Cancer Prevention And Advocacy Essay
Cancer Prevention And Advocacy Essay
These ducts lead to the nipple in the center of a dark area of skin called the areola. Fat encloses the lobule and ducts. There are no muscles in the breast, but the rest underneath each and cover the ribs. These common features can from time to time cause the breasts to feel lumpy, especially in women who are poor or who have undersized breasts. