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ABSTRACT

This paper intends to discuss the most recent cures in


cancer namely chemotherapy, radiation therapy, gene
therapy, and targeted therapy in the Philippines. The
paper will also discuss the cost, side effects and the
availability of these treatments. The paper will then
study the diversity of the rich and poor and how this
diversity affects how treatment is distributed in the
country. It is also a study on how the government
organizations respond to the increasing incidence of
cancer in the country and how they help those who
are marginalized in terms of treatments. It is also a
study on non-government organizations acting more
to help the marginalized than the government.

1. INTRODUCTION

According to the World Health Organization, cancer Figure 1-1


is a generic term for a large group of diseases that can
actually affect the different parts of our body. It is a
class of diseases wherein a group of cells exhibits an The two graphs show us the type of cancer that is the
abnormal and uncontrolled growth, invasion and even leading cause of cancer deaths in the Philippines.
metastasis. Metastasis is the ability of the cancer cells This was taken by the World Health Organization in
to actually affect the other parts of the body. Others the year 2005. For men, trachea, bronchus and lung
may term this as malignant neoplasm. cancer are the most common cause of cancer deaths
in the Philippines while, for women, breast cancer is
1.1 Cancer the most common type of cancer that causes cancer
deaths.
This is one of the diseases that are being feared by
everyone. This is maybe because almost all the
people who actually have cancers may die especially
if the severity of the cancer is already very high.
Many actually believe that the cure for cancer is not
really effective and that those are very expensive for
someone who does not have the money to spend.
Cancer is one of the leading causes of death in the
world. It killed almost 7.4 million people in the year
2004. It caused 13% of all the deaths there was in
that year only and this number keeps on increasing
every year. On the other hand, it is said that 30% of
the cancer deaths could have been prevented. Among
all the types of cancer that are present, lung, stomach,
colorectal, liver and breast cancer cause the most
number of cancer deaths and tobacco is the major
contributor to cancer cases. It is shown below the
number of deaths per type of cancer. [1]
According to the World Health Organization, in the
Philippines, there were approximately 44, 000
Filipinos who died because of cancer in the year 2005
alone as shown in the graph below.

Figure 1-2
are chemotherapy, radiation therapy, gene therapy
and targeted therapy.

