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'We are either bad at treating or bad at diagnosing' - state oncological aid in Kazakhstan

Photo courtesy of pokupon.ua Photo courtesy of pokupon.ua

Oncologist Nasrulla Shanazarov reported on the state of oncological help in Kazakhstan at the recent International Oncological Symposium, Tengrinews reports.

“As for the number of cancer patients in Kazakhstan, 53.6% are I-II stage, 28.3% are III stage and 14.1% are IV stage. But what is striking here is the correlation between the cancer death rate and the number of IV stage patients. In theory, there should be the same number of death cases as there are IV stage patients within one year. But this index is 2.2. So then, a question arises; it is either we are bad at treating or bad at diagnosing,” Dr. Shanazarov stated.

The southern region of Kazakhstan, oncologist stated, have the lowest numbers of cancer patients. “The southern region has the lowest cancer rates with 100 cancer patients in 100 thousand people. On the north of Kazakhstan, the cancer rates are close to 300 (cancer patients in 100 thousand people). There are regions, where cancer rates per 100 thousand people exceeds 300,” Shanazarov said. East Kazakhstan Oblast, North Kazakhstan Oblast  and Pavlodar Oblast are the leaders in terms of cancer rates.

This year, Kazakhstan initiated a program of researching five main types of cancer that have the highest death rate. Lung cancer has death rate close to the number of diseases cases. “In terms of gastric cancer, South Korea is a role model for us because they have reached good results in comparison to us. We do not have a big difference between the numbers of lethal cases and disease cases of esophageal cancer. Japan has the best index. As for liver cancer we have small difference between disease and mortality rates. (…) In pancreatic cancer the number of patients and diseased is the same,” he said.

There are, according to Dr. Shanazarov, 14 oncological dispensaries and 2 science and research institutes of oncology and radiology in Kazakhstan. In 2014, the national oncology and transplantation center was opened. In addition, there have been a number of private oncological clinics opening in the country.

“As of today, there are more than 400 oncologists and around 100 radiologists working in Kazakhstan. Hospitals have a capacity of accepting around 4 thousand patients (at the same time),”Dr. Shanazarov said. He added that oncological help in Kazakhstan was far from perfect, and required improvements.

According to Kazakh non-governmental foundation Together against Cancer there are 140 thousand people diagnosed with cancer in Kazakhstan.

According to the official statistics, cancer mortality rate in Kazakhstan is second only to heart diseases mortality rate. Around 17 thousand people die from cancer in Kazakhstan every year, with 42% of them being people of economically active age. The number of cancer cases has been growing at the rate of 5% per annum over the past years.  

Cancer becoming younger in Kazakhstan, is another problem. 350-400 children under the age of 15 are diagnozed with cancer in Kazakhstan every year.

To address the problem, Kazakh government adopted a 2012-2016 state-run program of oancological aid in March 2014.The state program was adopted in March. It is aimed at reducing cancer morbidity rate through improving early diagnostics of cancer and accessibility of high-tech methods of diagnostic and treatment to reveal the tumours at the stages when they are still treatable. The 5-year project is worth almost $1 billion and is funded from the state budget. 

In April this year Vice-Minister of Healthcare of Kazakhstan Erik Baizhunusov said that the project helped increase the number of cases of early diagnostics of cancer, but not nearly enough. Worldwide 65-70% of cancer cases are diagnosed early, while is Kazakhstan the rate is only at 40%, he said.  

But early diagnostics that is achievable with screenings is only part of the problem. Treatment of revealed cancer cases is another part. International practices show that full recovery and brining the five-year survival rate of early diagnosed cancer patients to 80% requires high-tech treatment methods that are simply not available in Kazakhstan: proton therapy, radionuclide diagnostics and treatment, external-beam radiotherapy (gamma knife, cyber knife, tomotherapy, vero system, stereotaxic, conformal therapy), intraoperative radiation therapy, positron emission tomography, biotransplantation of organs and tissues, minimally invasive surgery, use of various biological markers in the clinical practices and etc. 

In Kazakhstan, amid lack of advanced methods of treatment and late diagnostics, radiation, 'heavy' chemotherapy and invasive surgery are the three most common tools that doctors use to attempt to fight cancer. In most cases this results in disability or death. 

By Gyuzel Kamalova and Tatyana Kuzmina (Assemgul Khassenova contributed to the story)

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