Life expectancy of Cuban population has increased significantly over the past decade. In 2014, an average life expectancy was shown to be 78.5 years (1). It is predicted that approximately a third of the entire population in Cuba is going to reach the age of 60 by the year 2030 (2). The increased life expectancy, increase in the prevalence of elderly population combined with an unhealthy lifestyle represents a significant risk of increased cancer burden for the people living in Cuba. In 2012, cancer became a leading cause of death in Cuba, counting for approximately a quarter of all fatal outcomes (3). Due to these data, Cuba has developed strong mechanisms of cancer prevention, management, and research that are comparable to those in the developed countries. A comprehensive and systematic approach to cancer prevention, early diagnosis, treatment and palliative care has shown results including increased survival and better quality of life in patients suffering from cancer (4).
The strategy of fighting cancer in Cuba has been established a decade ago. The main objectives include education and communication of cancer risk factors to the general population, early detection of cancer in the primary healthcare setting, treatment and supportive care in highly specialized institutions, as well as research and development of innovative therapeutic modalities against various types of cancer (5). A very developed network of primary healthcare institutions enables the physicians to discover cancer in the early stages. These patients are then referred to specialized institutions where an adequate diagnostics and staging are being made, followed by cancer management techniques. Following the implementation of the abovementioned strategy, cancer survival rates in Cuba have shown increasing trends, which are comparable to those in developed countries.
Due to an increased prevalence of cancer, Cuba has invested a significant amount of funds to cancer treatment and research in order to achieve the highest standards in cancer management. Some of the fascinating achievements of Cuban approach to cancer will be reviewed in this article.
NATIONAL INSTITUTE OF ONCOLOGY AND RADIOBIOLOGY (INOR)
INOR serves as an international medical center that provides advanced and highly sophisticated medical care for cancer patients from all over the globe. Highest standards in the management of cancer are implemented at this institution with the goal to cure, improve and increase the quality of life of each patient that seeks medical attention. Advanced treatment modalities, holistic approach to each patient, integrative rehabilitation techniques combined with the use of natural healing methods are just some of the services aimed to increase patient welfare at this institution. INOR conducts scientific and educational activities related to the nature and biology of cancer. Various clinical trials are being conducted at this facility in order to investigate and evaluate novel and promising cancer treatment regimens (6). Patients from more than 50 counties worldwide including Europe, USA and Canada have been treated at this institution with exceptional quality of care.
SUCCESSFUL MANAGEMENT OF LEUKEMIA
In Cuba, the overall survival of kids suffering from acute lymphoblastic leukemia following standard therapeutic protocols is approximately 85% in standard risk patients (7). The improvement after the application of last generation cytotoxic treatments is seen in approximately 98% of children. Bone marrow transplants are performed with high success rates. Additionally, Cuba performed transplantation of cord blood hematopoietic stem cells in order to treat various forms of leukemia. All of the treatments are totally free of charge for all Cubans.
NON-MELANOMA SKIN CANCER
Skin cancer is among the most frequent cancers in Cuba (8). The challenges in the treatment of nonmelanoma skin cancers include non-resectable, aggressive and recidivant forms, which are difficult to treat and often lack in proper and effective therapeutic modalities. The successful management of nonmelanoma skin cancer in Cuba is reflected in the application of the novel combination of two interferons. More than 400 patients have been treated with this combination with high rates of success, reaching clinical remission in approximately 65% of cases (8).
Oral cancer was among the most frequent forms of cancers in Cuba. The development of preventative actions including regular oral examination of individuals at least once a year led to significant decrease in the incidence of advanced oral cancer. The vigilant approach to early detection of oral cancer resulted in significantly higher detection rates of low-grade oral cancers that are more sensitive to treatment and have much better prognosis (9).
Early detection of cancer remains the focus in the fight against malignancy in Cuba. Highly developed primary health care system represents a pillar stone of Cuban medical care. The early detection of malignancy on a primary health care level directly resulted in significantly better therapeutic outcomes in patients suffering from various types of cancer. The increasing aging of Cuban population increased the risks of developing malignancies. Therefore, Cuba has developed tertiary centersfor cancer diagnostics, staging, treatment and research. These centers are operating with the highest international standards in cancer management and offer innovative approaches in cancer treatment that are completely free of charge for any Cuban, rating the success of cancer management in Cuba to be among those in highly developed countries.
1. Oficina Nacional de Estadistica. Anuario demográfico 2014.
2. National Statistics Bureau (CU). El envejecimiento de la población cubana.
http://www.one.cu/publicaciones/cepde/envejecimiento/ envejecimiento2008.pdf. [Online]
3. Dirección Nacional de Registros Médicos y Estadísticas de Salud. Anuario Estadístico de Salud de
Cuba. http://files.sld.cu/dne/files/2015/04/anuario-estadistico-de-salud-2014. [Online] 2018.
4. WHO. Cuba – Battling cancer with biotechnology.
http://www.who.int/features/2013/cuba_biotechnology/en/. [Online] 2018.
5. Teresa Romero Pérez, Yaima Galán Alvarez and Rolando Camacho Rodríguez. THE BURDEN
OF CANCER IN CUBA AND CURRENT STRATEGIES FOR CANCER CONTROL.
http://www.cancercontrol.info/cc2016/the-burden-of-cancer-in-cuba-and-current-strategies-for-cancer-control/. [Online] 2018.
6. INOR. National Institute of Oncology and Radiobiology. http://instituciones.sld.cu/inor/. [Online]
7. Results of the treatment of child Acute Lymphoid Leukemia in Cuba. Alejandro, González-Otero et al.
s.l. : Revista Cubana de Hematologia, Inmunologia y Hemoterapia, 2014, Vol. 30(1). 36-46.
8. HeberFERON, formulation based on IFNs alpha2b and gamma for the treatment of non-melanoma skin cancer. Lorenzo, Anasagasti-Angulo et al. 10(6), s.l. : Australasian Medical Journal, 2017.
9. Research on cancer prevention, detection and management in low- and medium-income countries. R.
Sankaranarayanan, P. Boffetta. 10, s.l. : Annals of Oncology, 2010, Vol. 21. 1935–1943.