Recommendation guidelines in breast cancer resolution for the Eastern Mediterranean

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Published: 25 Jan 2018
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Dr Slim Slama - WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt

Dr Slama speaks with ecancer at the 10th BGICC in Cairo about his work with the regional office of the WHO, and participation in the congress panel on breast cancer guidelines for low and middle income countries.

He discusses public health approaches in cancer prevention and management, noting the essential consideration of guidelines to suit nations across the globe.

For more about global management of cancer care, watch our coverage of the UICC 2016 meeting here, and the 2017 meeting on Cancer Control in LMICs here.

 

I think I would like first to thank the organisers for the invitation for giving WHO the opportunity also to contribute to this important conference. As part of our work we try to support member states and Ministries of Health around the globe in trying to carve effective national responses for the prevention of those conditions and cancer is really an important condition that takes a lot of life and suffering. We know that about 8.8 million people worldwide are dying from cancer so it's the second cause of death for non-communicable diseases after cardiovascular disease so it's a really important public health concern that we are tackling here. So it's important that WHO take part in those activities and conference meetings to raise awareness and also to discuss better strategies and the latest scientific developments in the management and prevention of those conditions.


With all the international boundaries, are there issues with guidelines?


There is the dimension of clinical management which is all about the guidelines but beyond that there is also the public health approach on how cancer can be prevented in the first place, looking at the population level intervention like tobacco prevention is an important element of any cancer prevention programme worldwide. So it's not just about talking about guidelines for clinical management for early detection, for the surgical aspect, for the medical therapies but beyond that also trying to look at what are the strategies for prevention, early detection, management, even palliative care, which is one of the streams of this conference, also need to be included in our discussions. So clearly guidelines are part of this and knowledge is moving but what is important, perhaps, for a conference that is held here in Egypt and for the region is that whatever happens in Canada or in Switzerland or in the United States needs to be tailored to the context of our country. So the epidemiology might be slightly different but most importantly the systems and the health service provision is different from country to country. So we need to take into account those aspects of the system disparities so that we carve responses that are really contextualised.


Cancer, like all the non-communicable diseases, by definition requires multi-stakeholder involvement with the disciplinary teams and starting from the patient themselves. So a coalition not only of health professionals or public health officials but also having communities, patients, being involved in understanding how we can raise awareness, advocate for the provision of effective services that are reaching all.

How do you see these translating to breast and gynaecological cancers?


We have been working with the group of panellists and tomorrow morning we will meet also to try to carve a kind of consensus on a resolution what could be some of the main recommendations that this conference comes from. As I mentioned, it spans from prevention, early detection, management and some aspects of palliative care so we will try to also align those recommendations with what WHO is recommending in terms of normative work in this field of cancer prevention and control. In the region the countries have recently adopted during the original committee, the original resolution on the prevention of cancer with a framework that guides a bit the countries, a kind of road-map for countries to follow, if you want, to better address cancer prevention and control. So we will try to have this dialogue with the conference organisers of how we can match the conference specific recommendations with more broader initiatives taking place at the moment to support our member states in the region.


I'm a clinician by training and sometimes we used to be so much involved in individual care that we tend to lose a bit the public health perspective on how actually clinicians can contribute to that. So I would invite them also to take into consideration what is happening at the level of their ministries, at the national level and be informed about the national strategies and see how they can contribute to that so that progressively all those converging efforts will try to reduce the impact and the burden of cancer.