Cancer Care in Poverty

Abstract

Background and context: Cancer incidence is increasing more so in developing countries, simultaneously cancer treatment is skyrocketing, beyond the means of resource-limited country, where 80% world´s population lives. So how to bridge the gap. Or is there a hope? Aim: Bridge the gap of the level of cancer care between the resource-poor countries and resource-abound nations. In the term of therapy, our aim is to bring the therapeutic gain of treatments available for resource-poor countries, close to the rich countries. Strategy/Tactics: In the name innovation many useful cancer treatment are rejected, and thrown in the wayside. The strategy is to combine all rejected agents and combine them in an astute tactical manner, sequencing intelligently, to achieve a higher therapeutic gain. As we use multiple modality, the tiny gains can add up to a big gain. Program/Policy process: Bring back the telecobalt unit for radiotherapy, universal use of hyperthermia to enhance therapeutic gain. Plan to use combination of cheaper multiple combinations chemotherapy instead single expensive single combinations, use of neoadjuvant chemotherapy, concurrent chemoradiation, lesser and limited surgery, easy to manage. Thus, total plan is neoadjuvant chemo + hyperthermia + concurrent chemo-radiation + hyperthermia + if needed minimal surgical resection. With planned use of this program, the gain in therapeutic ratio may be close to expensive radiotherapy with or without innovative drugs costing hundreds of thousands per patient. Outcomes: Affordable effective, less technology dependent, less machine breakdown, higher cure rate for poor countries. What was learned: It is possible to offer effective cancer treatment in poor countries using biologically optimized higher therapeutic gain and cure as well, without modet drugs and radiotherapy equipment without any increase in side effects.