Putting the (cancer) game plan into action

Cancer Game Plan aims to change cancer disease care by promoting early detection and diagnosis, and highlighting new treatments, which are both critical to patient survival.

While waiting for the passage of the Cancer Bill and the Universal Health Care Bill into law, cancer patient groups, doctors, representatives from the national and local government, cancer organizations, hospitals, the private sector and financial and funding institutions banded together to discuss how an institutionalized Service Delivery Network (SDN) framework could be co-created to provide high-quality resources for patients so they can have a better journey in the continuum of cancer care.

“From diagnosis to treatment and palliative care, we want to shape a clearer pathway and make navigating through the disease more efficient, expedient and more beneficial to patients,” noted Fatima “Girlie” Lorenzo, president of the Philippine Alliance of Patient Organizations (PAPO) and founder of Kythe Foundation Inc.

Titled “Cancer Game Plan 2018 Summit,” the dialogue is patient-driven.

“We want the patients’ voices to be heard, especially when the Cancer Act Bill and the Universal Health Care Bill are passed into law,” added Lorenzo. “Once these laws are passed, a big component of it is the Service Delivery Network. So we want to show the LGUs how it can be done.”

Lorenzo elaborated on the value of patient group perspective in developing a cancer program within a functional SDN framework and for local government units (LGUs) to use the SDN in planning and implementing their own cancer program in their provinces, cities and municipalities.

Cancer Game Plan PH is an advocacy geared to systematically change cancer disease care by promoting early detection and diagnosis, and highlighting breakthrough new treatments, which are both critical to patient survival.

Community-based patient navigation

According to Lorenzo, the success of most patient programs is attributed to an institutionalized Service Delivery Network system. “Through SDN, stakeholders understand their role and there is a clear patient pathway, making navigation from early detection, access to diagnosis and treatment easier,” explained Lorenzo.

I Can Serve Foundation co-founder Kara Magsanoc-Alikpala, co-chair of Cancer Coalition Philippines and PAPO board member, shared case studies and examples of local government Service Deliver Networks (SDNs) during the dialogue.

She talked about how Ating Dibdibin, a community-based early breast cancer detection program, helps in identifying cancer within partner communities.

A breast cancer survivor herself, Kara shared how the mortality rate has been reduced to a third thanks to the early breast cancer screening program and patient navigation.

“When we started I Can Serve Foundation 20 years ago, we mainly focused on high-impact information campaigns on early breast cancer detection,” Kara related. “Through the years, we noticed there was more information, more awareness campaigns in the country than solutions to breast cancer.”

Kara and her team realized it’s irresponsible to just keep promoting early detection if the patients had nowhere to go after discovering symptoms of breast cancer.

“It felt like we’ve navigated the road for the patients but led them to a dead end — leaving them more lost and scared,” Kara said.

And that’s when I Can Serve Foundation decided to be part of the solution.

Fatima “Girlie” Lorenzo, president of Philippine Alliance of Patient Organizations, stresses the significance of patient group perspectives in creating cancer programs.

“We started to help build the road to get the patients to their destination — to wellness, survival and quality of life. We’re still building… one brick at a time, one conversation at a time,” Kara added.

In 2008, I Can Serve Foundation started Ating Dibdibin. In partnership with the city or LGU, the program helped train city health officers on early breast cancer detection methods, showed them how to stage community screenings, home visits, how to jazz up forums to make them as engaging as possible.

“At the end of the intensive training session, we usually request that the city partner will create a simple breast cancer help desk or clinic, better yet, a breast cancer center,” Kara said.

And for the partnership to happen between the I Can Serve Foundation and the LGU, Kara and her team sees to it that every breast cancer patient — regardless of the stage and income bracket — is served.

“We also ask the LGUs that they make Ating Dibdibin permanent. They should institutionalize it through a local ordinance to help secure the program’s sustainability and the women’s future,” she added. “It’s not easy to partner with the private sector and the government because some are cynical of our intentions.”
And there’s the Patient Navigation Program, a patient-focused service aimed at breaking barriers to healthcare in cancer patients.

“Because of Patient Navigation, survival rate for breast cancer improved on average over 87 percent, up from 60 percent in a five-year period,” noted Kara.

At the Philippine General Hospital alone, in the first six months of implementation, breast cancer patient compliance rate improved to 68 percent compared to 18 percent for patients who didn’t benefit from patient navigation.

“So for us, the Patient Navigation Program was a big boost of our Ating Dibdibin program. It maximizes the benefits of a fragmented health system, increased breast checkups, improved patient compliance and, of course, survival, which is the goal of all of us here.”

Breakout sessions focusing on the four pillars of the Cancer Bill — Registry, Access to Diagnosis, Access to Treatment, Palliative Care — were held after the talks.

Each session, which gathered representative leaders from key stakeholder groups, turned out to be an open dialogue between the patients and caregivers.

The insights and necessary steps to move each pillar of the SDN forward was synthesized by the Department of Health with the aim of making the health policy more supportive for patients.
“The data that was gathered from each stream (we refer to the sessions as work streams) will be put into a manifesto, which we will present once the Implementing Rules and Regulations of the Universal Health Care Bill and Cancer Bill convenes. We will tell them that this manifesto came from the ground — the patients,” explained Lorenzo.

In expressing private sector commitment, Michael Alzona, engagement lead for MSD in Asia Pacific, emphasized how cancer need not be an automatic death sentence.

“The strengthening of patient-centered and multi-stakeholder collaborative efforts that are targeted to save more lives against the dreaded disease.”

Former Health Secretary Esperenza Cabral, who is also a cancer survivor, shared her two cents on the matter.

“Cancer is both complicated and complex. We are not going to solve the problems of cancer care in one summit like this, but it’s a step in the right direction,” she said. “I hope that those policies are finally going to translate into something that would benefit each and every one of you.”