2.1 Chemotherapy

Chemotherapy, also called “chemo” is one way to


treat people with cancer. This therapy treats diseases
by chemicals that destroy cancer cells to prevent
them from spreading and eventually shrink the size of
the tumor for the surgeon to be able to remove it.
Chemotherapy works throughout the body. Its goal is
to destroy cancer cells wherever they may be, even if
they have spread to parts of the body far from the
original location of the tumor site.
Chemotherapy destroys cancer cells by
interfering with their growth, by preventing them
from reproducing, and in some cases, inducing the
cell to program itself to die. Also in some cases,
chemotherapy may be used to shrink a tumor so that
the surgeon won’t have a hard time to remove it
completely. Chemotherapy can also be given to
enhance the cell destroying effects of radiation. [5]
Today, researchers are developing newer
agents based upon their increasing knowledge of the
molecular structures within the cell that can be
targets for new compounds that interfere with the
Figure 1-3 cell's ability to grow and reproduce it, sparing the rest
of the body of other side effects.
1.2 Poverty However it is said that Chemotherapy agent
targeted for cancer cells can also affect the patient’s
In the Philippine society poverty is often associated normal healthy cells. That results in damage to
with persons having no proper meals a day, no proper healthy tissue which is one of the main side effects of
job, no proper shelter and a like. In accordance to chemotherapy. The area of these effects on normal
this, Asian Development Bank’s meaning on poverty tissue varies depending upon the type of drugs that
is: “While usually associated with the lack of are used and how the patient’s body reacts. But over
incomes, poverty can be defined more generally as a time, normal cells will recover and continue
state of want in relation to a social standard. This functioning as cancer cells die off. Having this
suggests an absolute notion of poverty that says that treatment can also affect your bone marrow and the
every person is entitled to a minimum level of well- body's ability to produce red blood cells. These are
being, regardless of how affluent others may be. some effects that could be experienced: [6] [7]
Measuring poverty relative to a poverty threshold, or
some predetermined consumption standard implies an a) Nausea and vomiting
absolute notion of what it means to be poor. The b) Mouth sores
extent of poverty will be higher or lower, therefore, c) Fatigue
depending upon how high or low the poverty line is d) Anaemia
set. Commonly used measures of poverty such as the e) Low platelets and white blood cells
poverty incidence, depth of poverty, and severity of f) Hair loss
poverty are all taken relative to a poverty g) Fertility (for women)
threshold.”[3]
Chemotherapy in the Philippines is the most widely
2. CANCER TREATMENTS use cancer cure. It is available in a lot of hospitals in
the country however it is said that each chemotherapy
With the current advancement in medical technology session in the Philippines would cost around P50, 000
there have been various cures that were developed in and the number of sessions will still depend on the
accordance to cancer patients. Some of these cures severity of the cancer. [4]
2.2 Radiation therapy
Radiation Therapy, also called “radiotherapy”,”x-ray
therapy”, or “irradiation” is the use of high-energy
rays or particles to kill cancer cells. This treatment is
used to cure cancer by destroying cancer cells,
controlling cancer cells to keep them from growing,
or reducing cancer symptoms by damaging their
genetic material that makes these cells impossible to
grow or spread. Although radiation damages both
cancer cells and normal cells, most normal cells can
recover from the effects of radiation and function
properly. Radiation therapy’s goal is to damage as
many cancer cells as possible, while limiting harm to
nearby healthy tissue. Figure 2-1
There are different types of radiation. There It is said that every session of radiation
are certain types that can penetrate more deeply into therapy will cost the patient PHP5, 000 to PHP 8,
the body than can others. Some types can be very 000. The treatment will last for about 30-35 sessions
finely controlled to treat only a small area without depending on the disease.[16]
damaging nearby tissues and organs. And other types
are better for treating larger areas. 2.3 Gene therapy
There are also different ways to deliver the
radiation. It can be by External radiation therapy, or Genes, who are hereditary from our bloodline, are the
by internal radiation therapy. External radiation basic physical and functional units of heredity. Genes
therapy is usually given on patients who do not need are exact sequences of bases that create instructions
to stay in the hospital. External radiation therapy is on how to make proteins. Although genes are the
used to treat most types of cancer, including cancer ones thought of normally, it’s the proteins that
of the bladder, brain, breast, cervix, larynx, lung, perform most life functions and even make up the
prostate, and vagina. In addition, external radiation majority of cellular structures. When genes are
may be used to relieve pain or ease other problems altered so that the encoded proteins are unable to
when cancer spreads to other parts of the body from carry out their normal functions, genetic disorders
the primary site. Internal radiation therapy on the can result. [8]
other hand, may require a hospital stay. It uses Gene therapy is a technique for correcting
radiation that is placed very close to or inside the defective genes responsible for disease development.
tumor. The radiation source is usually sealed in a In most gene therapy studies, a "normal" gene is
small holder called an implant. Implants may be in inserted into the genome to replace an "abnormal,"
the form of thin wires, plastic tubes, or seeds. The disease-causing gene. A carrier molecule called a
implant is put directly into the body. vector must be used to deliver the therapeutic gene to
The difference of this treatment is it does not the patient's target cells. Currently, the most common
kill cancer cells right away. It takes days or weeks of vector is a virus that has been genetically altered to
treatment before cancer cells start to die. Then, carry normal human DNA. Viruses have evolved a
cancer cells keep dying for weeks or months after way of encapsulating and delivering their genes to
radiation therapy ends. Radiation therapy does not human cells in a pathogenic manner. Scientists have
hurt while it is being given. But the side effects that tried to take advantage of this capability and
people may get from radiation therapy can cause pain manipulate the virus genome to remove disease-
or discomfort. [15] causing genes and insert therapeutic genes.
Target cells such as the patient's liver or
lung cells are infected with the viral vector. The
vector then unloads its genetic material containing
the therapeutic human gene into the target cell. The
generation of a functional protein product from the
therapeutic gene restores the target cell to a normal
state.
Targeted cancer therapy drug Nimotuzumab
was approved by the Bureau of Food and Drugs
(BFAD) in the Philippines for the treatment of adult
and pediatric glioma. The approval for the drug was
based on clinical trials conducted in Germany and
Cuba. [13]
The cost of Targeted therapy ranges from
USD10, 000 to USD18, 000 per month. The
treatment is given every day until the disease starts to
recede. [14]

