Radiation therapy and cancer control in developing countries: Can we save more lives?

Abstract

Globally, morbidity and mortality due to cancer are predicted to increase in both men and women in the coming decades. Furthermore, it is estimated that two thirds of these cancer-related deaths will occur in low-and middle-income countries (LMIC). In addition to morbidity and mortality, cancer also causes an enormous economic burden, especially in developing countries. There are several treatment and management options for cancer including chemotherapy, radiation therapy, surgery, and palliative care. Radiotherapy or radiation therapy (RT) can be an effective treatment, especially for localized or solid cancers; about half of cancer patients receive radiation as a curative or palliative treatment. Because of its low cost, for patients from LMIC with inoperable tumors, RT may be the only option. With the overall increase in the number of cancer patients especially in resource-starved LMIC, the need for more RT facilities further affects the economic growth of those countries. Therefore, an advanced molecular-targeted and more integrated approach involving either RT alone or with surgery and improved cancer drug access worldwide are urgent needs for cancer care.

Keywords: Cancer; Cell death; Developing countries; Economic burden; Radiation therapy..

Figure 1

Irradiation damages the genome (DNA) of the cancer cells producing single strand breaks (SSB) or double strand breaks (DSB), which are repaired by several kinds of repair proteins. If cancer cells receive severe irreparable DNA damage, the cells undergo either cellular senescence or several types of cell death, dependent on the cell context.