Dr Jan Pinchevsky, Takeda medical affairs therapeutic area lead highlights the importance of lung cancer awareness and explains how unlocking access to appropriate diagnostics and care has become critical in South Africa.
According to the National Cancer Strategic Framework: “Cancer is a growing national health and socio-economic concern in South Africa. It has been recognised as preventable through immunisation, lifestyle changes, early detection as well as timely treatment, thereby relieving unnecessary suffering.”
From this same report and based on the National Cancer Registry (NCR) reports of national cancer incidences, these five cancer types in adults have been identified as priorities, namely, Lung cancer, Colorectal cancer, Cervical carcinoma, Prostate cancer and Breast cancer.
This reiterates the importance of raising ongoing awareness with regards to lung cancer and highlighting that lung cancer should not be treated as one disease only. The segmentation of the aforesaid is imperative to achieve more favourable health outcomes.
Lung cancer may occur in both smokers and non-smokers. Smokers are at an increased risk of developing lung cancer due to the increased frequency and accumulation of mutations within their lung cells. However, the fact is, not every smoker will get lung cancer due to effective DNA repair mechanisms. Although smoking remains the primary cause of lung cancer, it is important to know that around 8% of lung cancer cases are genetically predetermined.
COVID-19 made the world stand up and take notice of the deadly nature of respiratory diseases. As much as we are still in a pandemic, lung cancer remains one of those insidious diseases that doesn’t get diagnosed even when symptoms show up. When someone coughs, lung cancer is never the first thought. Most people tend to attribute it to an allergy, asthma, cold or flu and try to bear with it until the cough ‘goes away’. It’s only when the severity of the cough escalates or there is an onset of chest pain, shortness of breath, wheezing, tiredness and coughing of blood that they finally go to see a health care professional.
This is where the danger lies. There is an inherent belief in too many people that lung cancer is not a disease that can happen to them. Before they know it, they finally get diagnosed and the prognosis may not always be favourable. For lung cancer as with any cancer, late diagnoses and not seeking treatment more often than not may lead to fatal consequences.
The trouble is, most South Africans have limited access to treatment or even diagnosis. Oncology centres are generally only situated in and around major cities or centres. Primary care clinics and district hospitals in remote areas don’t tend to deal with oncological issues, so the disease gets relegated to the bottoms of our minds.
Regardless, these clinics and hospitals are too far away for too many. Travel becomes a barrier getting in the way of proper screening, diagnosis and even treatment. It’s not so easy to trek to a clinic 100km away considering the cost of transport and the rampant poverty impacting the majority of people, especially those who live in rural and remote areas. People would rather risk lung cancer than lose an income. That is a reality that is only going to become starker as the economic situation continues to decline.
Raising awareness of risk factors and screening for cancer in the population along with improved access and quality of health care is important. Diagnosis of lung cancer involves a team of trained healthcare professionals which is exactly why screening en masse is such a challenge. It is a cumbersome and costly process.
First you must present to a doctor, then you would need to have an examination performed.
Once you have been assessed, the doctor would decide on the next step. This could be an Xray, CT-scan which could then lead to further imaging through a PET-CT scan. If a lesion on the lung is detected, then a piece of that growth may need to be extracted for further laboratory testing. This is a comprehensive set of investigations that comes at no small cost – either to the medical aid or even the state.
We need to acknowledge that there are several system-related barriers to lung cancer care that need to be targeted to improve the outcomes. There is a need to strengthen lung cancer surveillance to accurately estimate the burden of lung cancer in the country and inform the responsible cancer control programme.
I speak mostly for the vast majority of South Africans who do not have the privilege of access to private healthcare. It is infamously well known that our healthcare system is as disparate as can be, so there is a need for strategic public-private partnerships to bridge the gap and finally deal with the lung cancer crisis that has been left dormant for so long.
While awareness will show South Africans the door, it is access that will help them open it. This is something that our healthcare sector needs to work towards.
As mentioned in the National Cancer Strategic Framework: “A cancer death is a tragedy for both the family and for the community. The financial costs of a cancer diagnosis impact on the family, community and the country as a whole”.
Takeda is a global, values-based, R&D-driven biopharmaceutical leader headquartered in Japan, committed to discover and deliver life-transforming treatments, guided by our commitment to patients, our people and the planet. Takeda focuses its R&D efforts on four therapeutic areas: Oncology, Rare Genetics and Hematology, Neuroscience, and Gastroenterology (GI). We also make targeted R&D investments in Plasma-Derived Therapies and Vaccines. We are focusing on developing highly innovative medicines that contribute to making a difference in people’s lives by advancing the frontier of new treatment options and leveraging our enhanced collaborative R&D engine and capabilities to create a robust, modality-diverse pipeline. Our employees are committed to improving the quality of life for patients and to working with our partners in health care in approximately 80 countries and regions. For more information, visit https://www.takeda.com.