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Cancer has become a leading cause of death and disability and a serious yet unforeseen challenge to health systems in low-and middle-income countries. A protracted and polarized cancer transition is under way and fuels a concentration of preventable risk, illness, suffering, impoverishment from ill health, and death among poor populations. Closing this cancer divide is an equity imperative. The world faces a huge, unperceived cost of failure to take action that requires an immediate and large-scale global response. Closing the Cancer Divide presents strategies for innovation in delivery, pricing, procurement, finance, knowledge-building, and leadership that can be scaled up by applying a diagonal approach to health system strengthening. The chapters provide evidence-based recommendations for developing programs, local and global policy-making, and prioritizing research. The cases and frameworks provide a guide for developing responses to the challenge of cancer and other chronic illnesses. The book summarizes results of the Global Task Force on Expanding Access to Cancer Care and Control in Developing Countries, a collaboration among leaders from the global health and cancer care communities worldwide, originally convened by Harvard University. It includes contributions from civil society, global and national policy-makers, patients and practitioners, and academics representing an array of fields.
In 2005, 7.6 million people died of cancer. More than 70% of those deaths occured in low and middle income countries. WHO has developed a series of six modules that provides practical advice for programme managers and policy-makers on how to advocate, plan and implement effective cancer control programmes, particularly in low and middle income countries.The WHO guide is a response to the World Health Assembly resolution on cancer prevention and control (WHA58.22), adopted in May 2005, which calls on Member States to intensify action against cancer by developing and reinforcing cancer control programmes.
Building on the innovative Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Quality Through Collaboration: The Future of Rural Health offers a strategy to address the quality challenges in rural communities. Rural America is a vital, diverse component of the American community, representing nearly 20% of the population of the United States. Rural communities are heterogeneous and differ in population density, remoteness from urban areas, and the cultural norms of the regions of which they are a part. As a result, rural communities range in their demographics and environmental, economic, and social characteristics. These differences influence the magnitude and types of health problems these communities face. Quality Through Collaboration: The Future of Rural Health assesses the quality of health care in rural areas and provides a framework for core set of services and essential infrastructure to deliver those services to rural communities. The book recommends: Adopting an integrated approach to addressing both personal and population health needs Establishing a stronger health care quality improvement support structure to assist rural health systems and professionals Enhancing the human resource capacity of health care professionals in rural communities and expanding the preparedness of rural residents to actively engage in improving their health and health care Assuring that rural health care systems are financially stable Investing in an information and communications technology infrastructure It is critical that existing and new resources be deployed strategically, recognizing the need to improve both the quality of individual-level care and the health of rural communities and populations.
This atlas illustrates the latest available data on the cancer epidemic, showing causes, stages of development, and prevalence rates of different types of cancers by gender, income group, and region. It also examines the cost of the disease, both in terms of health care and commercial interests, and the steps being taken to curb the epidemic, from research and screening to cancer management programs and health education.
An ideal health care system relies on efficiently generating timely, accurate evidence to deliver on its promise of diminishing the divide between clinical practice and research. There are growing indications, however, that the current health care system and the clinical research that guides medical decisions in the United States falls far short of this vision. The process of generating medical evidence through clinical trials in the United States is expensive and lengthy, includes a number of regulatory hurdles, and is based on a limited infrastructure. The link between clinical research and medical progress is also frequently misunderstood or unsupported by both patients and providers. The focus of clinical research changes as diseases emerge and new treatments create cures for old conditions. As diseases evolve, the ultimate goal remains to speed new and improved medical treatments to patients throughout the world. To keep pace with rapidly changing health care demands, clinical research resources need to be organized and on hand to address the numerous health care questions that continually emerge. Improving the overall capacity of the clinical research enterprise will depend on ensuring that there is an adequate infrastructure in place to support the investigators who conduct research, the patients with real diseases who volunteer to participate in experimental research, and the institutions that organize and carry out the trials. To address these issues and better understand the current state of clinical research in the United States, the Institute of Medicine's (IOM) Forum on Drug Discovery, Development, and Translation held a 2-day workshop entitled Transforming Clinical Research in the United States. The workshop, summarized in this volume, laid the foundation for a broader initiative of the Forum addressing different aspects of clinical research. Future Forum plans include further examining regulatory, administrative, and structural barriers to the effective conduct of clinical research; developing a vision for a stable, continuously funded clinical research infrastructure in the United States; and considering strategies and collaborative activities to facilitate more robust public engagement in the clinical research enterprise.
