Le traitement du cancer dans le monde en développement

BOSTON – Il y a plus de quatre décennies, Richard Nixon, le président des États-Unis, inspiré par les premiers résultats encourageants qui ont indiqué le potentiel de la chimiothérapie pour la guérison de maladies aussi graves que la leucémie lymphoblastique aiguë et la maladie de Hodgkin, a déclaré « la guerre au cancer ». Depuis, des progrès constants ont été observés dans l’utilisation de la chimiothérapie, la chirurgie et la radiothérapie pour traiter et guérir un nombre toujours plus grand de patients atteints du cancer. L’accès à ces avancées médicales susceptible de sauver des vies demeure cependant aléatoire dans les pays moins bien nantis, là où résident aujourd’hui la majorité des patients atteints du cancer.

Aux États-Unis, plus de 80 % des patientes atteintes du cancer du sein sont des survivantes à long terme et plus de 80 % des enfants atteints du cancer y survivent. En presque 40 ans de pratique de l’oncologie à l’Université Harvard, j’ai soigné des milliers de patients qui auraient eu une très mince chance de survie sans chimiothérapie. Beaucoup des patients qui ont reçu des traitements reçus dans les années soixante-dix sont vivants et bien portants ; leurs enfants sont maintenant des adultes productifs.

Mais ce n’est que lorsque j’ai travaillé au Rwanda en 2011 que j’ai vraiment saisi la puissance des moyens mis à ma disposition, en observant les conséquences de leur absence. Passer le seuil du service de pédiatrie du cancer à l’hôpital central public de référence à Kigali était comme un retour dans le passé. Les résultats des traitements chez les enfants rwandais atteints d’une tumeur de Wilms, une forme de cancer du rein qui afflige rarement les adultes, reflétaient ceux des États-Unis d’il y a 80 ans, avant que l’accessibilité aux traitements médicaux qui permettent de sauver aujourd’hui 90 % des enfants américains diagnostiqués.

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