Cancer Control Opportunities in Low- and Middle-Income Countries (2007) / Chapter Skim
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8 Cancer Centers in Low- and Middle-Income Countries
8 Cancer Centers in Low- and Middle-Income Countries
Pages 253-271
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From page 253... ...
Where resources are limited, cancer centers can play an especially important role in the development of cancer control programs, as catalysts for cancer control nationally, and as points of contact for the global community. This chapter describes LMC cancer centers and their roles, discusses aspects of establishing or expanding the scope of cancer centers with at least some government support and recognition, suggests and emphasizes ways in which international efforts can help LMC centers and thus LMC cancer control, and identifies the functions that these centers might carry out.
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From page 254... ...
DEFINITION OF A CANCER CENTER The term "cancer center" has no fixed definition. The United States has a well-developed network of cancer centers with official designation from the National Cancer Institute (NCI)
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Thus, research on the full spectrum of cancer control primarily distinguishes NCI-designated cancer centers from the many hospitals and other sites where cancer patients are treated. While some of the more developed middle-income countries may have an existing health care infrastructure that provides adequate cancer diagnosis and treatment, this is not generally the case.
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From page 256... ...
It is encouraging that some cancer centers in LMCs have taken on broader roles in cancer control, even without official recognition (see Box 8-1)
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. Ocean Road Cancer Institute, Dar es Salaam,Tanzania Sub-Saharan Africa has few cancer centers outside of South Africa.
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Services are paid for by the government with no charge to patients. ORCI also acts as the focal point for the Tanzanian National Cancer Control Program.
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. International Partnerships and Communication for LMC Cancer Centers One of the observations of this report is that the international health community -- cancer centers, the many academic global health programs, and the international development community -- have established relatively few activities related to cancer in LMCs.
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From page 260... ...
A few examples of successful tools and programs for developing country health care that could be useful to cancer centers include those described below. SatelLife SatelLife was founded with the purpose of putting technology, in particular space technology, to use for the benefit of people in developing countries.
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Currently, about 1,400 institutions (including cancer centers) in 104 countries (out of 113 eligible)
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St. Jude Children's Research Hospital International Outreach Program: CureKids Cure4Kids is an Internet-based distance learning program provided free to physicians, nurses, scientists, and health care workers who treat children with catastrophic illnesses (St.
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PACT, although an IAEA initiative, has much broader objectives. It is intended to go beyond radiotherapy by partnering with a range of organizations to establish comprehensive, multidisciplinary cancer control capacity, including training in prevention, early detection, palliative care, and potentially curative treatment in IAEA Member States.
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This will be the first major IAEA project that goes beyond radiotherapy toward helping the country advance its National Cancer Strategy and Action Plan. IAEA will focus on radiotherapy for treatment and palliation, while other PACT partners will assist with cancer surveillance, prevention, and early detection as well as strengthening civil society and community support for cancer control.
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From page 265... ...
This, in turn, led to the formation of a network of Latin American countries, and additional twinning projects between other Italian pediatric cancer units and units in Bolivia, Cuba, Paraguay, and the Dominican Republic (Masera et al., 2004)
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relationships with other organizations to strengthen the overall effort · A reciprocal respect for the autonomy, culture, and local traditions between partners · An active but noninvasive role of supervision and scientific advice from the higher income partner · A comprehensive disease-oriented approach to program development, including training professionals, assuring the availability of essential drugs and diagnostic tools, and strengthening physical facilities · Alliance among health professionals, families, and volunteers to support the center and its patients · Development of financial support through a diversified donor pool without excessive reliance on a single source (in particular, not assuming that all financial support will come from the higher income partner) ; local fundraising, at whatever level possible, is important · Assured salary support for at least a core of center personnel · Attention to quality of care, with standards and monitoring, from the inception · Promotion of collaborative research projects of local relevance, with LMC scientists in the lead
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From page 267... ...
. Although cancer centers with cancer control responsibilities should organize palliative care, the care itself should be delivered to a large extent as home care, in the community through local health workers.
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From page 268... ...
This critical mass is needed to attract and retain excellent staff and to take advantage of economies of scale and of scope. Going a step farther, cancer centers in LMCs -- where cancer expertise and resources are concentrated -- are the logical centers of gravity for national cancer control programs involving both clinical services to patients as well as public awareness, prevention, surveillance, research, and other functions in the cancer plan and program.
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From page 269... ...
In addition to support for the creation or expansion of public cancer centers through PACT or other sources, global partners -- one or more -- can greatly enhance the development of cancer control capabilities. In cancer, twinning relationships have been largely unexplored outside of pediatric cancer units, but these serve as useful examples.
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From page 270... ...
could be channeled into this effort as a means of progressiely increasing the global donor community's inestments in cancer control in LMCs in ways likely to hae the biggest impact. REFERENCES American Red Cross.
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From page 271... ...
2003. Partner profile: Ocean Road Cancer Institute.
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