3.0 GOVERNMENT
Figure 2-2 In the Philippines, the national government has
launched different programs that are geared to help
Gene therapy had some of its success in the cancer patients. One of the biggest programs of
curing cancer this was done by the Researchers at the the government is the Philippine Cancer Control
National Cancer Institute and The University of Program (PCCP).
Texas M. D. Anderson Cancer Center and the This effort is a product of the belief that
University of Texas Southwestern Medical Center. cancer can be prevented as a public health effort. The
These institutions were able to apply gene therapy in program was first implemented in the year 1988
curing cancer. [9] where they were able to provide guidelines for the
In the Philippines gene therapy was granted PCCP and specify the program policy, components,
accelerated approval by the Bureau of Food and implementing guidelines and timetable.
Drugs for the treatment of all solid tumours resistant PCCP is actually an organized and
to chemotherapy. In addition, Rexin-G (gene therapy integrated approach in battling controlling cancer.
variant) is approved under an expanded access The most common objective of this program is to
programme in the Philippines for use as a first-line significantly alter and reduce the morbidity and
therapy for pancreatic and breast cancer, and as a mortality of cancer in the Philippines through the use
second-line therapy for all other solid tumours of the prevention in the primary, secondary, and
refractory to standard chemotherapy. tertiary level in the different parts of the country. It is
However the cost of gene therapy treatment to establish and maintain a system that combines
is not without its cost. Gene therapy cost about scientific theories and progress and its applications
USD100, 000 or roughly PHP480, 000. [10] that produces a comprehensive program that will help
control cancer incidence in the Philippines. The six
Pillars of the PCCP are Epidemiology and Research,
2.4 Targeted Therapy Public Information and Health Education, Prevention
and Early Detection, Treatment, Training and Pain
Targeted cancer therapies are treatments that target Relief.
specific characteristics of cancer cells, such as a The program implements different specific
protein that allows the cancer cells to grow in a rapid programs that help prevent different types of cancers.
or abnormal way. Targeted therapies are generally This can be very helpful because different types of
less likely than chemotherapy to harm normal, cancers may have different measures that need to be
healthy cells. Some targeted therapies are antibodies implemented in order to control its number in the
that work like the antibodies made naturally by our country.
immune systems. These types of targeted therapies In the fulfilment of the program, PCCP
are sometimes called immune targeted therapies. [12] called forth local partners in the partner communities
Targeted therapy is a general term that refers all throughout the country that promotes cooperation
to a medication or drug that targets a specific between the communities and the government, and it
pathway in the growth and development of a tumor. was called Community-based Cancer Care/Control
By attacking or blocking these important targets, the Network (CCCN). CCCN was started in the year
therapy helps to fight the tumor itself. The targets 1998 with the vision of a self-sufficient network of
themselves are typically various molecules (or small empowered communities sharing responsibility for
particles) in the body that are known or suspected to total quality cancer care and control in the
play a role in cancer formation. [11] Philippines and its mission is to organize, integrate
and nurture such a network. [17]
4.0 NON-GOVERNMENT ORGANIZATION people get treatment. Although the number of people
they can help is still not high. At least they are
In the non-government sector, there are also some helping those who are afflicted with cancer.
efforts that are being done to control cancer in the Now this is a call to the government that
Philippines. One of these is the Cervical Cancer there are many of those who cannot afford treatment
Prevention Program (CECAP). CECAP is a group of of cancer due to poverty. This is a call to help these
health professionals and non-government people and increase the budget of the health sector in
organizations in collaboration with the John Hopkins order to help this people.
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