In Costa Rica each year, more than 13,000 people are diagnosed with cancer and more than 6,000 die from this disease.According to the World Health Organization (WHO), by 2040, the number of new cases and deaths in the country will almost double.
This drastic increase would occur if actions are not taken promptly and decisively to stop the avalanche of cancer cases and deaths that could occur. That is what specialists Warner Alpízar, an expert in tumor biology at the University of Costa Rica, and Luis Bermúdez, from the Robotic Radiosurgery Center, consider.
“Thanks to improvements in social and health conditions, life expectancy has increased substantially,” they highlight.“However, living longer leads to a longer exposure time to environmental and lifestyle factors strongly associated with the risk of developing cancer,” both warn.
Researchers list a series of elements as possible causes of diseases such as cancer. Among them they mention:
Smoking
Overweight
Obesity
Prolonged exposure to ultraviolet light
Excessive alcohol intake
Early diagnosis:
According to experts, to stop these growing trends, efforts must be redoubled in early diagnosis.“We have to take into account that early detection by itself does not bear fruit if it is not part of a more comprehensive strategy, which also reinforces timely access to treatment and prevention,” they consider.
They emphasize that it is essential to guarantee that people suspected or already diagnosed will receive expeditious and more efficient treatment for their disease.“And while the patient waits, the disease progresses, which reduces their chances of survival, impairs their quality of life and makes treatment more expensive,” they lament.
Cancer Advancement
As the cancer grows in size, the cancer cells accumulate more mutations – DNA damage, their instruction manual.“Therefore, the diversity of malignant cells increases and this affects the growth and degree of tumor aggressiveness. With this, it is increasingly likely that resistance to anticancer therapies will emerge,” the specialists explain.
Over time, the likelihood of cancer cells breaking away from the primary tumor, spreading to other sites in the body, and forming metastases also increases,” they added.This situation is key in the management of the disease. It is estimated that 90% of cancer deaths are due to metastatic cases.
Nutrient depletion
Another aspect that worsens over time is the uncontrolled growth of cancer cells, which excessively and inefficiently consume the nutrients that are necessary for the healthy cells that make up the body’s tissues.
“The larger the cancer, the more the person’s physical condition deteriorates, because normal cells are left without the necessary inputs for their functions,” the doctors detail.
Taken together, the biological factors make it clear that a cancer detected and treated late is synonymous with a more aggressive disease, which worsens the probability of survival, quality of life and increases the cost of care for the health system.
Diagnosis and treatment
Epidemiological studies have shown in practice that the time between diagnosis and treatment of a cancer patient is critical if mortality is to be reduced.For example, a 2020 study concluded that for every month of delay in the treatment of a person with this condition, the risk of death increases by about 10%.
Doctors consider that in Costa Rica it is necessary to define strategies that reduce the time that elapses from when a patient is referred for suspicion until treatment.In first world countries such as Iceland, New Zealand and the United Kingdom, the target time between referral for suspicion and treatment is eight weeks, while the period between diagnosis and treatment is four weeks.
“There are no times”
“If we look at the case of Costa Rica, there is no target time at the country level in the path of the cancer patient. In addition to this, each region and hospital in the country has different management,” the specialists highlight.
According to the consensus of three national oncologists, who were consulted, in Costa Rica there are no statistics on the average time that passes between the referral for suspected cancer and the patient’s treatment.In some hospitals the time between diagnosis and treatment could be four weeks, the time between suspicion and diagnosis can be several months.
“One of the causes of this is due to the lack of specialists, which leads to enormous waiting lists and deadlines for reporting procedures of six months to a year,” the two experts acknowledge.
“This situation is alarming. If for every month of delay in the treatment of the disease the risk of death increases by 10%, as the study showed, in Costa Rica cancer patients could have a risk of mortality that is up to 50% higher, compared to other countries“, they point out.
This could be one of the reasons why, despite the fact that diagnosis has been improved, the incidence of cases is similar to first world countries, but the cancer mortality rate is the second highest in Central America and Mexico and similar to that of Honduras.
For specialists, a change is urgently needed in Costa Rica to reduce the increase in incidence and mortality. Some of the actions they recommend are:
Attack the structural problems that the health system currently presents
Improve access to services
Guarantee the training of more specialists
Reduce waiting times
Invest in cutting-edge technologies
Streamline bureaucratic systems with the intention of guaranteeing patient access to the most effective treatments currently available
“In summary, it is crucial to establish a country goal in the path of the cancer patient, because although time heals wounds, in the fight against cancer, time is our worst enemy,” they concluded.
