Saturday, August 21, 2010

The Most Costly Disease In The World

If an interviewer asked "people on the street" what they thought was the greatest threat to worldwide health, the answers would most likely be "AIDS", "Malaria", "Flu", or another infectious disease. I would have given a similar response.

Surprisingly, the answer is - "cancer".

At a global cancer conference being held in China this week, the American Cancer Society presented new findings about cancer: not about treatments, cure rates, or research, but that cancer is now the world's leading cause of death, and literally costs more than any other disease in terms of disability and years of life lost.

A staggering $895 billion was attributed to cancer's economic cost for 2008 - this is roughly 1.5% of the entire world's GDP (gross domestic product). And, this is only the figure linked to disability and life-years lost to the disease. The costs of treatment, which are not included here, are also astronomical, and will only increase in the coming years.

The World Health Organization has estimated that cancer would replace heart disease as the leading cause of death this year. In 2008, 7.6 million people worldwide died of cancer, and each year, 12.4 million new cases are diagnosed.

This is an impending world health crisis of unimaginable proportions. Some are now comparing it to the global crisis leading to increased spending on AIDS in the early 1990s. The current 3% of public and private funding dedicated to global health must be greatly increased if we are to have any hope in turning the tide against cancer.

Many Women Not Informed of Reconstruction Options

Last Sunday, New York signed a new State Law requiring hospitals and physicians to discuss breast reconstruction options with patients prior to performing cancer surgery.

Sadly, although breast reconstruction following cancer surgery has been a Federally mandated covered benefit since 1998, the rate of post-mastectomy reconstructions is far lower for poor and minority women. I know that this is the case.

I had personally been asked to research this issue a while ago, and I was completely taken aback to see the incredibly low rate of reconstructions vs. mastectomies in the Bronx. It did not ring true that 80% or more of these women would actively choose to live the rest of their lives this way, when the law says that they are entitled to reconstructive surgery. Not all women are medically eligible for reconstruction, but this could not possibly account for the disparity. Were these women not aware that reconstruction is indeed a covered benefit? Could something be done to raise awareness of the situation, and help these women to be "whole" again, following the devastation which cancer had caused them?

A major factor is that women undergoing mastectomies at hospitals which do not offer breast reconstruction were not informed of their right to have this procedure performed at another hospital equipped to offer this service. From now on, if the hospital where the mastectomy was done does not offer breast reconstruction, it is mandated that the patient be referred to a facility where the procedure is available. In the NYC area, breast cancer patients at academic medical centers, which have breast plastic surgeons on staff, are far more likely to be informed of, and to undergo, breast reconstruction. The new legislation will ensure referrals to these institutions for post-mastectomy patients.

I was fortunate enough to undergo surgery and treatment at a facility of my choice. This legislation means that other women will have access to the same level of care and treatment options, no matter where they are initially treated for their breast cancer.