Dr. David J. Kerr has large experience in organization of cancer treatment in Africa, Middle East, South America and Asia. Why point-of-care diagnostics is crucial for early cancer diagnosis? How to ensure better and cheaper treatment of cancer in developing countries? The Journal of Global Oncology helps to spread the work of cancer researchers and doctors from the developing countries. Cancer care in developing countries. Dr. David J. Kerr, MD. Emerging markets and developing countries in Africa, Asia, Middle East and Russia / Eastern Europe have limited resources to fight cancer, including colorectal cancer. Dr. Anton Titov, MD. Leading colorectal cancer expert discusses cancer care in developing countries. Cancer treatment in Africa, Asia, South America and Eastern Europe has to be more efficient and rely on point of care diagnosis and treatment. Renowned colon cancer specialist Dr. David Kerr talks about cancer care organization in Africa, Middle East and other developing countries. Journal of Global Oncology new editor Dr. David J. Kerr, MD.. Cancer treatment in Africa charity AFROX (afrox.org) helps to establish best practices in cancer treatment in Africa. Use of mobile phone networks and point of care technology to diagnose cancer at the earliest stages offers best hope for cancer treatment in Africa, Middle East Asia and Russia / CIS. Interview with famous cancer specialist from Oxford University, Dr. David J. Kerr. Cancer care in developing countries: Africa, Asia, Middle East. Dr. Anton Titov, MD. You have particular interest and very impressive track record in organization of international cancer care. Dr. Anton Titov, MD. Cancer treatment and cancer diagnostics is very expensive. For most of the world outside of the United States and Western Europe the established system of very high-cost cancer treatment is just not achievable. But over 70% of new cancer cases occur in the developing world. It is important to know that many of cancer cases are preventable in the first place. Dr. Anton Titov, MD. Cancer prevention is a very important strategy of controlling cancer in the developing world. Nevertheless, for treating cancer patients in developing world other system has to be established. You have a large experience in cancer care organization in Africa and the Middle East. You have led a conference on treatment of cancer in Africa recently. How cancer care, cancer diagnostics and cancer treatment should be approached in the emerging markets? Dr. David Kerr, MD (Colon cancer oncologist, Oxford). Organization of international cancer care has become a dominating theme of later part of my career. Dr. David J. Kerr, MD. We all look back at our careers and decide what good we've done if anything. I like the concept of "amplified good". I can do this much (a little) by treating individual colorectal cancer patient. I sit across the colon cancer patient, I communicate cancer treatment decisions clearly, I love that aspect of clinical medicine (treating cancer). My colorectal cancer research can help hundreds of thousands of patients. This has larger impact on the world. There is an even larger potential in work to develop national cancer treatment plans. Dr. David J. Kerr, MD. We must develop health policies to treat cancer. We must work with healthy ministries and presidents of poorer countries. Cancer treatment organization has potential to save hundreds of thousands of lives. To me that is what the professional gift is. It is a gift of life. We have to pay attention to epidemic of cancer treatment in low income countries. Dr. David Kerr, MD (Colon cancer oncologist, Oxford). We have to establish basic building blocks of modern cancer care. Then we can change cancer care in the developing world for good. Dr. Anton Titov, MD. Where do we start across the spectrum of cancer control? We can start from raising awareness of cancer epidemic. Prevention of cancer and early cancer diagnostics is most important. 80% to 90% of cancer patients in sub-Saharan Africa present with Stage 4 cancer. It does not matter where those patients with Stage 4 cancer would be treated. Dr. David J. Kerr, MD. The impact of cancer treatment in such advanced cancer stage 4 is small in any cancer treatment system. Focus on prevention and early detection of cancer. This will make most difference in these resource-challenged countries. I work with colleagues in sub-saharan Africa. We have a small charity Afrox (www.afrox.org). I am honored by ASCO, American Society of Clinical Oncology to be made Editor-in-Chief of the new Journal of Global Oncology. This journal gives voice to our cancer treatment colleagues who are working in these poorer countries. Treating cancer in Africa is a difficult work. Some African languages do not have a word for cancer. Some dialects do not name cancer as disease. The Journal of Global Oncology will be a means for us to campaign on behalf of our oncology colleagues working in Africa (and other countries). Journal will bring their cancer research work to the world. But we are hungry to add their knowledge to the global knowledge about cancer treatment. we will support our international colleagues in this work. This is really important work. Dr. David J. Kerr, MD. We require greater understanding and volunteer efforts from our cancer treatment colleagues working in the developed countries. Dr. Anton Titov, MD. It's important to emphasize from examples such as telecommunications that a lot of the Asian and African countries are "mobile first". Dr. Anton Titov, MD. They bypass high-cost landline infrastructure. They go straight for mobile technology. Maybe medicine will develop in a similar fashion in Africa and Asia. You must have enough knowledge in medicine. Dr. David J. Kerr, MD. You must focus on prevention and early detection of disease. Then you can bring the costs of healthcare down. That is a trend in the world for cancer treatment and other medical care. Dr. David Kerr, MD (Colon cancer oncologist, Oxford). It is a good analogy. Mobile phone connectivity is better in Rwanda than in England. Technology adapts to environment. We must be more lateral in our thinking. Applying all modern western medicine to Africa does not work. It doesn't work. Dr. Anton Titov, MD. We need to adapt the ideas and concepts that we have on cancer diagnosis and cancer treatment. We need to involve engineers in hand-held cancer screening devices development. All medical technology has to work at point of care. This requires thought, innovation and invention. The reward of this work in cancer treatment is not only financial. There has to be some commercial return, it is true. But perhaps the sense that we are helping our brothers and sisters who are less well-off is a large reward in itself. Dr. Anton Titov, MD. This approach is very important. Perhaps it brings analogies from computer and consumer products world. The usability of products, the user experience. As you mentioned, the importance of handheld diagnostic equipment something that can be intuitively used. Intuitive use of medical devices means they can be used by many more patients. Dr. Anton Titov, MD. This is in contrast to equipment that requires sophisticated training. Dr. David Kerr, MD (Colon cancer oncologist, Oxford). I agree. We need to set challenges for us. We can avoid developing the next most expensive cancer medication or the next most complicated set of radiation therapy machines. That is the way medicine evolves in the West. Medicine becomes ever more expensive and complex in the West. Often it brings only marginal results. We need to step back. We need to design a very low cost linear accelerators rather than proton beam machines. Dr. David J. Kerr, MD. We can achieve much more good with that strategy. I am not a physicist or radiation oncologist. But there is a challenge in that. There is also a challenge in cancer diagnostics. Do we need all gene sequencing to come up with key elements to deliver precision medicine to Africa? I guess not. These are some big challenges that we now have in cancer treatment in Africa. Dr. Anton Titov, MD. This is very important work that you are doing. Dr. Anton Titov, MD. I am glad we have had a chance to discuss it. Cancer treatment in Africa, Middle East, Russia, South America - what are leading challenges? Point of care and early cancer diagnostics saves money and lives.
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