Development of Medical Oncology in Taiwan

Abstract

Ever since 1982, the cancer is the number one cause of mortality in Taiwan. Taiwan has locally prevalent cancers; such as hepatoma, nasopharyngeal cancer, gastric cancer and cervical cancer but after 1970, the changing of Westernized lifestyle we also adapted the lung cancer, breast cancer, colorectal cancer and prostate cancer. With the limited resources of available drugs and lack of cancer specialists, cancer was considered as a deadly and fatal disease. When Dr. Whang-Peng had a meeting at Israel 1986, she had a chance to discuss with her old boss at NIH, Dr. Paul Carbone (President of the Wisconsin University Cancer Center) and Dr. Paul Ts'o of Johns Hopkins University. We had a conclusion to start the Medical Oncology Training Program as soon as we can. Dr. Paul Carbone agreed to be the Chairperson for this program. With the approval of Department of Health and National Science Council, the decision was made to sponsor the develop an experiment in Medical Oncology Education using a United States-style training program in Medical Oncology in three Taiwan University Hospitals. In doing so, the training did not necessary prepare the individuals with skills to treat the indigenous cancers, nor did they work with other related specialists or support staff such as nursing and pharmacy, so important to providing good cancer care. The first class was established in 1989 as a continuation of Medical Oncology Training Program, 13 fellows of the first two classes were trained with significant laboratory experience working with American faculty on-site. The major benefits of this model for oncology training are that the trainees developed important interdisciplinary relationships with local staff at each of the hospitals. They were involved in the treatment of the major cancer diseases of Taiwan. They completed a certification process involving written and oral tests by two senior American Oncologist examiners. National Medical Oncology Certificate was given first time from the Taiwan Oncology Society. For facilitate the clinical trial, Dr. Paul Carbone also follow the Eastern Cooperative Oncology Group as a model to build Taiwan Cooperative Oncology Group (TCOG) at 1992. This is the first organization to conduct multi-center clinical trial on cancer treatment in Taiwan. We used the same way proceed Surgical Oncology Fellowship Training Program, Gynecological Oncology Fellowship Training Program and now for the Radiation Oncology Fellowship Training Program. To facilitate the promotion of the Biotech Industry and new drug development, the regulatory authority implemented the GCP (Good Clinical Practice) on July 1, 1997, JIRB (Joint Institutional Review Board) 1997, CDE (Center for Drug Evaluation) 1998, Bridging study 2001 and set up the National Reporting System of Adverse Drug Reaction (ADR) in Taiwan. Bureau of Pharmaceutics also support currently 14 high quality GCRCs (General Clinical Research Centers) to facilitate the available site for early clinical trials. Up to May 18, 2007 Taiwan registered clinical trials are ranked at number 9 (first for Asian Pacific Region) with 531 trials and 170 for cancer trials. I am sure Taiwan is a great site and ready for high quality clinical trials. The Republic of China has 23 million people on the area of 36,006 sqm. It held 19 Medical Centers and 114 Regional Hospitals and 209 Medical Oncologists. Ever since 1982, cancer is the number one cause of mortality in Taiwan. For the year of 2006, total mortality was 37,998 and represents about 28.1% of all death and age adjusted Death rate was 139.3/100, 000. Cancer Incidence is rapidly increasing; 8,569 for male and 6,823 for female in 1982 and raised to 39,431 for male and 29, 476 for female in 2005. In 1986, a decision was made by Dr. Cheng-Wen Wu, Director of the Institute of Biomedical Sciences, Academia Sinica with the approval and support from the Department of Health and National Science council, to sponsor and develop an experiment in medical oncology education using a United States-style training program in Medical Oncology in three Taiwan University Hospital.