“Global Cancer Burden and Natural Disasters: A Focus on Asia’s Vulnerability, Resilience Building, and Impact on Cancer Care”
Journal: Journal of Global Oncology
The world has been witnessing more frequent and greater intensity of weather-related disasters. Natural disasters hit every continent in the world. Asia bears the brunt in terms of frequency and the total numbers of people affected. This is mainly due to Asia’s increasing population, and large and varied landmass, with multiple river basins, mountains, flood plains, and active seismic and volcanic zones.
The Union for International Cancer Control New Global Cancer Date: GLOBOCAN 2018 has estimated the global cancer burden to have risen to 18.1 million new cases and 9.6 million deaths. Asia constitutes roughly 60% of the world’s population. The region contributes nearly half of new cancer cases and more than half of cancer deaths worldwide. This increase in the regional burden of cancer is largely a result of socioeconomic growth and the increasing size and aging of the population. In addition to the increasing cancer cases, the string of natural disasters will cause heavy damage and a great human toll in Asia.
Medical care for disaster-affected populations is traditionally focused on management of immediate trauma and acute infections. For people with noncommunicable diseases this presents a significant risk. Patients with cancer are especially susceptible to the disruptions that natural disasters can cause. Their needs are largely neglected. There is a need to refocus and expand disaster risk reduction strategies and resources to include patients with non-communicable diseases such as cancer because these conditions are generating the bulk of disability, ill health and premature death around the globe. Having the world’s biggest burden of cancer, Asia will definitely be facing these challenges.
Roselle De Guzman, MD, St. Luke’s Medical Center, in Quezon City, Philippines
Q: What are patients with cancer at risk for in areas where natural disasters occur?
Dr. De Guzman: The damaged infrastructure and disrupted health care system cause an inability to provide and meet the demands for optimal oncology care. In addition to physical injuries, there are risks for infectious complications, disrupted access to medicines, and interruptions of routine treatments and multidisciplinary care. The adverse effects of natural disasters on the environment impact morbidity and the quality of life of patients.
Natural disasters overwhelm the ability of the community to cope. Food shortages lead to severe nutritional consequences. Serious disruptions in the provision of standard medical care affect the psychosocial and emotional well-being of patients with cancer. Socioeconomic risks are also real issues. Natural disasters widen inequality. There is a close connection between disasters and poverty. The damaged livelihoods of people especially those in low-income nations exacerbate inequalities. Patients with cancer from the low-income communities have less socioeconomic resilience.
Q: How do patients with cancer handle having a disruption in care due to a damaging storm?
Dr. De Guzman: There is a greater challenge to face for patients with cancer during a devastating storm. They are particularly more vulnerable as a result of physical injuries, forced displacement, degradation of living conditions, and interruption of care. In life-threatening situations, patients and their families prioritize survival more than anything else. They ensure adequate supply of food and clean water, stay in a safe housing and evacuation center, and try to protect their livelihoods.
Access to medical care may not be an immediate concern for most of them in the aftermath of a disaster. When it is, however, patients and their families or caregivers learn to be self-sufficient and self-reliant. They find their own ways to access their needed medical care; it typically can take several weeks to months following the disaster for patients to get care. It is definitely a struggle for them, especially those in low- and middle-income countries where cancer care capacity and the health care support system may already be limited even before the disaster strikes.
Q: What is currently being done to improve conditions for disaster-hit areas?
Dr. De Guzman: Different United Nations agencies and national governments develop interrelated agreements that compose the global development framework. These pointed out the need for integrating policies on disaster prevention, mitigation programs, and resilience building into national development agenda. The World Health Organization, through the United Nations Interagency Task Force on the Prevention and Control of Noncommunicable Diseases, issued the priority actions and the minimum standards to be adopted in relation to noncommunicable disease care in emergencies. Their key actions include ensuring access to treatments and to essential diagnostic equipment, ensuring treatment of people with an acute life-threatening condition, and establishing standard operating procedures for referral. Local governments have followed the global development framework from disaster prevention to disaster risk reduction and mitigation strategies.
Q: What are some disaster risk reduction strategies that you’d like to see implemented?
Dr. De Guzman: International agencies have provided framework on disaster risk reduction for countries to adopt and implement. Nonetheless, there is a need for more dynamic orientation, education, and engagement with a variety of disaster relief stakeholders, including national institutions, private sector, and civil society. The growing burden of cancer and the increasing frequency and intensity of natural disasters in Asia are outpacing the implementation of risk reduction strategies. A call to action should be made in raising the awareness among health care professionals, medical societies, and hospitals on the vulnerabilities and needs of patients with cancer during natural disasters.
A coordinated workforce, integrated health information, and disaster-proof medical record and pathology specimen storage system are very helpful and relevant strategies. Equally important is a simple and efficient way of educating patients and caregivers at a primary health care level to promote self-management. In a natural disaster, personalized cancer treatment and multidisciplinary team management are unattainable without a knowledgeable patient, an effective communication system, and a complete and accurate medical record.