Lecture 7&8: PC in Cancer and Viral Disease Flashcards
Cancer is ranked what in leading causes of death globally?
2nd
T/F most of cancer deaths occur in high income countries
FALSE- 70% cancer deaths occur in LMIC
1/3 of cancer deaths are related to which 5 risk factors?
High BMI Low fruit/veggie diet Lack of exercise Tobacco use Alcohol use
What are 5 barriers to opioid access for PC?
- US produces + imports way more opioids than it needs resulting in less countries having access
- Lack of PC training for doctors
- Laws + police with strict rules
- opiophobia
- pharma companies uninterested in marketing generic opiates because they won’t make money
How does the US influence other countries’ opiophobia’?
Declaring the War on Drugs
$100 billion spent
We still produce/import excess opioids
T/F There are less cancer cases in the developing world so the death rate is much lower
FALSE
there ARE less cancer cases in developing world bc most people die of communicable diseases (increasing life expectancy–> increasing cancer rates)
HOWEVER, death rates are MUCH higher because of lack of screening/treatment
What are 3 types of preventable cancers that are rising in LMIC? And why?
Cervical- no HPV vaccine & HIV complications
Liver- no Hep B/C vaccine available
Stomach- h. pylori infection
T/F The mortality for AML and cervical cancer is the same in developing and developed countries
FALSE
HIGH disparity in survival rates
For AML and cervical cancer, survival in the US is ~90% and in Middle East/Africa, survival rates are under 20%
What are 3 main challenges to cancer care?
- lack of infrastructure (ex 385 radiotherapy machines for 1 BILLION people in africa)
- Poor distribution of resources (most radiotherapy machines are located in 3 African countries-SA, Egypt, Morocco)
- Lack of data
What country was successful in achieving opiate access for its people?
Uganda
11% of opioid needs met- considered successful bc it’s much higher than national average
What were 4 reasons why Uganda was successful in meeting opioid needs?
- People put pressure on authority (older doctors, etc) and president actually listened
- President acknowledged AIDS epidemic
- Specially trained nurses can prescribe morphine
- Outpatient setting: govt only allows oral morphine mixed with water
- –> it’s really difficult to become addicted to the oral morphine (morphine syrup) since you’d need a lottt to experience a high and the 2 doses people get are still effective
What are some developing world risk factors for cancer?
- HPV/Hepatitis/HIV
- Tobacco & alcohol
- Obesity
- Diet low in fruit/vegetable
- Sedentary lifestyle
- Occupational hazards
- UV exposure
- Urban air pollution
- Indoor smoke
- Harmful cultural behaviors
- Skin Bleaching
- Late Presentation
What are some reasons cancer presents later in developing world populations?
- Distrust of health services
- Different cultural beliefs about cancer
- Lack of knowledge about cancer
- Lack of knowledge about early warning signs
- Poor screening access
- Poor transportation infrastructure
- Poverty
- Lower assessment skill of local doctors
- Political/Economic/Social disenfranchisement
What are the 6 steps to addressing cancer in developed world?
- Planning- assess needs, capacity, social context
- Prevention- education, reduce risk factors
- Early Detection- screenings, self exams
- Better Treatment- equity of drug/tx distribution
- Palliative Care
- Policy and Advocacy
Why is early detection of cancer so important?
many patients are diagnosed at late stages when curative treatment may no longer be an option.
What are the 2 main components of early detection?
- Early diagnosis
- greater probability of surviving, less $$ treatment - Screening
-ex: VIA (vinegar method for cervical cancer)- low income
pap smears- middle/high income
mammography- for well developed systems
T/F Developed world solutions usually transfer to developing world
FALSEEEEEEE
No they don’t (Exhibit A the white girl group)
Cervical cancer PAP smear screening is not going to work in a super low income setting
