The high costs of cancer

Every year, around 9,000 Filipinas die from breast cancer. Many of these deaths are preventable, especially if it is a non-aggressive type of breast cancer and detected at an early stage. Aside from the sad loss of lives, our country has been losing as much as P110 billion worth of economic productivity yearly due to cancer-related deaths, according to doctors and health economists.

The recent passing away of the late Department of Migrant Workers (DMW) Secretary Susan “Toots” Ople at a young age of 62 years is the latest evidence of such heavy loss to our country. The “untimely” demise of a very hardworking and dedicated public servant like her was cut short. Toots, as she was fondly called, has thus become the face of these breast cancer victims who have unfortunately succumbed to this deadly illness.

While there may be available access to early detection and medical interventions to ensure survival of cancer-stricken persons, apparently these are not enough. It brought out to light the gaps in our country’s primary health care system that, among other advantages, ensure early detection of cancer growths through “screening” procedures.

According to local and foreign studies, the incidence of breast cancer cases is nearing epidemic level on a global scale. Oncologist Dr. Edgar Christian Cuaresma and health economics doctorate Val Ulep revealed these dire projections based on these studies from the World Health Organization (WHO) as well as those done by the Philippine Institute for Development Studies (PIDS).

Cuaresma and Ulep were our resource persons at the Kapihan sa Manila Bay news forum last Wednesday. Cuaresma is the head of Oncology and Transfusion at the University of the East Ramon Magsaysay Memorial Medical Center Inc. in Manila and in a hospital in Cabanatuan City in Nueva Ecija. The 39-year-old oncologist also works as assistant professor at UERMM College of Medicine.

Ulep, on the other hand, is a Senior Research Fellow of the PIDS where he directs various health economics research projects for this agency attached to the National Economic Development Authority (NEDA). He holds a Ph. Degree in Health Economics and a Masters Degree in Epidemiology.

The two specialists, one on the medical field and the other on public health economics both agreed that the COVID-19 pandemic could be accounted as a major reason on the sudden rise of the mortality rate of breast cancer victims in the past two to three years. And the same mortality rates rose in other non-COVID but “chronic” illnesses also, Cuaresma and Ulep noted.

The PIDS study showed an increase in the economic costs of cancer if nothing will be done now to address this health menace.

“We had projections on the economic cost of cancer in the next 20 years and it will double if we don’t address this. This is really a burden to the government but more to the household (of the patient),” Ulep warned.

On a global scale in 2020-2021, Cuaresma noted with concern there were 23 million people who have breast cancer and 685,000 of them died already due to it. On the plus side, he cited, 7.8 million of them have survived it the last five years. But what was shocking to learn is the fact that around 0.5 to 1 percent of these breast cancer patients were male or menfolk. The WHO record in 2021, Cuaresma further noted, the breast cancer cases have surpassed already the number of lung cancer cases.

In the same published study of the PIDS, Ulep cited that the economic cost of cancer could reach around P110 billion annually. This is equivalent to almost one percent of the country’s gross domestic product (GDP), Ulep noted. Out of this total, Ulep estimated around P40 billion refers to the medical costs such as hospital expenses, and the bulk of P70 billion comprise the “indirect” costs.

The household bears greatly the costs such as the out-of-the-pocket expenses for the patient which Ulep conceded  “can really be catastrophic” to the family’s financial situation. “There is a great chance for them to become impoverished,” Ulep quipped.?

These “indirect” costs also include productivity costs. “Cancer is chronic. You won’t be able to work for a long time because there is a need to show up for treatment on a regular basis,” Ulep explained. “Our data showed that several family members or relatives resign from their jobs, and that contribute to economic costs,” he further pointed out.

“So these are the things being experienced by cancer patients in the Philippines. So it’s really tragic,” Ulep rued.

Cuaresma and Ulep welcomed though as good news that President Ferdinand “Bongbong” Marcos Jr. (PBBM) has signed into law Republic Act (RA) 11959, or the “Regional Specialty Centers Act.” RA 11959 signed on Aug. 24 mandates the national government to ensure accessible and affordable healthcare services for all Filipinos through the establishment of specialty centers in Department of Health (DOH)-run hospitals and in the government-owned or -controlled corporation (GOCC) hospitals all over the country.

Under the law, the DOH is designated to establish specialty centers in its hospitals in every region and in GOCC specialty hospitals, prioritizing cancer care, cardiovascular care, lung care, renal care and kidney transplant, brain and spine care, trauma care and burn care.

RA 11959 aims to address the wide gap in the country’s healthcare system in a bid to build more Philippine Heart Centers, Lung Centers of the Philippines, National Kidney and Transplant Institutes, and Philippine Children’s Medical Center. At present, all these four specialty hospitals are all located in Metro Manila. Under this law, these specialty hospitals will be replicated in all 17 regions around the country from Luzon, Visayas and Mindanao over the next few years.

But more than building the hospitals, medical equipment and personnel, putting up more primary health care centers would lessen the high cost of cancer. This will give Filipinos more “fighting chance” if given more access to early screening and detection of this dreaded illness.