The UICC Cancer Congress is a place where we usually participate from WHO, it brings all the major players in cancer together, it gives a lot of opportunity for networking and by the very nature of the cancer societies being present in such meetings it helps us to know what is the grass roots action going on, where we need more focus, what are some of the good results. So it actually is a good platform for exchange of information, for getting to know people and to disseminate what the WHO is doing through the WHO booth and other interactions. We also participate in many sessions, we have a good number of WHO staff participating in the various technical discussions as well.
What are you presenting?
Yesterday I gave a presentation on taking cancer as part of the overall non-communicable diseases which is very important because cancer shares many risk factors – tobacco, alcohol, unhealthy diet etc. So there is a lot of momentum if we bring all those parties together so that they can be addressed together and when it comes to cancer itself of course there are unique features of cancer that need to be addressed within the health system in terms of diagnosis and management. So while cancer is part of the NCD and the global momentum about non-communicable diseases and the global targets, there are also some features by which we want to really support countries to advance cancer control.
I have a session today which I am even more interested, it is on cancer screening and early diagnosis. So I just want to bring up this issue that while screening is important we have to have a lot of considerations before we start screening. All cancers cannot be screened, there are many prerequisites that a country needs to look into before they start screening. Screening of breast cancer is very different from cancer of the uterus, cervix, so the WHO is coming up with some guidance on these two issues which are very important for countries before they invest in such programmes. Because one of the key areas in cancer is the investment so we have to invest where there is maximum return, we have to invest in things which are feasible, we have to invest in things which are evidence based.
Where do you see the role of WHO in informing the practice and guidelines of cancer care?
That is very important, as you said. The unique situation is the issue. There are windows of opportunity we need to seize in many countries and put some intervention which is appealing to that window and that particular point of time. So in terms of displaced populations, WHO has been working mainly in supporting some sort of primary care interventions for start off, so we are looking at diabetes, heart disease, epilepsy and other conditions, but we also have recourse from some of these countries to say they also have a larger number of cancer patients who are displaced or their cancer treatment facilities have been destroyed. So we are working on a rapid assessment to see what is the situation and how best we can help them to improve upon some of the services. Of course there are a lot of challenges but we will see how we can support some of these issues.
Pain relief and palliative care is another very important issue, especially in cancer and also in displaced populations where there is no semblance of a health system sometimes. So we need to find innovative ways of reaching people who may not be in any list, who may not be coming to any particular [?? 3:22] but we need to reach them and make sure they are provided and cared for.
How will the information presented at WCC 2016 inform your work in future?
A lot of experience has been accumulated as we are seeing in this conference which is very useful and countries are also beginning to realise what is good for them at this given point in time. All the high income countries which are doing cancer screening or cancer control now have gone through a fifty year pathway and some of the countries that we are trying to help are at different stages in this pathway. So that is the most important learning, to say where we are, what are the prerequisites for a particular programme, how much of that is satisfied and what is the realistic incremental improvement that we can make in those prerequisites so that the next intervention can go in? It’s a continuous learning process, it is learning by doing and doing by learning so it has to be continuous in that way. So there are no easy fixes here, it has to be thought through, it has to be evidence based and contextualised to where the country is.
But there are a lot of other good things that we can look at. There is this good synergy between HIV programmes and cervical cancer that is coming up. There are various opportunistic case detection that is possible that many countries are trying to do. There are cheaper tests that we need to do for cervical cancer like the HPV testing. So there are avenues that the global community has to still push to make it more affordable, more available more accessible because the good things in cancer control need to be for the poorest people. That needs a lot of push from the UICC and from the WHO and agencies.
Any final thoughts?
The WHO is very pleased to be working with the UICC and all its partner agencies very closely. We are very committed to supporting cancer control so we are coming out. Our main function at the headquarters level is developing norms and guidance and standards, so we are developing such materials for cancer screening, for setting up pathology departments, for childhood cancer which, again, I wanted to highlight as a particular issue that needs to be taken up very fast. It may not need all the elements of cancer control but we still can make a big difference in childhood cancer. Nobody wants to see a child suffering from cancer or dying from cancer so that is something that we are pushing. But we need a lot of people, all hands have to be on deck to make a change.
