Worldwide, nearly one in six deaths are caused by cancer-related illnesses. According to the World Health Organization, 70 percent of these deaths occur in low- and middle-income countries.
Besides personal acceptance, family issues, quality of life, and absence from work, cancer patients worry on how to sustain their expensive treatments to somehow survive or extend their lives.
Cancer knows no age or gender. It chooses no one whether he’s rich or poor. And with any cancer, grief begins at the time of diagnosis where life of a patient drastically changes.
Chemo vs immuno-targeted therapies
Targeted therapy, as the name indicates, “target” specific cancer cells. It alters the inner workings of the cell focusing on the part of the cancer cell that makes it different from the normal, healthy cell.
Immunotherapy, on the other hand, uses the body’s immune system to fight cancer cells. It stimulates the immune system and may be used with other types of treatment or by itself.
While chemotherapy, as a general rule, targets the cells that are rapidly growing, however, it cannot differentiate between cancerous and healthy cells. Cells such as those in gastrointestinal tract have fast growing cells, and the side effect is they could get affected.
“That’s why the nausea, diarrhea, and hair loss happen because chemotherapy might target normally fast growing cells by mistake. Chemotherapy doesn’t directly target cancer cells,” said Aghmesheh.
However at present, immunotherapy is being offered only for certain diseases such as lung cancer, melanoma, Hodgkin’s lymphoma, bladder, head, and neck cancers and at certain stages based on the recommendation of a medical oncologist who helps the patient understand when it is feasible to use it.
“It is sad that we cannot offer this to our patients left and right because of the financial constraints. But we have a very good network nowadays such as Philippine Alliance of Patient Organizations [PAPO], Department of Health, PCSO [Philippine Charity Sweepstakes Office], PhilHealth, academic societies – working together to be able to bring new treatment approaches and assistance to the patients,” said medical doctor Mary Claire Soliman, president of the Philippine Society of Medical Oncology.
In 2017, one newspaper reported that families spend an average of P150,000 per cancer treatment alone, and now immunotherapy is estimated at P300,000 per session.
Most requested case
The PCSO through the Charity Assistance Department reported that chemotherapy ranked No. 2 in the most requested cases, next to confinement/hospitalization.
“As of first quarter this year, the agency already received 8,313 requests amounting to P386.15 million for chemotherapy,” said PCSO General Manager Alexander Balutan.
But there are limitations to the amount of assistance being released, which is based on the classification system established by the program.
“All Filipinos can request assistance personally or by sending a representative if they are confined in any health facility and receiving healthcare management as outpatients. Those who want to seek management in foreign countries can avail of IMAP, as long as, no health facility within the Philippines is capable of providing such procedure,” clarified Balutan.
Requests for chemotherapy sessions fall under the Individual Medical Assistance Program (IMAP) of PCSO. IMAP is the flagship program of the agency, which was institutionalized in 1995 to provide timely and responsive financial assistance to individuals with health-related problems.
As an alternative, patients are advised to go directly to At-Source-Ang-Processing (ASAP) Desks located in hospitals and health facilities to relive them from going to PCSO Main Office or Lung Center of the Philippines, Quezon City.
PCSO also has 63 branches across the country with the opening of seven new branches last year in the provinces of Lanao del Norte, Catanduanes, Sultan Kudarat, Eastern Samar, Biliran, Davao del Norte, and Ifugao.
“We issue guarantee letters addressed to health facilities [hospitals, dialysis centers, among others] where PCSO assumes the obligation of a specific amount due from the client for the services rendered,” explained Krisch Trine Ramos, medical officer at the Office of the Assistant General Manager for Charity Sector of PCSO.
Early detection is key
In a Globocan data prepared by the Philippine Cancer Society, there are estimated 11,000 new cancer cases in 2015.
Leading the new cancer cases from both sexes are breast, lung, colorectal, liver, and cervical cancers. In terms of new cancer deaths, the top is lung, liver, and breast cancers.
According to Aghmesheh, it is a possibility that cancer cells are already present in one’s body and are only triggered by certain factors.
“It is quite possible that all of us have cancer cells, but the body has so many defense layers that this can sustain us unless they can become smart enough and can get through all those layers of defense to be able to grow,” he said.
He further explained that for cancer cells to become a tumor, it needs to go to so many steps and also to go under the radar of the immune system in order for the cancer to grow.
A patient may have some abnormality in the immune system. Some immune deficiencies in the early childhood that can get different conditions but in general, 60 percent of cancer happens over the age of 60.
“Elderlies, I think, like any other organ in the body over time can become weak, like heart, kidneys, lungs, the immune system wears off in time as well and may become weaker as one grows older and may fail to defend the body,” said Aghmesheh.
Apart from treatment options, Soliman emphasized the need to go back to the basics, live healthier, and avoid “instant” foods.
Early detection is also important in winning the war against cancer. But when one has already been diagnosed with cancer, he has to look for a cancer center that has multi-modality and multi-disciplinary team approaches in managing and promoting the patient’s better survival.
“All cancers are treated by a group of specialists composed of surgical oncologist, general surgeons, colorectal surgeons, ears-nose-throat doctors, gynecologists, radiation oncologists, and other specialists who meet together to discuss and decide the manner of treatment/sequence in the way the patient is managed,” said Soliman.
She clarified, however, that having a team of specialists doesn’t mean the patient has to consult each one of them or pay for each of the doctor’s consultation/professional fees, which are one of the major concerns of patients.
“Sometimes we present a patient’s case in a discussion/conference to the tumor board. We just try to pick each other brains to ask what modality to use to make this patient live longer,” clarified Soliman.
Article published at The Manila Times, April 21,2018