FACTSANDFIGURES
CAUSESOFCANCER
PREVENTION
EARLYDETECTION
CUREANDCARE
CONTACTS
Statisticsarepeople
withthetearswiped
away.
ProfessorIrvingSelikoff
“
”
WorldHealth
Organization
WorldHealth
Organization
Wecansavetwomillionlives
inourlifetime
ISBN9241593148
NOW!
GLOBALACTION
AGAINSTCANCER
UPDATEDEDITION2005
Thinkofthepeopleyouknow.Howmanyofthem
havehadcancer?Howmanymorewillgetit?
WHOLibraryCataloguing-in-PublicationData
GlobalActionAgainstCancer-Updatedversion.
1.Neoplasms–epidemiology2.Neoplasms–mortality3.Neoplasms–preventionand
control4.Worldhealth5.InternationalcooperationI.WorldHealthOrganization
II.InternationalUnionAgainstCancer.
ISBN9241593148(WHO)(LC/NLMclassification:QZ200)
ISBN2-9700492-1-X(UICC)
?WorldHealthOrganizationandInternationalUnionAgainstCancer,2005
Allrightsreserved.
PublicationsoftheWorldHealthOrganizationcanbeobtainedfromWHOPress,World
HealthOrganization,20AvenueAppia,1211Geneva27,Switzerland(tel:+41227912476;
fax:+41227914857;email:bookorders@who.int).Requestsforpermissiontoreproduce
ortranslateWHOpublications–whetherforsaleorfornoncommercialdistribution–
shouldbeaddressedtoWHOPress,attheaboveaddress(fax:+41227914806;email:
permissions@who.int).
PublicationsoftheInternationalUnionAgainstCancercanbeobtainedfromthe
Campaigns&CommunicationsCluster,3rueduConseil-Général,1205Geneva,
Switzerland(tel:+41228091811;fax:+41228091810).Requestsforpermissiontorepro-
duceortranslateUICCpublications–whetherforsaleorfornoncommercialdistribution
–shouldbeaddressedtoUICCPublications,attheaboveaddress(email:
permissions@uicc.org).
Thedesignationsemployedandthepresentationofthematerialinthispublicationdonot
implytheexpressionofanyopinionwhatsoeveronthepartoftheWorldHealth
OrganizationandtheInternationalUnionAgainstCancerconcerningthelegalstatusof
anycountry,territory,cityorareaorofitsauthorities,orconcerningthedelimitationofits
frontiersorboundaries.Dottedlinesonmapsrepresentapproximateborderlinesforwhich
theremaynotyetbefullagreement.
Thementionofspecificcompaniesorofcertainmanufacturers’productsdoesnotimply
thattheyareendorsedorrecommendedbytheWorldHealthOrganizationandthe
InternationalUnionAgainstCancerinpreferencetoothersofasimilarnaturethatarenot
mentioned.Errorsandomissionsexcepted,thenamesofproprietaryproductsaredistin-
guishedbyinitialcapitalletters.
AllreasonableprecautionshavebeentakenbytheWorldHealthOrganizationandthe
InternationalUnionAgainstCancertoverifytheinformationcontainedinthispublication.
However,thepublishedmaterialisbeingdistributedwithoutwarrantyofanykind,either
expressorimplied.Theresponsibilityfortheinterpretationanduseofthemateriallieswith
thereader.InnoeventshalltheWorldHealthOrganizationandtheInternationalUnion
AgainstCancerbeliablefordamagesarisingfromitsuse.
