World Cancer Leaders’ Summit 2015

Creating 'a world community' for cancer prevention, diagnosis and treatment

Dr May Abdel-Wahab - IAEA Division of Human Health, Austria, Vienna

You are a radiation oncologist of international repute, you’ve got a lot of experience at top centres in the States. You’re in Vienna for the International Atomic Energy Association that concerns itself very much with health related issues and cancer. Can you tell me what you’ve been talking about right here in Istanbul about developing cancer care?

We’re talking about partnerships and the importance of partnerships and also one of the main things we were talking about is how to evaluate what a country needs through specific impact missions etc. We’re very active in that area, we did have a mission in Peru a few years back, and this gives guidance. First of all it evaluates the situation, what’s available on the ground, then it gives guidance later on in terms of planning for the future.

What in fact were you doing in Peru and what did you find as an example of what you’re talking about?

The IAEA was there as part of an impact mission initially to assess the situation in terms of cancer control on the ground. We do it in conjunction with, as I said, the WHO and IARC and each group or each agency has its own area of expertise. Ours is mainly in radiation medicine and diagnosis so, for example, CT scans, PET scans, things like that, then there’s prevention. There’s also all the way from the beginning to the palliative care, so from prevention to palliative care.

Of course in cancer care the use of known treatment methods without using any vastly expensive new approaches, if you actually implement that you get a huge bonus, don’t you?

Yes, definitely. There’s a lot of opportunity for prevention, for example, of different cancers that could be of great benefit but then we also have to think of the cancers that are already present or occurring in the population and we need to provide good ways, interventions to treat them and cure them or palliate them.

I’m interested in finding out how you develop your partnerships to improve prevention but first of all the treatment. What are the big areas that need to be addressed globally in getting some of the basic treatments in there in each country?

That’s an excellent question. There are a wide variety of treatment techniques that we have to use and interventions and they all have to work together. So it’s not if you get one type of treatment only then it’s not going to work, you have to have the whole health system has to be comprehensive and work well. For example, if you have only, let’s say, radiation therapy or chemotherapy services that are well established but then you don’t have proper diagnosis and pathology and labs then you risk making a wrong diagnosis and everything will be based on the wrong premise. So it’s important to have the whole spectrum, hence the importance that we all work together. The WHO, IARC and IAEA has worked together at the UN inter-agency taskforce and we have a joint programme as well to try to promote this kind of comprehensive view and also include NGOs and others in some of these projects as well. So the whole group, we are a world community against cancer and we have to work together as such.

What sorts of priorities do you have in prevention and screening?

Prevention and screening, the WHO is very active in that area. Our contribution is basically through looking at nutritional issues related to prevention and also through a radiation-based process or radiation derived process. So deuterium, for example, to assess the intervention programmes within countries that are looking at, for example, preventing malnutrition or obesity or things like that. So that’s the main part of the prevention. In terms of diagnosis we’re very active in terms of CT scans, PET scans etc, to help countries develop these products and, at the same time, more importantly to get good teaching and training which is essential, and safety.

Now, if I live in any particular country what can I be doing? We can obviously hope that there are some important bodies like your own that are taking care of everything but how can the public and doctors get involved in all of this?

It’s important that we all get involved, whether as physicians through professional associations or NGOs, for example, or the general public is very effective in terms of intervening with advocacy and other things like that and to increase awareness of specific diseases and signs and symptoms for early diagnosis. Everyone has a role and if we all play that role we get more success stories.

So what’s the bottom line take home message that you’d like people to remember in order to get involved?

Many of us, unless we’re touched by cancer, either we work in the cancer field or we have cancer ourselves or have family members that have cancer, we don’t realise the need that’s out there and what needs to be done. So I would like people to get educated on this issue and try to be proactive and intervene so we can have less unnecessary cancer deaths. The other thing is that’s related to policy makers and decision makers is radiation therapy in itself is a very important part. 50% of all cancer patients are getting radiation therapy and the realisation is the equipment may be expensive up front but long term it’s very cost effective because the machine will last fifteen years and people will keep getting treated on the machine. The more people you treat the less expensive the cost is so it’s been found to be very cost effective. So we help people who are dealing with that kind of issue to determine whether it’s a good idea to start building a new centre, for example, or the need for radiation therapy.

So campaigning to get funding for radiotherapy equipment is campaigning well spent?

Definitely, definitely. It’s very cost effective and, more importantly, even in the palliative setting it’s very important. You can lessen dependence on opioids, lessen pain, so it’s definitely very important to have a good system.