Cancer touches everybody’s life in one way or another. But most of us know very little about how the disease works, why we treat it the way we do, and the personalities whose dedication got us where we are today. For fifty years, Dr. Vincent T. DeVita Jr. has been one of those key players: he has held just about every major position in the field, and he developed the first successful chemotherapy treatment for Hodgkin’s lymphoma, a breakthrough the American Society of Clinical Oncologists has called the top research advance in half a century of chemotherapy. As one of oncology’s leading figures, DeVita knows what cancer looks like from the lab bench and the bedside. The Death of Cancer is his illuminating and deeply personal look at the science and the history of one of the world’s most formidable diseases. In DeVita’s hands, even the most complex medical concepts are comprehensible. Cowritten with DeVita’s daughter, the science writer Elizabeth DeVita-Raeburn, The Death of Cancer is also a personal tale about the false starts and major breakthroughs, the strong-willed oncologists who clashed with conservative administrators (and one another), and the courageous patients whose willingness to test cutting-edge research helped those oncologists find potential treatments. An emotionally compelling and informative read, The Death of Cancer is also a call to arms. DeVita believes that we’re well on our way to curing cancer but that there are things we need to change in order to get there. Mortality rates are declining, but America’s cancer patients are still being shortchanged—by timid doctors, by misguided national agendas, by compromised bureaucracies, and by a lack of access to information about the strengths and weaknesses of the nation’s cancer centers. With historical depth and authenticity, DeVita reveals the true story of the fight against cancer. The Death of Cancer is an ambitious, vital book about a life-and-death subject that touches us all.
Dr. Keith Block is at the global vanguard of innovative cancer care. As medical director of the Block Center for Integrative Cancer Treatment in Evanston, Illinois, he has treated thousands of patients who have lived long, full lives beyond their original prognoses. Now he has distilled almost thirty years of experience into the first book that gives patients a systematic, research-based plan for developing the physical and emotional vitality they need to meet the demands of treatment and recovery. Based on a profound understanding of how body and mind can work together to defeat disease, this groundbreaking book offers: • Innovative approaches to conventional treatments, such as “chronotherapy”–chemotherapy timed to patients’ unique circadian rhythms for enhanced effectiveness and reduced toxicity • Dietary choices that make the biochemical environment hostile to cancer growth and recurrence, and strengthen the immune system’s ability to attack remaining cancer cells • Precise supplement protocols to tame treatment side effects, relieve disease-related symptoms, and modify processes like inflammation and glycemia that can fuel cancer if left untreated • A new paradigm for exercise and stress reduction that restores your strength, reduces anxiety and depression, and supports the body’s own ability to heal • A complete program for remission maintenance–a proactive plan to make sure the cancer never returns Also included are “quick-start” maps to help you find the information you need right now and many case histories that will support and inspire you. Encouraging, compassionate, and authoritative, Life over Cancer is the guide patients everywhere have been waiting for.
Cancer care today often provides state-of-the-science biomedical treatment, but fails to address the psychological and social (psychosocial) problems associated with the illness. This failure can compromise the effectiveness of health care and thereby adversely affect the health of cancer patients. Psychological and social problems created or exacerbated by cancer-including depression and other emotional problems; lack of information or skills needed to manage the illness; lack of transportation or other resources; and disruptions in work, school, and family life-cause additional suffering, weaken adherence to prescribed treatments, and threaten patients' return to health. Today, it is not possible to deliver high-quality cancer care without using existing approaches, tools, and resources to address patients' psychosocial health needs. All patients with cancer and their families should expect and receive cancer care that ensures the provision of appropriate psychosocial health services. Cancer Care for the Whole Patient recommends actions that oncology providers, health policy makers, educators, health insurers, health planners, researchers and research sponsors, and consumer advocates should undertake to ensure that this standard is met.
In Enduring Cancer Dwaipayan Banerjee explores the efforts of Delhi's urban poor to create a livable life with cancer as patients and families negotiate an overextended health system unequipped to respond to the disease. Owing to long wait times, most urban poor cancer patients do not receive a diagnosis until it is too late to treat the disease effectively. Drawing on ethnographic fieldwork in the city's largest cancer care NGO and at India's premier public health hospital, Banerjee describes how, for these patients, a cancer diagnosis is often the latest and most serious in a long series of infrastructural failures. In the wake of these failures, Banerjee tracks how the disease then distributes itself across networks of social relations, testing these networks for strength and vulnerability. Banerjee demonstrates how living with and alongside cancer is to be newly awakened to the fragility of social ties, some already made brittle by past histories, and others that are retested for their capacity to support.