PrintedinSwitzerland
Design:HelenaZanelliCréation
Contacts
CONTACTS
FurtherReading
WorldHealthOrganization
ProgrammeforCancerControl
ChronicDiseasesPreventionandManagement
20AvenueAppia
1211Geneva27
Switzerland
Tel:+41227913314
Fax:+41227914297
InternationalUnionAgainstCancer
Campaigns&CommunicationsCluster
3rueduConseil-Général
1205Geneva
Switzerland
Tel:+41228091811
Fax:+41228091810
JoséJulioDivinoUICC
JacquesFerlayIARC
IsabelMortaraUICC
PaolaPisaniIARC
PáraicRéamonnUICC
CeciliaSepúlvedaWHO
EvaSteliarova-FoucherIARC
AndreasUllrichWHO
MariaVillanuevaWHO
Websites
WorldHealthOrganization:www.who.int/cancer
WHOTobaccoFreeInitiative:www.who.int/tobacco
InternationalAgencyforResearchonCancer:www.iarc.fr
InternationalUnionAgainstCancer:www.uicc.org
UICCGLOBALinkTobacco:www.globalink.org
Acknowledgements
Thefollowingpeoplehaveprovidedvaluableinputtothissecondedition:
WorldHealth
Organization
InternationalUnion
AgainstCancer
Contacts:
WorldHealthOrganization
ProgrammeforCancerControl
ChronicDiseasesPreventionand
Management
20AvenueAppia
1211Geneva27
Switzerland
Tel:+41227913314
Fax:+41227914297
InternationalUnionAgainst
Cancer
Campaigns&CommunicationsCluster
3rueduConseil-Général
1205Geneva
Switzerland
Tel:+41228091811
Fax:+41228091810
CurbingtheEpidemic:GovernmentsandtheEconomicsofTobaccoControl
WorldBank,1999.
NationalCancerControlProgrammes:PoliciesandManagerialGuidelines
2
nd
edition,Geneva,WorldHealthOrganization,2002.
WorldCancerReport
Lyon,InternationalAgencyforResearchonCancer,2003.
ACommunityHealthApproachtoPalliativeCareforHIV/AIDS
andCancerPatientsinSub-SaharanAfrica
Geneva,WorldHealthOrganization,2004.
Referencesavailableonrequest
6.7million
deaths
10.9million
newcases
24.6million
peoplelivingwithcancer
Figurebasedona5-year
prevalencebetween1998-2002.
GLOBALACTION
AGAINSTCANCER
O
urknowledgeabouttheprevention
andtreatmentofcancerisincreasing,
yetthenumberofnewcasesgrows
everyyear.Ifthetrendcontinues,16million
peoplewilldiscovertheyhavecancerin2020,
two-thirdsoftheminnewly-industrializedand
developingcountries.
Itistimetoputcurrentknowledgeintoaction
inordertosavelivesandpreventsuffering.
Thisrequiresconcertedactionbetweeninter-
nationalorganizations,governments,public
andprivateinstitutions,andindividuals.
Thatactionhasalreadybegun.Weeachhave
animportantroletoplay.
Thisbookletpresentsthechallenge.
1
Source:IARC,Globocan2002
CentralAmerica,
SouthAmerica
andtheCaribbean
479,900
245,000
234,900
NorthAmerica
631,900
331,200
300,700
Cancerkilledmorethan
Year2002:
Cancerdeaths
Cancerknowsnoborders.Itisthesecond
leadingcauseofdeathindevelopedcountries
andisamongthethreeleadingcausesof
deathforadultsindevelopingcountries.
12.5%ofalldeathsarecausedbycancer.
That’smorethanthepercentageofdeaths
causedbyHIV/AIDS,tuberculosis,and
malariaputtogether.
Cancerisapublichealthproblemworldwide.
Itaffectsallpeople:theyoungandold,the
richandpoor,men,women,andchildren.
“
”
FACTSANDFIGURES
3
FACTSANDFIGURES2
peoplearoundtheworld
6.7million
MenWomen
Percentageofdeathsduetocancerin2002
NorthernEurope
241,100
126,300
114,800
WesternEurope
475,100
264,700
210,400
SouthernEurope
348,400
208,100
140,300
Sub-SaharanAfrica
412,100
201,900
210,200
NorthernAfricaandWesternAsia
224,000
123,700
100,300
SouthCentralAsia
845,200
434,600
410,600
South-EasternAsia
363,400
195,700
167,700
Oceania
49,500
27,300
22,200
EasternAsia
2,016,300
1,278,300
738,000
Centraland
EasternEurope
637,000
359,200
277,800
Source:IARC,Globocan2002;WHO2004<5%5-10%10-15%15-20%20-25%>25%
Cancerrepresentsatremendousburdenon
patients,families,andsocieties.Itisoneofthe
leadingcausesofdeathintheworldandisstill
increasing,particularlyindevelopingcountries.
