Recently Kyiv hosted the Twenty-first Century Cancer Forum that gathered specialists to yet again discuss the problems relating to malignant tumors. Cancer along with heart disease tops the list of the world’s most frequent killers. According to European Commission experts, “One in four EU residents dies of cancer, which claims 837,000 lives in Europe annually.” Below Health Minister Andriy PIDAYEV discusses the cancer situation in Ukraine.
“What scientific and practical developments has Ukraine seen in the sphere of cancer treatment?”
“Today we have significant scientific potential, with British and American scientists drawing on Ukraine’s experience. Our scientists have made great strides in the sphere of developing new methods of treatment, and our cancer surgeons have considerable expertise. To illustrate, last year they performed 80,098 surgical procedures and operated on 72,677 patients. Meanwhile, a total of 140,976 cancer patients received treatment, of whom 719 were children.
“In 1992, a specialized cancer care service was created in Ukraine, which is operating successfully. Our cancer care system includes 46 cancer dispensaries, anti-tumor centers, and hospitals employing 2,296 oncologists and radiologists. A total of 728 cancer departments and 2004 examination rooms supervise and provide treatment for cancer patients. We are working to create specialized departments at cancer care facilities such as breast, thoracic, and head-and-neck cancer departments, which will help increase the quality of medical care received by cancer patients. Simultaneously, I must admit that the current level of cancer care provided to Ukrainians still does not meet the real needs and present-day requirements.”
“What are the reasons behind this situation? After all, cancer incidence figures have been growing for years.”
“There is no denying that cancer remains a major problem for Ukraine. Compared with other diseases, there is a discernible upward trend in the number of cancer patients, with 322 new cases registered per 100,000 population annually. Many factors are at work: Chornobyl, a high level of environmental pollution, and lifestyle changes. Thus this unfortunate cancer trend is only natural and should be taken as a matter of course.”
“Does taking it as a matter of course mean giving up hope and waiting?”
“By no means. A top priority for the doctors is to change their attitude toward the problem and prepare to actively combat it. However, in Ukraine, much like in the rest of the world, using state-of-the-art technologies and medication in diagnosing and treating cancer is expensive. Meanwhile, in Ukraine we say that treatment is free of charge, and this is in fact so. And while a course of treatment in the West is very costly, believe me, here it is no cheaper. Thus, without doubt, even the seemingly generous funds allocated for oncology are inadequate.”
“Are there plans for an increased funding of the needs of oncology?”
“In May 2002 we adopted the state program, Oncology for the Years 2002-2006. UAH 105 million has been allocated for medication and an additional nine million for equipment. Thanks to the government, in 2003 this program was financed in full. Yet the practice has shown that this is not enough either. Although the draft budget for 2004 envisions increased funding, and UAH 115.6 million has been allocated for medication, the real figure of required funding exceeds 300 million annually.”
“Much has been said about the financial state of oncology. But imagine that tomorrow the required 300 million will be allocated. Will it really solve all the problems?”
“That the patients are diagnosed with advanced cancer is a major problem for the cancer care service, which is due to a number of factors and the low level of cancer awareness among general practitioners, along with the lack of cooperation between general practitioners and oncologists. Special attention should be paid to rural residents. As a rule, they are diagnosed when the disease is too advanced to respond to treatment. Early diagnosis and detection of the disease in its early stages is one of the ways to optimize the expenditure of state funds and achieve the best possible results in treatment.
“The second thing that merits special note is the treatment process. In terms of ensuring effective treatment of cancer patients, we set only such tasks as we can realistically hope to fulfill. Simultaneously, the array of various — both in terms of their mechanism of action and cost — chemotherapy drugs significantly complicates the process of planning allocations to buy them. The unification of the treatment system should significantly improve the provision of cancer care facilities with indispensable drugs. We assess our capabilities realistically. Today it is possible to provide all patients with drugs of the first line (those used in the initial drug therapy — Ed.), and should the Standards of Diagnostics and Treatment of Malignant Tumors be introduced this process will be accelerated to the maximum.
“As for making provisions for the treatment process, specialists in the sector should agree on a single interpretation of the notion of first line drugs both in quantitative and qualitative terms. And there is another aspect of planning the sector’s demand for medication. Recently the Commission of the State Drug Quality Control Inspection has completed its checks, and its findings are far from positive. The commission revealed violations of transport, storage, and application regulations for cancer drugs and blamed them on regional cancer services, which failed to take into account factors of the transport, storage, and application of drugs when drafting their requisitions.”
“What tops the list of priorities for the cancer service?”
“Among the major goals of Ukraine’s cancer service are early cancer detection, adequate treatment in the early stages of the disease, increasing life expectancy of cancer patients, rational use of funds by means of the introduction of new treatment protocols, and preserving the cadre potential. In my view, there is another important aspect, that is, maintaining continuous discourse among specialists, promoting the exchange of information, experience, and a common search for ways to increase the quality of treatment, as well as intensifying preventive measures.”
