Despite the high – and growing – burden of cancer in Asia, guidelines for treatment and care of cancer tend not to take into account differences in income levels across the region. 

In order to redress this imbalance, The Lancet Oncology is publishing three sets of resource-stratified guidelines for the management of kidney cancer, colon cancer, and palliative care for patients with cancer in Asia.

The statements each represent a consensus formed by panels of experts attending the Asian Oncology Summit in April, 2012, and review the latest evidence to provide guidelines that can be used in countries of different income levels across Asia. 

Asia has a high burden of cancer, with 6.1 million new cases diagnosed in 2008 – 48% of all new cases worldwide in that year – and deaths from cancer expected to rise in the region due to ageing populations and increased uptake of tobacco, alcohol, as well as rising levels of obesity. 

In the guidelines for supportive, palliative and end-of-life care for patients with cancer in Asia, lead author Professor Sheila Payne, at Lancaster University, UK, points out that, “Supportive, palliative, and end-of-life care offer the potential to enhance quality of life, improve pain control, and reduce suffering for patients with cancer and their families, and to give patients a dignified death.  However, many patients in Asia do not receive the supportive, palliative and end-of-life care that they need.” 

The authors go on to provide specific recommendations for pain assessment, medication, professional education and specialised interventions in Asian countries with different levels of resources, adding that, “Momentum is building in the development of palliative care services in Asia.  With increasing worldwide recognition of the essential contribution of palliative care to cancer care, many of the early steps in the development of palliative care services could be skipped or shortened.”

A second set of guidelines outlines how the most effective strategies for controlling colon cancer – which is becoming increasingly common in the Asia-Pacific region – can be applied in Asian countries with different levels of health-care resources and economic development. 

According to lead author Dr Gilberto de Lima Lopes, at Johns Hopkins Singapore International Medical Centre, “Colon cancer is a major public health challenge in the Asia-Pacific region.  Opportunities are available to improve prevention, early detection, and treatment of this malignant disease.  Resource-based guidelines should assist the health care community to implement the most cost-effective strategies in a stepwise fashion, aiming to improve health outcomes for this disease.”

Finally, a group of authors led by Dr Edmund Chiong, at the National University Health System in Singapore, provide resource-stratified guidelines for the management of kidney cancer in Asia. 

According to Dr Chiong, “With the increasing number of therapeutic options for kidney cancer, and the diverse infrastructure and economies in Asian countries, there is a need for management strategies that not only aim to improve cancer outcomes and minimise morbidity, but are also sensitive to cost and resources.”

The next Asian Oncology Summit will take place in Bangkok, March 22–24, 2013, in conjunction with the Organisation for Oncology and Translational Research.

Source: The Lancet