Almostsevenmillionpeopledieeachyearofcan-
cer,andmanyofthesedeathscanbeavoidedif
appropriatemeasuresareputinplaceto
prevent,earlydetect,cureandcare.Withthis
goalinsight,cancerisanimportantissueonthe
WHOagenda.WiththesupportofMember
Statesandotherpartnersworldwide,weare
developingtheWHOCancerControlStrategy,
whichaimsatacceleratingthetranslationof
knowledgeintoactioninordertosavemillionsof
livesandreduceunnecessarysuffering.
DrLEEJong-wook
Director-General,WHO
NorthernEurope
426,400
WesternEurope
873,700
SouthernEurope
617,300
Sub-SaharanAfrica
530,100
NorthernAfricaandWesternAsia
319,800
SouthCentralAsia
1,261,500
South-EasternAsia
524,900
Oceania
111,400
EasternAsia
2,890,300
CentralandEasternEurope
903,400
Prostate
Lung
Colorectal
Breast
Colorectal
Lung
Lung
Prostate
Colorectal
Breast
Colorectal
Uterus
Prostate
Lung
Colorectal
Breast
Colorectal
Lung
Lung
Bladder
Colorectal
Breast
Cervix
Colorectal
Oral
Lung
Pharynx
Cervix
Breast
Oral
Lung
Liver
Colorectal
Breast
Cervix
Colorectal
Prostate
Colorectal
Lung
Breast
Colorectal
Melanoma
Stomach
Lung
Liver
Stomach
Breast
Lung
Lung
Colorectal
Stomach
Breast
Colorectal
Stomach
Kaposisarcoma
Liver
Prostate
Cervix
Breast
Kaposisarcoma
Thethreemostcommoncancers
inmenandwomenperregion
CentralAmerica,
SouthAmerica
andtheCaribbean
833,100
NorthAmerica
1,570,500
Prostate
Lung
Colorectal
Breast
Lung
Colorectal
Prostate
Lung
Stomach
Breast
Cervix
Colorectal
FACTSANDFIGURES
5
FACTSANDFIGURES4
Typesofcancer
Lungcancerkillsmorepeoplethananyother
cancer.
Morementhanwomengetcancerofthe
lung,stomach,throat,andbladder.
Cancerstriggeredbyinfections–liver,stom-
achandcervixcancers–aremoreprevalent
inthedevelopingworld.
Inrichercountries,prostate,breastandcolon
cancersaremorecommonthaninpoorer
countries.
Cancersthataremostoftencuredarebreast,
cervix,prostate,colonandskin,iftheyare
diagnosedearly.
Year2002:
10.9million
newcasesaroundtheworld
24.6million
peoplelivingwithcancer
MenWomenSource:IARC,Globocan2002
By2020,cancercouldkill
CentralAmerica,
SouthAmerica
andtheCaribbean
833,800
425,100
408,700
NorthAmerica
951,400
514,700
436,700
FACTSANDFIGURES
7
FACTSANDFIGURES6
Trends
Thebiggestratesofincreaseareindevelop-
ingandnewlyindustrializedcountries.
Therelativeincreaseissmallestinsome
Westerncountrieswherepopulationsare
rejectingtobaccoandadoptinghealthier
lifestyles.
10.3million
peopleperyearunlessweact
MenWomen
Percentageincreaseincancerdeathssince2002
Source:IARC,Globocan20020-25%25-50%50-75%75-100%
NorthernEurope
297,600
159,600
138,000
WesternEurope
617,100
357,100
260,000
SouthernEurope
427,300
259,100
168,200
Sub-SaharanAfrica
626,400
310,100
316,300
NorthernAfricaandWesternAsia
389,200
218,600
170,600
SouthCentralAsia
1,389,800
719,600
670,200
South-EasternAsia
709,300
331,800
377,500
Oceania
77,300
43,300
34,000
EasternAsia
3,223,700
2,033,500
1,190,200
Centraland
EasternEurope
742,800
432,600
310,200
FACTSANDFIGURES8
Trends
Asteadilyincreasingproportionofelderly
peopleintheworldwillresultinapproxi-
matelya50%increaseinnewcancercases
overthenext20years.Ifcurrentsmoking
levelsandtheadoptionofunhealthy
lifestylespersisttheincreasewillbeeven
greater.
