Tuesday, March 26, 2019

Cancer and Poor Kids

Every year, 429,000 children and adolescents are expected to develop cancer. The vast majority of those – 384,000 – are from developing countries

Figures reveal a striking disparity in five-year cancer survival rates for children in developing nations compared with those from rich countries. More than 80% of children diagnosed with the disease in high-income states will live for more than five years, yet fewer than 30% of young people with cancer in low- and middle-income nations have the same chance of survival, research has shown.
“Why should a child in the UK have access to the latest medicines and treatments while a child in Myanmar does not? Why should a family in the UK have an opportunity to contribute to future cures by participating in a clinical trial, while a family in Myanmar should not? Every child should have access to the best care and the best research on the planet.”
Treatment failure is common in poorer countries for various reasons, including failure to diagnose, misdiagnoses, unaffordable or abandoned treatment, and toxic death – yet most of these reasons are preventable, according to the study’s first author Catherine Lam, a paediatric oncologistat St Jude Children’s Research Hospital, in Memphis. The research suggests that simple interventions such as providing free meals and temporary housing could help improve global survival rates. Outcomes for children in developing countries could be dramatically improved by addressing key issues such as delayed diagnosis and lack of access to essential medicines, said Lam.

Providing support for well-trained cancer treatment teams and by eliminating abandonment – whereby a child starts treatment but cannot continue, usually due to socioeconomic barriers – poorer nations could double their current rates of cancer survival.

“Abandonment can be prevented with inexpensive, low-technology interventions like providing a free guesthouse for patients who come from out of town to get their treatment, and could raise the cure rate by 23 percentage points – from about 25% to 48% – by eliminating it altogether,” said Scott Howard, secretary-general of the International Society of Paediatric Oncology, who co-authored the study. “At key centres in Recife, Brazil, abandonment has been decreased from 16% to 0%, in El Salvador from 20% to 2%, and in Ethiopia from 95% to 30%, with similarly dramatic reductions in many parts of the world. ”
“If there’s no place for children and families to sleep, or if they have to travel for eight hours and are then told that they have to come up with the money to pay for their child’s medicines or IV fluids, that might all contribute to treatment abandonment, even for children who have a really curable cancer and are being managed by a local team that knows exactly how to cure them,” said Lam.

“Children’s cancers won’t just disappear – if you don’t get the right drugs, then the child is destined to die,” said professor of paediatric oncology at London’s UCL Institute of Child Health, Kathy Pritchard-Jones.


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