Cancer now kills more people worldwide than AIDS, tuberculosis and malaria combined, and more than half of deaths are in developing countries.
Yet many people, including policymakers, still harbor the misconception that cancer is a concern only for industrialized nations, rather than developing countries.
Cancer activists will try to dispel such myths today, as they mark World Cancer Day, an annual event organized by the Union for International Cancer Control, a global health group. Participants are planning more than 200 events around the world.
Traditionally, developing nations focused largely on preventing infectious diseases that kill infants, rather than on cancer, which is most common in older people. Today, however, thanks to clean water, refrigeration of food and vaccines, more people in developing countries are living longer, and the elderly populations of these countries are growing, says Otis Brawley, chief medical officer at the American Cancer Society.
Some cancers are more common in poor countries partly because access to health care and preventive services is lacking. For example, 85% of cervical cancer deaths are in developing countries, according to the cancer union.
Cancer rates are increasing in developing nations for many reasons. As poor countries industrialize, people are exposed to more hazardous chemicals, Brawley says. Cigarette companies also market their products heavily overseas. As more people take up smoking, lung cancer rates are rising, says Cy Stein, deputy director of clinical research at City of Hope Medical Center's cancer center in Duarte, Calif. Nearly 80% of the world's 1 billion smokers live in low- or middle-income countries, according to the World Health Organization.
"It's a perfect storm: more urbanization, with more fast food and more inactivity," says Katie Horton, a research professor with the George Washington University School of Public Health and Health Services in Washington, D.C.
Yet developing nations are often ill-equipped to care for cancer patients, Brawley says. Many dying patients lack even the basics, such as adequate pain relief, he adds. According to the Union for International Cancer Control, 99% of patients with "untreated and painful deaths" live in developing nations.
"Pain relief is cheap to do, and should logistically be easy to do, but it's not being done," Brawley says. "It's an issue of human suffering."
And 90% of the global consumption of opioid analgesics, such as morphine, is in just five regions: Australia, Canada, New Zealand, the USA and Western Europe. Less than 10% of these pain relievers are used by the other 80% of the population, the cancer union says. While some poor nations lack a strong health care system, part of the problem involves policy. Twenty-five nations, including many in Africa, make it illegal to import narcotic painkillers, Brawley says.
In the USA, myths about cancer can prevent people from getting appropriate treatment, Stein says. For example, some people are reluctant to have surgery because they mistakenly believe that exposing a cancer to air will make it grow. Others refuse to join clinical trials because they assume they will be a "guinea pig," when in fact patients in clinical trials are carefully looked after, he adds.
Some patients refuse hospice or palliative care (pain control), fearing that their doctors are giving up on them. And others think they can save themselves with "positive thinking," a fallacy that can lead patients to blame themselves if their disease gets worse, Stein says.
Today, cancer advocates will attack three additional myths involving global health:
- Cancer is just a health issue. More than 13 million people worldwide were diagnosed with cancer in 2010, creating $290 billion in health care costs. Cancer "has far-reaching social, economic, development and human rights implications," the cancer union says.
- Cancer is a death sentence. Many patients can now be cured, and others treated effectively so that people can live a long time after diagnosis, Stein says.
- Cancer is my fate. One-third of the most common cancers can be prevented largely through lifestyle changes, such as avoiding tobacco, limiting or eliminating alcohol, eating a healthy diet and maintaining a healthy weight, according to the international cancer union.
Cancer survivors and advocates will try to spread their message in a variety of ways. Brawley will lead a Twitter chat today at 11 a.m. EST, using the hashtag #WorldCancerDay.
He also will lead a Google Plus chat and live video broadcast from 3 to 5 p.m. EST. The American Cancer Society will also light the Empire State Building in orange and blue to draw attention to the global cancer fight.