Thenumberofnewcases
eachyearcouldrisefrom
10.9millionin2002
CentralAmerica,
SouthAmerica
andtheCaribbean
1,404,700
680,700
724,000
NorthAmerica
2,295,200
1,264,800
1,030,400
FACTSANDFIGURES
9
to16millionin2020
nearlya50%increase
MenWomen
NorthernEurope
516,900
266,600
250,300
WesternEurope
1,104,300
622,300
482,000
SouthernEurope
745,700
430,100
315,600
Sub-SaharanAfrica
804,000
385,300
418,700
NorthernAfricaandWesternAsia
549,100
287,800
261,300
SouthCentralAsia
2,041,000
981,800
1,059,200
South-EasternAsia
864,000
423,800
440,200
Oceania
169,700
92,800
76,900
EasternAsia
4,495,700
2,715,500
1,780,200
Centraland
EasternEurope
1,030,200
553,100
477,100
Theestimatednumberofnewcases
inmenandwomenperregionin2020.Source:IARC,Globocan2002
Whatwillthefuture
picturebeifweact
NOW?
Wecansave
2millionlives
by2020,
and6.5millionlives
by2040.
FACTSANDFIGURES
11
FACTSANDFIGURES10
?
?
?
?
?
?
Cancerispotentiallythemostpreventableand
mostcurableofthemajorlife-threateningdis-
easesfacinghumankind.Byapplyingexisting
knowledgeandpromotingevidence-basedactions
incancercontrol,wewillturnthistruthinto
realityforallpeopleeverywhere.
DrJohnR.Seffrin
President,UICC
“
”
CAUSESOFCANCER
13
CAUSESOFCANCER12
Tobacco
Tobaccoconsumptionistheworld’s
mostavoidablecauseofcancer.In
mostdevelopedcountries,smoking
isresponsibleforupto30%ofall
cancerdeaths.Worldwide,itis
responsibleformorethan80%of
lungcancercasesinmen,and45%
inwomen.
Tobaccoalsocausescanceratmany
othersitesincludingthroat,mouth,
pancreas,bladder,stomach,liver,
andkidneycancers.
Diet
Indevelopedcountries,almostas
manycancercasesareattributable
toanunhealthydietandaninactive
lifestyleastosmoking.
Overweightandobesityareassoci-
atedwithcolon,breast,uterus,
oesophagus,andkidneycancers.
Excessivealcoholconsumption
increasestherisksofcancersof
theoralcavity,pharynx,larynx,
oesophagus,liverandbreast.For
someofthesecancers,therisksare
evengreaterifyousmoke.
Theincidenceofstomachcancer
hasgonedownbecauseofreduced
intakeofsaltandimprovedliving
conditions.
Infection
One-fifthofcancersworldwideare
duetochronicinfections,mainly
fromhepatitisviruses(liver),
papillomaviruses(cervix),
Helicobacterpylori(stomach),
schistosomes(bladder),theliver
fluke(bileduct)andhuman
immunodeficiencyvirus(Kaposi
sarcomaandlymphoma).
43%ofcancerdeaths
areduetotobacco,
dietandinfection.
Thesefactorswereresponsiblefor
4.4million
newcancercasesin2002
WH
OP
.
Mer
chez
WH
OP
.
V
i
r
o
t
UI
C
C
Sub-SaharanAfrica
Total:37%
Europe(Northern,
SouthernandWestern)
Total:49%
Fromaglobalperspective,thereisstrongjustification
forfocusingcancerpreventionactivitiesonthesethree
maincancer-causingfactors.
Source:WHO,IARC2003Source:IARC2000
Source:WorldBank1994
PREVENTION
15
PREVENTION14
Thebattleagainsttobacco
Ifcurrenttrendspersist,about500millionpeoplealive
todaywilleventuallybekilledbytobacco,halfofthemin
productivemiddleage,losing20to25yearsoflife.
WorldBank,1994
“
”
Tobaccouseisthemostpreventablecauseof
death.Halvingtobaccoconsumptionnow
wouldprevent20-30millionpeoplefrom
dyingbefore2025and170-180million
peoplefromdyingbefore2050fromall
tobacco-relateddiseasesincludingcancer.
Toquitsmoking,orevenbetter,toavoid
startingtosmoke,isthesinglebestthinga
personcandoforhisorherhealth.Forthose
whodosmoke,thereareimmediatehealth
benefitstobegainedfromquitting.
