Cancer Care for the Developing World

Over the last 40 years, steady progress has been made in the use of chemotherapy, surgery, and radiation to treat and cure cancer patients. But access to these life-saving advances remains elusive in low- and middle-income countries, where the majority of cancer patients reside today.

BOSTON – More than four decades ago, US President Richard Nixon, inspired by early and encouraging results that showed that chemotherapy could cure diseases such as acute lymphoblastic leukemia and Hodgkin’s lymphoma, declared “war on cancer.” Since then, steady progress has been made using chemotherapy, surgery, and radiation to treat and cure an increasing number of cancer patients. But access to these life-saving advances remains elusive in low- and middle-income countries, where the majority of cancer patients reside today.

In the United States, more than 80% of patients with breast cancer are long-term survivors, and more than 80% of cancer-stricken children survive. In my nearly 40 years as an oncologist at Harvard University, I have cared for thousands of patients who would have had little chance of survival were it not for chemotherapy. Many of the patients who received treatment in the 1970s are alive and well today; their children are now productive adults.

But it was not until I began working in Rwanda in 2011 that I fully grasped the power of the tools at my disposal, by witnessing the impact of their absence. Stepping into the pediatric cancer ward at the central public referral hospital in Kigali was like traveling back in time. Outcomes among Rwandan children with Wilms’ tumor, a form of kidney cancer that rarely afflicts adults, mirrored those in the US 80 years ago, before the availability of drugs that today enable more than 90% of diagnosed American children to survive.

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