Cancer Care in Low-Resource Areas: Cancer Treatment, Palliative Care, and Survivorship Care: A Workshop

When: November 14, 2016 - November 15, 2016 (8:00 AM Eastern)
Where: Keck Center (100) • 500 Fifth St. NW, Washington, DC 20001

Topics Biomedical and Health Research, Diseases, Health Care Workforce, Health Services, Coverage, and Access, Quality and Patient Safety
Activity: National Cancer Policy Forum
Board: Board on Health Care Services

Though cancer was once considered to be a problem primarily in wealthy nations, low- and middle-income countries now bear a majority share of the global cancer burden, and cancer often surpasses the burden of infectious diseases in these countries. Effective low-cost cancer control options are available for some malignancies, with the World Health Organization estimating that these interventions could facilitate the prevention of approximately one-third of cancer deaths worldwide. But these interventions remain inaccessible for many people in the world, especially those residing in low-resource communities that are characterized by a lack of funds. Low-resource areas tend to be concentrated in low- and middle-income countries, but these conditions exist in many populations and communities throughout the developed world as well, including the United States.

Few guidelines and strategies for cancer control consider the appropriateness and feasibility of such interventions in low-resource settings, which may undermine the effectiveness of these efforts. For example, interventions that are designed for high-resource settings may not account for important considerations such as resource constraints, infrastructure requirements, or whether a community has the capacity to deliver downstream care. In addition, social stigma, geopolitics, and cultural norms may limit access to adequate cancer care. As a result, cancer patients in resource-constrained communities continue to face delayed diagnosis of the disease, resulting in a more advanced stage at diagnosis and worsened prognosis.

A major goal of oncology practice is not only to reduce mortality, but also to decrease the burden of treatment and improve quality-of-life for cancer patients and survivors. The unmet need for palliative, end-of-life, and survivorship care is a challenge in many of the poorer regions of the world. There are also wide disparities in availability and quality of palliative care around the world and within countries. 

Recognizing the challenges of providing cancer care in these settings, the National Cancer Policy Forum developed a workshop series examining cancer care in low-resource communities. The first workshop focused on cancer prevention and early detection and was held on October 26 and 27, 2015. The summary from that workshop is available here.

The second workshop, held on November 14-15, 2016, focused on cancer treatment, palliative care, and survivorship care in low-resource areas.  The workshop featured invited presentations and panel discussions on topics that included:

  • An overview of disparities in cancer control and outcomes, accounting for cultural and political barriers to access as well as resource-constraints
  • The current evidence base and strategies to support effective cancer diagnosis and treatment in low-resource settings
  • Key gaps in the evidence base and the challenges and opportunities to address those gaps to improve cancer outcomes for patients in low-resource populations
  • Potential action steps for effectively applying the available evidence on cancer diagnosis and treatment in resource-constrained communities
  • Principled evaluations of successes and failures in cancer control efforts in low resource settings, which could serve as models for how to develop effective and affordable cancer control 

Planning Committee Members

Robert Carlson, Co-Chair, National Comprehensive Cancer Network
Richard Larson, Co-Chair, University of Chicago
Wendy Demark-Wahnefried, University of Alabama at Birmingham
Samir Khleif, Georgia Regents University Cancer Center
Mark Lazenby, Yale School of Nursing
Greta Massetti, Centers for Disease Control and Prevention
Worta McCaskill-Stevens, National Cancer Institute
Loyce Pace, Global Health Council
Kathleen Schmeler, University of Texas MD Anderson Cancer Center
Ya-Chen Tina Shih, University of Texas MD Anderson Cancer Center
Lawrence Shulman, University of Pennsylvania Abramson Cancer Center
Bhadrasain Vikram, National Cancer Institute

Confirmed Speakers

Lucile Adams-Campbell, Georgetown University
Ben Anderson, University of Washington
Rifat Atun, Harvard University 
Marie Bakitas, University of Alabama at Birmingham 
Michael Barton, University of New South Wales 
Eduardo L. Cazap, Latin American & Caribbean Society of Medical Oncology
James Cleary, University of Wisconsin
Gwen Darien,  National Patient Advocate Foundation 
Sheila Davis, Partners in Health
Sara W. Day, St. Jude Children’s Research Hospital 
Pat Garcia-Gonzalez, Max Foundation
Stephen Grubbs, American Society of Clinical Oncology
David Jaffray, Toronto General Hospital 
Marjorie Kagawa-Singer, UCLA Fielding School of Public Health 
Judith Salmon Kaur, Mayo Clinic 
Jeffrey McCullough, University of Minnesota
Karen Meneses, University of Alabama at Birmingham 
Danny Milner, American Society for Clinical Pathology
Augusto Ochoa, Louisiana State University
Olufunmilayo Olopade, University of Chicago
Stephanie Petrone, Novartis
Melanie Royce, University of New Mexico
Kathleen Schmeler, University of Texas MD Anderson Cancer Center
Lawrence Shulman, University of Pennsylvania Abramson Cancer Center
Judith Steinberg, Health Resources & Services Administration 
Edward Trimble, National Cancer Institute
Gina Villani, Ralph Lauren Center for Cancer Care

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