SECTORS CONVERGE From left: Cancer survivor and advocate Jojo Flores, Dr. Joline Lim, president of Philippine Society of Medical Oncology (PSMO) Dr. Rosario Pitargue, Dr. Alesha Thai, Dr. Jack West, broadcast journalist Nina Corpuz, and president of New Vois Association of the Philippines Engr. Emer Rojas

In the Philippines, cancer cases are rising at a disquieting rate of 400 per day. With 250 Filipinos losing their lives to the disease daily, cancer has become the third leading cause of death in the country. Of these cancer-related deaths, lung cancer tops the list, followed by breast, and liver. To address the pressing matter, supportive leadership and innovative approaches are required.

Hope from within

Pharmaceutical company MSD in the Philippines, through its Hope From Within advocacy, hosted a forum called “Making Cancer Care Innovation Accessible to Every Juan,” which tackles how cancer innovations and resource-appropriate interventions can aid in closing the cancer care gaps in the Philippines.

Hosted by broadcast journalist and health advocate Nina Corpuz, the event brought together local and foreign health experts, cancer patients, and health champions, to put into perspective the various advancements in technology in cancer care, as well as how the proper implementation and funding of the National Integrated Cancer Control Act (NICCA) could help build access to earlier diagnosis and more efficient treatment to improve patient outcomes and survivorship.

Hope From Within aims to create a platform for open dialogue and collaboration among key stakeholders in the fight against cancer, working toward a future where every Filipino can have the best possible care.

A vignette of cancer

Knowing to navigate the course is half the journey. Philippine Society of Medical Oncology (PSMO) president Rosario Pitargue, MD, opened the program with a conversation about the leading cancer types, namely head and neck, lung, and triple-negative breast cancer.

As per the Global Cancer Statistics, lung cancer is the most common worldwide, affecting approximately 2.2 million people in 2020. The lung is also the second leading cancer site. In the Philippines, lung cancer is the primary cause of mortality among all types.

High incidence of tobacco smoking is reported in the country, with almost a quarter of the Filipino population aged 15 years and above engaged in the habit. This puts millions at risk for lung cancer. Recent studies from Asia reveal that some of the main contributors to lung cancer in non-smokers are environmental risk factors like exposure to high levels of air pollution and secondhand smoke, as well as occupational exposures and comorbid lung diseases.

The two classifications of lung cancer are “small cell” and “non-small cell.” The latter is the most common kind, accounting for over 80 percent of cases.

Another risk factor that heightens the chances of getting lung cancer is exposure to substances found at workplaces like asbestos, arsenic, diesel exhaust, and some forms of silica and chromium.

Radiation therapy to the chest, family history or genetics, diet, and lifestyle are other elements that give rise to cancer.

Head and neck cancers, on the other hand, affect the oral cavity, pharynx, larynx, nasal cavity, paranasal sinuses, and salivary glands. With 1.1 million new diagnoses annually, it is the seventh most common cancer in the world while 7,000 new cases are detected in the Philippines each year.

Cancer of the head and neck set off significant physical and emotional damage to individuals and their families. The afflicted experience pain, disfigurement, anxiety, depression, reduced quality of life, social isolation, and difficulties in swallowing, speaking, and breathing. Primary risk factors are tobacco and alcohol use.

Triple-negative breast cancer (TNBC), meanwhile, is a subtype of breast cancer that does not have estrogen, progesterone, or HER2 receptors. TNBC is more common in younger women and those with a BRCA1 mutation. TNBC grows and spreads faster, has fewer treatment options, and tends to have a worse prognosis than other types of invasive breast cancer.

“Cancer is just a word. It is not a sentence, much less a death sentence,” says Dr. Rosario.

No longer a death sentence

There are several treatments available for patients to fight the disease, from surgery to radiation therapy, and innovative therapies such as immunotherapy and targeted therapy. With the right treatment plan, patients can hope to beat cancer and live healthy, fulfilling lives. The challenge now is how to make these cancer innovations available to every Filipino patient.

For the second part of the conference international medical oncologists and thoracic oncology specialists puts into perspective the current state of medical innovations and the needs of health experts to further revolutionize cancer care.

Dr. Alicia Thai from Melbourne Australia explains that one of the biggest steps forward in cancer care caused by the health crisis was telehealth. “Everyone was on lockdown during the pandemic. Movement just wasn’t allowed. It was hard to travel to see your doctor. The telehealth model had an enormous impact, saving a lot of time and money for patients,” she says.

“We increasingly find the need for collaboration with so many stakeholders, the government, the policymakers, the pharmaceutical companies, the physicians, and even the patients,” says Dr. Howard Jack West from Los Angeles, California.

ADVOCATE OF INCLUSIVE HEALTHCARE AnaKalusugan Party-list representative cong. Ray Reyes

“You have to give it to the global community that has given much effort and research to bring this [cancer care] forward,” says Dr. Joline Lim, a Singapore-based oncologist who specializes in breast cancer.  “We’re fortunate in Singapore because we have an excess of the new drugs. In terms of reimbursement, the government helps in 90 percent of the drugs to keep them affordable.” The clinician-scientist furthers that the medical community hopes to make cancer a chronic disease, where you take a pill in the morning, get one treatment weekly, and life goes on.

Local laws weigh in

The National Integrated Cancer Control Act (NICCA) was enacted in 2019 to improve cancer prevention, survivorship, and access to cancer care for Filipinos. Its goal is to make cancer services and care accessible to all by institutionalizing interdisciplinary care and promoting an equity-based, whole-of-government approach.

To ensure that said landmark health legislation is properly implemented and adequately funded, a “Call for Solidarity against Cancer” was drafted by patient groups and cancer advocates to appeal to the government to increase funding and progressively implement the provisions of the NICCA, “mindful of the need to act with urgency, because cancer does not wait.” Cancer patients need timely support and interventions if they are to beat the disease and have a healthier, more productive, and brighter future.

“We may be far from eradicating [cancer], but nothing holds us back from continuing to fight back by improving and strengthening the support systems for patients and their families,” says AnaKalusugan party-list representative Ray Reyes in his closing remarks.

The solidarity statement highlights the need to intensify and expand public and private collaboration in cancer care. It calls on cancer patients, survivors, and their families, as well as cancer advocate groups, to augment conversations on cancer care, treatment, and life after cancer.