Smokingisapublichealththreatandjustifies
theinvolvementofsocietyasawholein
combatingit.
Exposuretotobaccosmoke(passivesmok-
ing)increasestheriskoflungcancerby20%
innon-smokers.
Theeconomiccostoftobacco,including
treatmentoftheillandlossofproductivity,
outweighstaxrevenuesderivedfromtobacco.
Makethisthelast
generation
thatsmokes
200000
0
400000
600000
800000
1000000
1200000
1400000
1600000
2000201020202025
Developedcountries
Developingcountries
Transition
Thenumberofsmokersisincreasing
particularlyinthedevelopingworld.
Numberofsmokers(inthousands)
Source:WHO&WorldBank2003
WH
OP
.
V
i
r
o
t
PREVENTION
17
PREVENTION16
Inmanycountries,peopleare
eatingmoreandexercisingless
andthereisapotentialdangerforother
countriesadoptingthislifestyle
Promotingahealthydiet
andanactivelifestyle
Germany
(1998)
Lithuania
(1997)
Peru
(2000)
Russia
(1996)
SouthAfrica
(1998)
USA
(2002)
Women
Obesity(BMI≥30.0)
BodyMassIndexkg/m
2
Men
WH
OA.W
aak
WH
OP
.
V
i
r
o
t
Inhighincomecountries,peopleareeating
moreandexercisingless–withresulting
increasesinbodyweight.Inmanydeveloped
countries,asmuchashalfoftheadultpopu-
lationmaybeoverweightandmorethan25%
obese.
Societiesreliantonsaltedandpickledfood
havehigherincidencesofgastriccancers.
Throughdietandexercise,wecanpreventup
toathirdofcancercases.Physicalactivity,
avoidanceofoverweightandfrequentdaily
intakeoffreshfruitsandvegetablesreduce
theriskofbreast,colon,oralcavity,lung,
cervix,andothercancers.
Source:WHOGlobalDataBaseonBMI,2005
WH
OP
.
V
i
r
o
t
%ofobesepopulation
EARLYDETECTION
19
PREVENTION18
Preventingcancerscaused
byinfection…
Earlydetectioncansavelives
bypreventingtheinfection
ChronicinfectionwithHepatitisBvirus
(HBV)increasestheriskoflivercancerat
least40-fold.IntheGambia,whereinfection
withthisvirusisendemic,aprogrammeis
underwaytovaccinatechildrenagainst
HBV.Surveysofthefirst60,000children
vaccinatedbetween1986and1990have
alreadyshownthat90to95%ofchronic
HBVinfectioncanbeprevented.Inthe
yearstocomeresearcherswillbewatching
thesechildrentoseewhethertheexpected
decreaseinlivercanceralsoresults.
Thesexually-transmittedhumanpapillo-
mavirus(HPV)canincreasetheriskofcervi-
calcancer100-fold.VaccinesagainstHPV
arebeingdevelopedandtested.Earlyresults
lookpromising.
PreventionofHIVinfectionwillalsoreduce
theincidenceofrelatedcancerssuchas
Kaposisarcomaandlymphoma.
Thechancesofsurvivingtheonsetofsome
commoncancersdependlargelyonhow
earlytheyaredetectedandhowwelltheyare
treated.Earlydetectionisbasedontheobser-
vationthattreatmentismoreeffectivewhen
cancerisdetectedearly.Itincludesaware-
nessofearlysignsandsymptomsofcancer
(e.g.lumps,sores,bleeding),andscreening.
Screeningisthemasstestingofpeoplewho
appeartobehealthy.Paptestforcervical
canceristhescreeningmethodthathassub-
stantiallycheckedthemortalityratesinmost
developedcountriesandtheprogrammes
insomemiddle-incomecountriesusingPap
testsareworking.
Inmanydevelopingcountries,wherethese
arenotfeasible,severalotherlowtechnology
approachesarebeingstudiedandlook
promising.
Thesuccessofpublichealthprogrammesin
detectingcancerearlydependsonthealloca-
tionofresources,availabilityofqualified
specialists,andaccesstofollow-uptreatment.
