PERSPECTIVES ON THE QUALITY OF CANCER CARE IN THE U.S. AND LATIN AMERICA: Two leading Latino oncologists discuss the promise of therapeutic Inroads and the challenge of expanding access to latin America.

Author:Aviles, Alexander

THE FUTURE OF cancer presents a bit of a paradox. On one hand, experts foresee cancer diagnoses and fatalities increasing sharply in the coming decade, with as many as 12 million cancer deaths worldwide per year by 2030. At the same time, technological breakthroughs and immunotherapy treatments in development offer the hope of better prognoses and higher survival rates.

Few physicians understand the promise and peril of these double trend lines better than Arturo Loaiza-Bonilla, MD, MDEd, FACP, Vice Chair, Department of Medical Oncology at Cancer Treatment Centers of America[R] (CTCA), a comprehensive cancer care network of hospitals and Outpatient Care Centers in five U.S. cities--Atlanta, Chicago, Philadelphia, Phoenix and Tulsa.

"In the areas of immunotherapies and targeted therapies, innovation is taking place across the board," says Dr. Bonilla. "We're seeing the emergence of a new paradigm of treating patients by looking at their genomics and DNA biomarkers, not just their type of tumor. The bottom line is patients are living longer and living better. It's an exciting time for the field."

Consider breast cancer. The last few years have seen a revolution in the development and application of fresh combinations of new drugs (many of them less toxic) resulting in a significantly increased life expectancy for many patients. This is enabled by doctors' growing ability to identify and precisely target multiple sub-groups of cancer in a way that would have been unimaginable a decade ago.

Sadly, and for many reasons, opportunities to benefit from genomic sequencing, immunotherapy and other technological advancements are not equitably and geographically distributed. The new science requires high levels of specialization supported by sophisticated diagnostic and treatment technologies. These are mostly concentrated in the U.S., Canada and a few large Latin American capitals, notably Mexico City.

"Generally speaking, there is a resource and access problem in Latin America when it comes to the detection and treatment of cancer," says Ricardo Alvarez, MD, MSc, Medical Director of the Breast Cancer Center and Director of Research at CTCA[R]. "In many rural parts of Latin America, for example, it can be difficult to even find a physician who specializes in oncology. There are countries in Latin America where only one fellowship program exists in the entire country."

This resource gap will come into even sharper focus in the coming years as the...

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