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      The Situation of Cancer Treatment in Ethiopia: Challenges and Opportunities

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          Abstract

          Background

          Less attention is given to cancer treatment and control in Ethiopia.

          Methods

          To investigate the challenges and opportunities facing cancer treatment services in Ethiopia. A purposive sampling technique was applied to recruit the study subjects from Black Lion Specialized Hospital Oncology Department. A semi-structured interview guide was used to investigate challenges and opportunities in oncology service in Ethiopia. Data was transcribed and coded by two independent coders and analyzed thematically in reference to the objectives.

          Results

          Fifteen professionals from four different disciplines were interviewed on opportunities and challenges facing cancer treatment in Ethiopia. Out of these respondents 3 were senior clinical oncologists while 4 individuals were senior oncology residents. The rest were 2 medical Physicists, 2 radiotherapy technologists and 4 oncology nurses. Majority (80%) of the respondents were males. We demonstrate that the challenges of cancer treatment service in Ethiopia emanate from the patients themselves, the administrating body, the professionals, and the technology limitations. In general, the result of this study was grouped under the following five themes: Customer-related challenges, provider-related challenges, facility-related challenges, technology-related challenges and the opportunities.

          Conclusions

          Several assignments are waiting for the policy makers, the professionals, the communities and other concerned bodies to combat the alarmingly growing burden of cancer in Ethiopia. Escalating the awareness of the general population about cancer, expanding well-developed diagnostic and treatment centers, and producing well-trained competent oncology professionals are the forefront challenges in combating cancer in Ethiopia.

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          Most cited references30

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          Expansion of cancer care and control in countries of low and middle income: a call to action.

          Substantial inequalities exist in cancer survival rates across countries. In addition to prevention of new cancers by reduction of risk factors, strategies are needed to close the gap between developed and developing countries in cancer survival and the effects of the disease on human suffering. We challenge the public health community's assumption that cancers will remain untreated in poor countries, and note the analogy to similarly unfounded arguments from more than a decade ago against provision of HIV treatment. In resource-constrained countries without specialised services, experience has shown that much can be done to prevent and treat cancer by deployment of primary and secondary caregivers, use of off-patent drugs, and application of regional and global mechanisms for financing and procurement. Furthermore, several middle-income countries have included cancer treatment in national health insurance coverage with a focus on people living in poverty. These strategies can reduce costs, increase access to health services, and strengthen health systems to meet the challenge of cancer and other diseases. In 2009, we formed the Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries, which is composed of leaders from the global health and cancer care communities, and is dedicated to proposal, implementation, and evaluation of strategies to advance this agenda. Copyright © 2010 Elsevier Ltd. All rights reserved.
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            Globalisation and the prevention and control of non-communicable disease: the neglected chronic diseases of adults.

            The growing global burden of non-communicable diseases in poor countries and poor populations has been neglected by policy makers, major multilateral and bilateral aid donors, and academics. Despite strong evidence for the magnitude of this burden, the preventability of its causes, and the threat it poses to already strained health care systems, national and global actions have been inadequate. Globalisation is an important determinant of non-communicable disease epidemics since it has direct effects on risks to populations and indirect effects on national economies and health systems. The globalisation of the production and marketing campaigns of the tobacco and alcohol industries exemplify the challenges to policy makers and public health practitioners. A full range of policy responses is required from government and non-governmental agencies; unfortunately the capacity and resources for this response are insufficient, and governments need to respond appropriately. The progress made in controlling the tobacco industry is a modest cause for optimism.
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              Targeted therapies: a new generation of cancer treatments.

              Targeted therapies, which include monoclonal antibodies and small molecule inhibitors, have significantly changed the treatment of cancer over the past 10 years. These drugs are now a component of therapy for many common malignancies, including breast, colorectal, lung, and pancreatic cancers, as well as lymphoma, leukemia, and multiple myeloma. The mechanisms of action and toxicities of targeted therapies differ from those of traditional cytotoxic chemotherapy. Targeted therapies are generally better tolerated than traditional chemotherapy, but they are associated with several adverse effects, such as acneiform rash, cardiac dysfunction, thrombosis, hypertension, and proteinuria. Small molecule inhibitors are metabolized by cytochrome P450 enzymes and are subject to multiple drug interactions. Targeted therapy has raised new questions about the tailoring of cancer treatment to an individual patient's tumor, the assessment of drug effectiveness and toxicity, and the economics of cancer care. As more persons are diagnosed with cancer and as these patients live longer, primary care physicians will increasingly provide care for patients who have received targeted cancer therapy.
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                Author and article information

                Journal
                J Cancer Prev
                J Cancer Prev
                JCP
                Journal of Cancer Prevention
                Korean Society of Cancer Prevention
                2288-3649
                2288-3657
                March 2019
                30 March 2019
                : 24
                : 1
                : 33-42
                Affiliations
                [1 ]Department of Reproductive Health and Health Service Management, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
                [2 ]Department of Nursing and Midwifery, School of Allied Health Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
                [3 ]Department of Oncology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
                [4 ]Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
                [5 ]Department of Pathology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
                Author notes
                Correspondence to: Wajana Lako Labisso, E-mail: wajana.lako@ 123456aau.edu.et , ORCID: Wajana Lako Labisso, https://orcid.org/0000-0003-0687-3745
                Article
                jcp-24-033
                10.15430/JCP.2019.24.1.33
                6453587
                30993093
                363d79b9-5792-4a54-b45a-fa83be2a1047
                Copyright © 2019 Korean Society of Cancer Prevention

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 07 February 2019
                : 21 March 2019
                : 21 March 2019
                Categories
                Original Article

                cancer,ethiopia,challenges,opportunities,black lion specialized hospital

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