UI
C
C
UI
C
C
“
”
Source:IARC2004
Source:VivianiS.etal.,1999
InGuatemalanculture,itistabootospeakabout
cervicalcancer,andthereislittletonoeducation
aboutthedisease.Husbandsarereluctantto
bringtheirwivestodoctorsforscreeningortreat-
ment.Andoften,whentheydo,itistoolate.
Today,midwives,nursesandsocialworkersare
succeedinginbreakingtaboos,establishingasys-
temoftrust.Withthehusbands''approval,we
accompanythewomenfromthehometothedoc-
torsothattheyreceivethecaretheyneed.
MagdalenaTepeu,Midwife,PIENSA
SanJuanSacatepequez,Guatemala
CUREANDCARE
21
EARLYDETECTION20
Theworldaverageisbetween30to40%
Canceralsoaffects
children
Source:IARC1998
WH
OP
.
V
i
r
o
t
Eachyear,morethan160,000childrenare
diagnosedwithcancer,anditisestimated
that90,000willeventuallydieofcancer.
Althoughchildhoodcancersrepresenta
smallpercentageofallcancers,mostofthem
canbecuredprovidedpromptandessential
treatmentisaccessible.However,as80%of
childrenwithcancerliveindevelopingcoun-
trieswhereeffectivetreatmentisnotavail-
able,oneintwochildrendiagnosedwithcan-
cerwilldie.
Universalaccesstohigh-qualitycareand
support,togetherwithacommitmenttoallo-
cateresourcesforhealtheducationmust
becomeapriority.Acoordinatedstrategyby
theglobalcancercontrolcommunity–one
thatcombinesinnovativescienceandsound
publichealthpolicies–cansavealargepro-
portionofthe90,000youngliveslostevery
year.Thetimetoactisnow.
Survivalstrategies
Effectivetreatmentexistsformanycancers.
Optimaltreatmentcombinedwithearly
detectionleadstoahighrateofcurefor
cancersofthecervix,breast,oralcavity
andcolon.
Forsomecancersitessuchastheoesopha-
gus,treatmenthaslimitedeffectiveness
regardlessofcountry.However,therearesig-
nificantinequalitiesbetweencountriestreat-
ingthemorecurablecancerssuchasbreast
andleukaemia.
Thesuccessofpublichealthsystemsin
treatingpotentiallycurablecancersdepends
ontheappropriateallocationofresources
andequalaccesstogoodqualitycareand
informationforallcancerpatients.
“
”
Thebesttreatmentforall
Inhigh-incomecountriesthe5-year
survivalrateisbetween50to60%
5-yearCancerSurvivalRate(%)
USA
USA
USA
EUROPE
EUROPE
EUROPE
CHINA
CHINA
CHINA
Cancers
LeukaemiaOesophagusBreast
Survivaloutcomesvarydramaticallythroughout
theworld–notjustbetweencountries,notjust
betweencities,butevenbetweeninstitutionswith-
inthesamecity.Widevariationinaccesstoqual-
itycancercareisamajorcauseofthese
discrepancies.
DrKetayunA.Dinshaw
Director,TataMemorialCentre
Mumbai,IndiaSource:IARC,Globocan2002
ThePINDAprogramme(NationalChildhoodProgrammeof
AntineoplasticDrugs)wasinitiatedin1988aspartoftheNational
CancerControlProgramme.Initially,ittreatedleukaemias,lym-
phomasandsomesolidtumors,andprovidedpsychosocialsupport.
Lateronitincludedallcancers,aswellasaBoneMarrow
TransplantProgramme.ChilenowhasaNationalPediatricOncology
Programmewhere400newcases(thatis85%ofallchildhoodcan-
cers)aregivenfreetreatmenteachyear.Thankstothisprogramme,
over4,000patientshavereceivedthefulltreatmentandmorethan
2,600havebeencured.
DrMyriamCampbell,PediatricHematoncology
HospitalRobertodelRío,Santiago
NationalCoordinatorPINDA,Chile
“
”
CUREANDCARE
23
CUREANDCARE22
Today,24.6millionpeople
arelivingwithcancer
and6.7millionaredying
ofcancereveryyear
Improvingthequalityoflife
bymeetingpatientneeds
Improvingthequalityoflifeofpatientsliving
withcanceranddyingfromcancerisan
urgenthumanitarianneed.Morepeopleare
diagnosedwithcancer,andneedadequate
care.Manyofthem,particularlyinlessdevel-
opedcountriespresentinverylatestages.For
allofthemthebesttypeofcareispalliative
care,thatisthephysical,psychosocial,and
spiritualsupportthatcanconsiderably
improvetheirqualityoflifeandthatoftheir
familiesbyrelievingunnecessarysuffering.
