Freedom from cancer

Cancer has become such a major concern a coalition of cancer prevention organizations is asking government to pass a law  which will “expand efforts to effectively manage and control cancer, in all its forms.” The legislation calls for increased investments for the prevention, early and accurate detection, optimal treatment, and adopt an integrated, multi-disciplinary, and patient/family centered approach.”

The call for congressional action on preventing the disease is being made by Cancer Coalition Philippines consisting of the Philippine Cancer Society, Philippine Society of Oncologists, ICANSERVE Foundation, Cancer Warriors Foundation, Carewell Community Foundation, PROJECT: BRAVE KIDS, and the Pharmaceutical and Healthcare Association of the Philippines.

Here are facts about cancer presented by the Coalition:

• Cancer incidence is increasing, and is ranked as one of the leading causes of death among adults and children.  As of 2012, 189 out of 100,000 Filipinos are afflicted with cancer every years. At least 3,900 children are diagnosed with cancer every year.

• The Philippine Statistical Authority (PSA) reports that one in every registered deaths in the country is attributable to cancer. Since 2004, cancers have been the third leading cause of death following cardiovascular disease; for child mortality and morbidity, cancer ranked 4th.

• Survival rates for the most common adult cancers (i.e. lung, breast, color, cervical, prostate, liver) are relatively low compared to other countries in Asia and the world.

• For females, in all cancer mortality rate, the Philippines ranks second highest among 15 counties in Asia, with 124 deaths per 100,000 population.

• Compared to Asian countries, the Philippines has the highest mortality rate for two types of cancer: breast (27 per 100,000 population) and prostate cancer (13 per 100,000 population). Lung cancer mortality rates are also high exceeding 40 per 100,000. For breast cancer, the Philippines also has the lowest survival (.58 mortality to incidence ratio).

• For childhood cancers, which now has an average survival rate of 84 percent in high income countries and a growing number of middle income countries, average survival rate in the Philippines is at a low 30 percent.

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The Coalition says cancer is “a catastrophic disease which pushes families deeper into poverty. It debilitates not only patients, but also their families and loved ones. 

The financial burden on families can be overwhelming, given that financial risk protection mechanisms are limited and patients often need to shell out money from their own pockets to pay for treatment and other costs, such as medical supplies, food and transportation. This is not to mention the high cost of post-operation expenses for chemotherapy and other treatments.

 Evidence shows that in a cohort of cancer patients, the mean out-of-pocket expenditure for cancer treatment far exceeds the mean household income, says the Coalition.  Huge out-of-pocket costs often lead to discontinuance and abandonment of treatment, in some areas can be as high as 75 percent, while average treatment compliance at a low 21 percent. These conditions, says the Coalition, are most observed among the poor, marginalized sectors but occurs even among the so-called middle class.”

 The incidence of cancer, says the Coalition, is projected to increase by as much as 80 percent, by 2030, in low resource countries like the Philippines. “This will have a staggering effect on the ability and resiliency of the Philippine health system as well as its overall economy.”

The Coalition’s call for legislative action is based on the constitutional provisions of Article II, Section 15 (“The State shall protect and promote the right to health of the people and instill health consciousness among them”), and Article 13, Section 11 (“The State shall adopt an integrated and comprehensive approach to health development which shall endeavor to make essential goods, health and other social services available to all people at affordable cost. There shall be priority for the needs of the underprivileged sick, elderly, disabled, women and children. The State shall endeavor to provide free medical care to paupers.”)

The law, according to the Coalition, should have integral elements.

Public health facilities shall be strengthened to provide services spanning prevention, detection, diagnosis, treatment, palliative and hospice care, survivorship follow up and rehabilitation.

There shall be created a competency-based curriculum for all health care workers providing cancer care treatment and support at all levels of the health care service delivery system. 

The Food and Drug Administration should be strengthened to ensure the safety, quality, and efficacy of medicines, biologics, and other health technologies.

A Cancer Assistance Fund should be established to reduce out-of-pocket expenditures for diagnosis, treatment, follow through survivorship care and rehabilitation services. PhilHealth benefit packages for cancer should include all forms of cancer including metastatic cancers and high risk cancers in children.  Social protection mechanisms  should be provided to cancer patients, caregivers and their families, to reduce treatment and rehabilitation costs.

According to the Coalition, “Increased survivorship and improved health outcomes for Filipinos with cancer will contribute to our country’s achievement of Sustainable Development Goal 3 (to reduce mortality from cancer by at least 30 percent), as well as the realization of our country’s health and development priorities.”

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Among  the members of Cancer Coalition Philippines, I know Kara Magsanoc Alikpala, daughter of  my most respected colleague, the late Letty Jimenez-Magsanoc. Beyond that, Kara has made a name for herself. She is founding president of the ICANSERVE Foundation, a Philippine-based advocacy group that promotes early breast cancer detection through multimedia platforms and community-based early detection programs. ICANSERVE has introduced many firsts, including the foundation’s flagship program, Ating Dibdibin, or Take Your Breast Cancer Care to Heart, OKtober Check Yourself Month and Silver Linings, the homecoming and forum for breast cancer survivors.

Kara is a member of the Global Action for Cancer Patients, vice chair of the Cancer Coalition of the Philippines, and  a trustee of the Philippine Alliance of Patient Organizations.

A broadcast journalist and documentarian, she is a contributing producer to CNN International and the Public Broadcasting Service. She is a recipient of the Legarda Award for her contributions to the promotion of breast cancer awareness.

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Email: [email protected]