on patient-centric treatments that extend lives while also improving quality of life. It envisions a world in which patients have access to cancer treatments that can improve both their chance of survival and quality of life regardless of where they live.

“We’re not proposing we have all the answers or that we know what every patient would want,” Booth said. “We’re saying we’ve not done a good job of communicating to patients and relatives benefits and risks of different treatments. We want to celebrate and promote what helps and speak out about what’s not in the best interest of patients.” 

Patel, meanwhile, helped establish No One Left Alone, a nonprofit organization that works to eliminate health care disparities and increase access to health care. 

“Solutions for disparities and healthcare inequities would stem from local actions,” Patel said. The risk of communicable diseases and cancer can be reduced by addressing the social determinants of health such as food, environment, housing, water and sanitation, and by increasing access to disease prevention and other services alone, especially if done at the local level, he said. 

Communities need to build healthcare “eco-systems” in which all stakeholders come together to create accessible and effective healthcare delivery, he said.

“The fundamental challenge in addressing these disparities is a compartmentalized healthcare delivery system,” Patel said. 

Questions to consider:

1. Why has the U.S. cancer death rate been dropping in recent years?

2. What barriers to cutting-edge care do some cancer patients still face in the United States, and why?

3. What measures are some oncologists, public health experts and others taking to address the rising rates of cancer cases in the world’s low- to middle-income nations?