Palliativecareisnotonlyendoflifecare,but
ispartofthecontinuumofcarefromthetime
cancerisdiagnosedthroughoutthecourseof
thedisease,alongsidetreatment.Itbecomes
moreintensivetowardstheendoflifeas
treatmentinterventionsbecomelesseffec-
tive.Palliativecarealsogoesbeyonddeath,
andincludesbereavementcareforfamilies.
Improvinghealthsystems
asapartoftheconcerted
actionagainstcancer
Positiveresultsforchronicdiseases,suchas
cancer,canonlybeachievedwhenpatients,
families,societies,andhealthcareteamsjoin
theireffortsinanorganizedandmotivated
way.
Healthsystemsneedtobeadaptedtomeet
theneedsofthehealthyandthesickby
developingcomprehensivecancercontrol
programmesthatseektoprevent,detectearly
cureandcare.
Uganda:Personalstory
AyoungUgandanwomanhadseverepain
becauseshewasinthelaststagesofatermi-
nalillness.Shehadbeenunabletosleep
becauseofseverepainformorethanthree
monthsbeforesheheardofHospiceAfrica
Uganda.Shewasgivenpalliativecareinclud-
ingoralmorphinetocontrolherpain.
Althoughthisyoungwomandiedeight
monthslater,shediedinpeaceandwithout
pain.Asshewasreachingtheendofherlife,
sheaskedherhospicenursetopassonher
message:
TheInternationalNarcoticsControlBoard
(INCB)continuestobeconcernedaboutthelow
consumptionofopioidanalgesicsforthetreatment
ofmoderatetoseverepaininmanycountries.The
BoardencouragesGovernmentsthathavenotyet
donesotoexaminetheextenttowhichtheir
health-caresystemsandlawsandregulationsper-
mittheuseofopioidsformedicalpurposes,and
todevelopplansofaction,withaviewtofacili-
tatingthesupplyandavaibilityofnarcoticdrugs
forallappropriateindications.
MrKoliKouame,Secretary
InternationalNarcotics
ControlBoard
“
”
Source:HospiceAfricaUganda
Pleasethankall.BecauseofyourhelpIampain
freeandabletomakeprovisionsformyfamily
aftermydeath.
“
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GLOBALACTIONAGAINSTCANCER24
Globalactionagainst
cancer
health-peoplearoundtheworldarealso
dealingwithotherdiseases,war,famineand
politicalinstability.Partlybecausecancerisa
complexdiseasewithmanyforms.Thereis
nooneanswer.Thereisnoonesolution.
Eachindividualhasaroletoplay.Health
careprofessionals,patients,survivors,pol-
icymakers,journalists,researchersand
donorscaneachcontributetotheglobal
effortagainstcancer.Thestrategiesare
availableandthetoolsready–thescience,
thelegislativeframeworks,thepro-
grammesandanenormousbodyofinfor-
mationononeoftheworld’smoststudied
diseases.
We''vetriedworkingalone,andwehavehad
limitedsuccess.Nowisthetimeforanew
approach-allsectors,publicandprivate,
workingtogethertoachieveacommongoal-
thecontrolofcancer.
Weknowthefacts.Theinexorableriseofa
largelyavoidablediseaseisexactinganunac-
ceptablehumanandsocialcostinevery
country.Everyyearalmost7millionpeople
dieofcancerworldwide.
Weknowwhatcanbedone.Wecansave
2millionlivesby2020.Agreatdealhas
alreadybeendonebutit’snotenough.
TheWorldHealthOrganizationandthe
InternationalUnionAgainstCancerare
workingtogethertoaddressthecancersitua-
tionatagloballevelandtopromoteconcert-
edactionagainstcancer.
Thechallengeisclearandmanypossible
solutions-prevention,earlydetection,cure
andcare-arewellknowntous.Sowhy
haven’tweachievedgreatersuccessin
reversingthetrends?Perhapspartlybecause
cancerisonlyoneofthemanychallengesto
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