In a country like the Philippines, few worse tragedies can befall a family than cancer. For the poor, the fate is doubly tragic—treatment is exorbitant, virtually impossible—and a diagnosis is almost always seen as an automatic death sentence.
It need not be, of course. Over the years and decades, sophisticated and advanced ways to treat cancer have been developed, thanks to tireless research. But between breakthroughs in laboratories and patients, the local realities to receive treatment is a long, complex, and expensive process. The multi-sectoral alliance of the Cancer Coalition Philippines is spearheading what it hopes would be landmark legislation that would institutionalize a comprehensive program that makes cancer awareness, prevention and treatment accessible especially to the poorest citizens of the country.
It’s not an isolated problem. According to the World Health Organization, cancer incidence is projected to increase by as much as 80 percent by 2030, with “low-resource countries” like the Philippines bearing the heaviest brunt. Already, cancer is the third leading cause of death in the Philippines, with an estimated one out of every 1,800 Filipinos diagnosed each year. This means more than 55,000 households have to contend with a terrifying cancer diagnosis annually.
Worse, studies said it is common for Filipino cancer patients to be diagnosed late, when the cancer has progressed to a later stage. This means the cost of care has risen and the odds of survival have narrowed. And yet, unlike heart disease or vascular problems, there is a glaring lack of decisive government response to deal with what is clearly a public health issue.
For cancer prevention advocate and Quezon City Rep. Alfred Vargas, these grim statistics stress the need for government to get its act together and institutionalize an integrated, multi-disciplinary, multi-sectoral, and nationwide cancer control and management for all types of cancer, including oft-ignored preventive and diagnostic services.
“Cancer poses a substantial challenge to our health systems. It affects not just the patients but has a significant impact on their families, friends and communities,” he said.
Senator Juan Edgardo “Sonny” Angara agreed, adding that the approach should bridge the divide between the kinds of access to cancer treatment that rich and poor patients receive. “We need to develop a system in which all people with cancer have access to high-quality and affordable cancer treatments,” he said.
Chemotherapy, for instance, remains to be one of the most expensive parts of cancer treatment, and is grossly inaccessible for the poor. Add visits to the doctor, radiation treatments, imaging tests like X-rays and MRIs, and even home care, and the cost easily runs into hundreds of thousands to even millions of pesos.
For the poorest of the poor, for whom putting food on the table every day is already a Herculean task, such an expense is hard to imagine, let alone cope with. A study pegs the cost of cancer treatment as more than what most families earn in a year.
The result? Families are stuck with a literal life-or-death decision: Either use up their life savings or sell property to pay for the cost of treatment or forego treatment and just wait for the disease to consume a loved one. The ultimate tragedy, of course, is that either option spells some version of death, financial or otherwise.
Abandonment or discontinuance of treatment in some areas and of certain types of cancer reach as high as 75 percent because of the reliably astronomical cost of treatment. It’s not a surprise that most patients do not follow their treatment plans, and even those who survive the disease shift to lower paid and unskilled work because of their illness, which result in worsening feelings of depression or anxiety.
This worrying trend, Angara noted, occurs not only among the poor but even among the middle class. A solution could come in the form of his proposed Senate Bill 1570, or the National Integrated Cancer Control Act, which seeks to make cancer treatment and care more equitable and affordable for Filipinos.
One such way is the establishment of a special cancer assistance fund for patients, especially indigents, as well as the expansion of the current benefits of the Philippine Health Insurance Corp. or PhilHealth to include screening, detection, diagnosis, palliative care, and rehabilitation.
“This should cover all types and stages of cancer of patients regardless of age,” Angara said.
The avowed goal is to lower the overall mortality and impact of all adult and childhood cancer, decrease incidence of preventable cancer in adults, and prevent cancer relapse and recurrence and secondary cancers among people living with cancers and survivors.
In terms of a broader ambition, however, the bill should seek to change the dangerous notion that a cancer diagnosis is an instant death sentence, and that treating it need not be a completely private matter because the government, as it should, is ready to offer support, especially for its most vulnerable sectors.
The Committees on Health of both Houses of Congress chaired by Senator JV Ejercito and Rep. Helen Tan have most commendably prioritized the passing of what may be one of the most important law that when fully implemented will address the country’s third cause of death. This problem cuts across all classes and can hit anyone.
We hope President Rodrigo Duterte will invest his strong political capital to support this people-led legislative initiative.
