l. pablos

scientific curator

CANCER IN MEXICO: AN OVERVIEW OF THE LANDSCAPE OF PEDIATRIC CANCER AND THE HEALTH SYSTEM IN MEXICO.

“If the trends continue as expected, by 2020, it is projected that Mexico will experience a total of 216,679 new cancer cases and 23,359 cancer-related deaths with an indirect estimated cost of cancer of approximately 1 billion dollars.”

Surviving cancer is not only a matter of an effective treatment, an inefficient health system afflicted with obstacles ranging from low resources to low accessibility to a lack innovation, has a detrimental effect on a country’s ability to increase cancer survival rates.

Just in 2013, worldwide, there were 14.9 million new cancer cases and 8.2 million cancer-related deaths, making cancer shift from the third to the second leading cause of death. [Global Cancer Facts 3rd Edition]

Despite the progress, the burden of cancer keeps increasing, and the appropriate allocation of resources for effective control strategies is becoming increasingly difficult and strenuous to a country’s health system. [A1]

THE BURDEN OF CANCER IN MEXICO.

Low accessibility, low quality, and lack of innovation, among others, are characteristics commonly found in the health system of developing countries.

Such is the case with Mexico, who also suffers from a public health system that is systematically fragmented, highly inefficient, and in high need of transformation.

Methods to control and/or reduce the catastrophic burden of cancer requires that the country drafts a well-planned strategy, taking into consideration careful allocation of resources towards prevention, screening, diagnosis, treatment, care, and surveillance, elements that in its entirety, are the basis for a cancer control program (Fig. 1).

IMAGE: BASIC ELEMENTS FOR A CANCER CONTROL PROGRAM

By failing to create or adopt the necessary strategies, a country’s health system could expect to see an increased number of new cancer cases as well as a severe deficiency in their resources.

A deficiency of resources due to the elevated costs of cancer therapies and the indispensable need for integral treatments that, in the majority of the cases, neither patients nor families or institutions can afford, would certainly place a high strain to the health system infrastructure. [E]

If the trends continue as expected, by 2020, it is projected that Mexico will experience a total of 216,679 new cancer cases and 23,359 cancer-related deaths with an indirect estimated cost of cancer of approximately 1 billion dollars.

Since Mexico lacks a cancer control program, understanding the incidence, prevalence, and morbidity of this disease so as to extrapolate an effective approach to alleviate the burden that a high impact disease like cancer places on the country, Mexico will be left struggling to find strategies for transforming its health system into a more efficient one.

THE BASICS OF CANCER

Both, pediatric and adult cancers arise from genetic mutations that lead to an uncontrollable growth of cells that are not “healthy”, thus, threatening the normal function of the body.

Biologically, adult and pediatric cancers are not the same, the primary reason for this, the type of cell from which cancer originates.

Adult cancers, such as breast, lung, and colorectal cancer, often develop from epithelial tissue- cells that cover or line bodily surfaces and cavities.

Conversely, pediatric cancers, including sarcomas and leukemias, often develop from immature pluripotent cells constituting non-ectodermal tissues such as bone marrow, lymph glands, bone, brain nerves, and muscle.

While adult cancers typically result from an accumulation of mutations that, in combination with external factors such as smoking or sun overexposure, later cause disease, pediatric cancers are more likely to develop due to genetics- inherited mutations passed from the parent to the child- or acquired during fetal development events.

In terms of growth and progression, most adult cancers grow slowly enough that they can be monitored periodically while pediatric cancers, because of the tissues in which they develop, proliferate at terrifying speeds. It is for this reason that, compared to adults, pediatric cancer is usually found at an advanced stage and require an immediate course of action.

Chemotherapy, radiation therapy, immunotherapy, surgery, and stem cell transplants are available and widely used methods of treatment for both adult and pediatric cancer patients.

However, one important considerations is that children’s bodies are unique and biologically different from adults- for example, lung, liver or kidney functions are not considered fully mature until 15 years of age.

Because some treatments or medicines for adults cannot be given to pediatric patients, the amount of treatment available for a pediatric patient becomes limited and the issue of the type of treatment and the dosage must be tailored to a patient’s personal level.