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Experts from CIS countries discussed the problem of cancer care accessibility

09.01.2014

On December 24, at the N.N. Blokhin Russian Cancer Research Center of the Russian Academy of Medical Sciences (RCRC RAMS), an international meeting of experts was held. It was devoted to up-to-date technologies for prevention, treatment and psychological rehabilitation of cancer patients in CIS countries. Leading experts discussed the latest developments in this area and the current situation with the organization of cancer care in CIS countries including Tajikistan and Kyrgyzstan. The event was organized by non-profit partnership “Equal Right to Life” with the assistance of the Gorchakov Foundation for Public Diplomacy.

Nowadays, the highest incidence and mortality in the world is connected with non-communicable diseases including cardiovascular diseases, cancer, diabetes and chronic obstructive pulmonary disease (COPD). Experts call them “the problem of millennium”. According to data for 2012 of the WHO Regional Office for Europe, non-communicable diseases contribute 52 per cent to the total mortality. Cancer ranks second in terms of mortality among them, but in some countries it intercepted the gloomy leadership this year. “Cancer, as a cause of mortality, came out on the top in 28 of the 53 countries in the WHO European region,” Tatiana Elmanova cites, a consultant to WHO for non-communicable diseases and social determinants. “This situation is observed in high- and middle-income countries, where the life expectancy is higher and a high quality medical care is available for cardiovascular diseases, diabetes and COPD.” According to WHO, cancer incidence and mortality is expected to rise two-fold by 2020, namely to 20.6 million of new cancer cases in 2020 as compared with 10.2 million of cases in 1999.

This meeting of experts (the Consilium) held at RCRC RAMS was attended by Russian experts, oncologists from Tajikistan and Kyrgyzstan and representatives of public organizations. The purpose of this meeting was to strengthen the cooperation between specialists from CIS countries, as part of implementation of the Political declaration of the High-level Meeting of the UN General Assembly on the Prevention and Control of Non-communicable Diseases. The guests met with Mikhail Davydov, chief oncologist of the Russian Federation, director of RCRC RAMS. In his welcome address, Academician Davydov said that doctors from CIS countries should not feel isolated from the extensive activities of the scientific community: “We are always open for cooperation with all colleagues, who work in the territory of the former Soviet Union. Our goal is to keep the common field of scientific communication and the historical ties that were created by our predecessors.”

The situation with cancer care in Tajikistan, according to chief oncologist of Sogdian region Furkat Mansurov, in general corresponds to that in the other countries of Central Asia. The expert mentioned the need to increase technical capacity of cancer care as one of the most pressing issues: “In Tajikistan there is only one radiotherapy unit, which is in the capital, while the population of the country is 8 million people. At the same time more than 3,000 new cancer cases are diagnosed each year. The prevailing types are tumors of the female reproductive system (breast, cervix) and stomach cancer. Because of geographical remoteness many people simply do not have the opportunity to come to Dushanbe to receive radiotherapy,” explained Dr. Mansurov.

In Kyrgyzstan, just as in Tajikistan, cancer ranks second in the mortality structure. Speaking about the reasons for this, the national coordinator of the Ministry of Health of the Republic of Kyrgyzstan for non-communicable diseases Rosa Dzhakipova highlighted the problem of one-year mortality of cancer patients: “There is neither early detection nor prevention. Cancer is often diagnosed at stage 3 or 4, and patients die within a year. We see the solution for the problem, among all, in creation of cancer register – a tool for early detection of diseases and registration of all patients. This will improve the quality and scope of cancer care.”

The scientific secretary of the National Center of Oncology of Kyrgyzstan Aizhana Aidarbekova raised the problem of the acute shortage of medical staff in the regions. This problem is typical for many countries: cancer care facilities are usually concentrated in the capitals only, at the same time in the regions a high-quality diagnosis and an adequate and full treatment are often not available for people not only because of lack of funding, but also because of the lack of qualified professionals. “Doctors practicing at many cancer rooms are not oncologists,” Aizhana Aidarbekova explained the situation in Kyrgyzstan. “They are doctors of other specialties having a second job. Our center, with the support of the Kyrgyzstan Ministry of Health, will take actions to solve the problem with training of staff for the regions, to staff those rooms with cancer specialists, as well as with trained cytologists and radiologists.” The need for training of specialists, especially in subspecialties, such as pathologists, histopathologists, radiation therapists, geneticists or medical physicists, was repeatedly noted by many participants of the Consilium. Without solving this problem it is impossible to raise the level of diagnosis in oncology.

Firuza Abdullaeva, representative of the European Coalition on Breast Cancer in Tajikistan and chairman of public organization “Avesto”, when describing the situation from her point of view, stressed the importance of educational campaigns to raise public awareness about cancer. This applies not only to patients but also to their relatives, healthy people, whose attitude to cancer patients often forces the latter ones to hide their disease. “One of the areas of our activities is the advocacy relevant to problems of breast cancer and cervical cancer”, stressed Firuza Abdullaeva. “In cooperation with primary health care facilities we run campaigns for the prevention of breast cancer and cervical cancer, organize patients’ schools, including educational programs on nutrition, physical activity and improving of family physicians’ skills to perform clinical examinations of breasts, conduct trainings on the effective interpersonal communication skills for patients’ family members. For patients it is important to have support in their families, and not to be discriminated. In addition, we conduct seminars for women on self-examination of breasts.”

The importance of working together with patient community was stressed also by Dmitry Borisov, Deputy Chairman of the Russian Association of oncologists, executive director of non-profit partnership “Equal Right to Life”, which acted as an organizer of the Consilium. “Our partnership “Equal Right to Life” supports more than 300 Patients’ Schools every year, which are conducted as events with face-to-face communication or as webcasts. During such events doctors answer patients' questions, patients are offered psychological and legal assistance,” said Dmitry Borisov. “Patients’ Schools have become very popular educational events, we have years of experience of conducting such schools and will be pleased to share this experience with our colleagues from other countries.” According to Dmitry Borisov, the activities of NP “Equal Right to Life” are not limited to those for patients. The partnership conducts many educational seminars, webinars and master-classes for doctors, and this Consilium became one of them. He was the third of a series of events organized by the partnership with the assistance of the Gorchakov Foundation for Public Diplomacy; the main goal of those events is the exchange of scientific and practical experience between medical professionals of CIS countries. The NP “Equal Right to Life” is ready to share with colleagues abroad all these know-hows, as well as experiences in other important areas, such as the creation of patient registries, which every country needs in order to establish an adequate system to identify treatment needs. Dmitry Borisov expressed readiness to continue a more detailed dialogue on cooperation at the next CIS Congress of oncologists and radiologists that will be held in Kazan in 2014.

Mikhail Lichinitser, Academician of RAS and deputy director of RCRC RAMS also emphasized the importance of international cooperation. Academician gave a tour for the Consilium participants to present them a department headed by him – the department of chemotherapy and combined treatment of malignant tumors at the RCRC RAMS, to which the most severe patients are sent for treatment from CIS countries. “Such sharing of experiences, discussions about the best methods of treatment are useful and interesting for all,” said Mikhail Lichinitser. “Today, there are many advances in oncology, but there are problems too, and we have to discuss them. Such activities ultimately result in the improvement of outcomes of treatment of cancer patients.”