Eduardo Cazap Espouses Global View of Cancer



More than 550 million people inhabit Latin America and the Caribbean — countries with a widely disparate range of resources for cancer care. Countries such as Mexico, Argentina, Chile, Brazil and Peru have modern cancer centers, well-trained health professionals and access to radiotherapy. Other countries — in the Caribbean, Ecuador, Bolivia and elsewhere — have limited resources. Vastly different incidence rates of individual cancers are also evident. The high incidence of gallbladder cancer in Chile is unheard of in Costa Rica. The cervical cancer so rampant in the Caribbean is rare in urban areas of Argentina, where, instead, breast cancer is epidemic. Less than an hour away, Argentina’s poorest patients arrive at the National Cancer Institute, predominantly with head and neck, cervical and lung cancers. And there are tremendous gaps in medical qualifications and the capacity for clinical and basic research. Countries like Argentina have a strong tradition in clinical cancer research, with several cancer institutes offering certification programs for medical oncology. In other Latin American countries, general surgeons provide cancer treatment and perform chemotherapy without the benefit of specialized training.

"The common denominator throughout Latin America and the Caribbean is the lack of support from governments for cancer plans, cancer registries, and cancer activities,” says Eduardo Cazap. Based on the recognition of the vast differences that exist between rich and poor countries, and the similarities we share with countries in Europe, we decided two years ago that we needed a regional organization to address these disparities. Cazap brought together leading oncologists from Mexico, Peru, Chile, Uruguay and Brazil to form the Sociedad Latinoamericana y del Caribe de Oncologia Médica. SLACOM’s mission is to access the educational, treatment and clinical research needs of the region, and to develop better cancer management programs through collaborative initiatives.

Eduardo Cazap espouses a global view of cancer.

"It is difficult for one organization to solve all the problems and to have sufficient resources and reach to manage the cancer situation,” admits Cazap, "so we have asked two leading oncology organizations in the world — the European Society of Medical Oncology and the American Society of Clinical Oncology — for endorsement and support of our project. We believe the best way to solve problems in the developing world is to bring together different organization from different regions. ” With the support of the European Society for Medical Oncology (ESMO), for which Cazap represented Argentina and Latin America from 1997 to 2003, SLACOM is working with specialists from Europe to develop guidelines for diagnosis and management and recommendations relating to the early detection of cancer to be used in Latin America.

Other organizations that could be helpful to SLACOM, he says, are UICC and the American Cancer Society. "If the effort of six or seven important organizations in the world could be coordinated, we could improve our ability to make a difference,” Cazap says. "INCTR is one of the groups that can be a player in this effort. My vision is similar to Ian Magrath’s — a global vision of cancer treatment and research, understood from the perspective of developing nations.”

A challenge for SLACOM is to find the intersection between those people with deep knowledge of the problem, and organizations that have the resources to help.

"We want to improve collaboration not only within our region, but throughout the world,” Cazap says. "Sometimes the situation is a lack of education, or of a cultural or social framework that makes for effective treatment. Our primary objective is to develop a strong organization to improve the quality of care in the region, and to improve the education of specialists, as well as general physicians and the general population. The International Union Against Cancer (UICC) and the American Cancer Society have already demonstrated that if the developing world makes better use of readily available information and technology, cancer curability improves significantly.”

E. Cazap provided the information for this article, which was prepared by M. Landskroener for INCTR.