CAIRO: The place where you live can influence your eating habits, clothing style, education and - according to a recent study - may determine the state of your health. According to a report in Lancet Oncology, low to mid-income countries have low survival rates for pediatric cancer, with Egypt having only a 40 to 60 percent five-year survival rate. While Egypt fares better than Morocco, where there is a 30 percent survival rate, and Bangladesh, the Philippines, Senegal, Tanzania, and Vietnam, which all have survival rates of only 5 to 10 percent, it lags behind higher income countries. The report was based on data from September 2005 to May 2006, and was collected through interviews with clinicians, hospital managers, health officials, and other healthcare professionals. Recent official statistics regarding the number of pediatric cancer cases in Egypt, however, are scarce, and even available statistics provided by the National Cancer Institute (NCI) may not reflect the totality of Egypt. Dr Hana Farid, Grants and Resources Director of the Children's Cancer Hospital, more commonly known as 57357, explained that many of the governorates within Egypt do not have cancer registries, and information is not systematically compiled in many places, making it difficult to determine the actual number of cancer cases. Though NCI estimates that only 6 percent of all cancer cases are pediatric, actual figures may be quite higher. In a country where 40 percent of the populace is below the age of 18, Farid believes there is likely upwards of 6,000 new pediatric cases a year. Hospital "57357, whose nickname refers to the account number set up at local banks to receive charitable donations, currently handles about 2,000 new cases a year, in addition to investigative and outpatient cases. The state-of-the-art pediatric cancer hospital became fully operational in July 2007 and provides free health care regardless of social or ethnic background. The new hospital has helped lighten the load of the NCI, which receives many patients from other parts of the country who journey to Cairo in search of better treatment. In many cases, these children have more advanced forms of cancer, as families often come to NCI after local treatment has failed. "They come to Cairo to the NCI either after they've been diagnosed and have started and failed their treatment, or after a very late diagnosis. And sometimes after they come, the treatment is stopped for one reason or another - they can't afford to pay for a hotel, or can't afford to continue paying for drugs. As you know, cancer is a long term illness and a burden on them financially and emotionally, Farid said. Ineffective or incomplete treatment and late diagnoses both contribute to Egypt's high mortality rate. Environmental factors also play a role, Farid explained, as well as low economic standards and inadequate education about the illness. Even when patients do complete their treatment, their families may not be prepared to deal with the subsequent stages of recovery. Families who cannot afford to remain in Cairo for outpatient treatment often return home, unaware that the child may need special care or further rehabilitation after receiving chemotherapy. "If the family is not very well educated about the low immunity the child will have after chemotherapy, that is when infections may happen, Farid said. "It's a disease that gets the whole family - it's a big problem. It has many facets, both emotionally and economically. There may be social problems for the child, emotional problems, depression or aggression, and difficulty in their education. The problem of low immunity post-treatment, the obstacles of transportation and accommodation costs, and the prevalence of late diagnoses all help raise the mortality rate and make the physician's work that much harder. Conditions at the NCI hospital itself also contribute to the problem, as doctors often do not have the supplies and support they need in order to accommodate the many who come seeking help, Farid explained. "The NCI is extremely crowded with poor conditions, and even though we are trying to innovate the wards, it's still a big load on one institution, Farid said. Hospital 57357 is hoping to ease that load, not only by taking many of the cases, but also through a campaign that aims to decrease the number of advanced-stage cancer cases. Through a series of cartoons about cancer, they hope to raise awareness about early detection and encourage families to seek treatment promptly. The advertisements have won awards from the World Health Organization. "Awareness is very important, Farid said. "The earlier the diagnosis, the better prognosis you will have.
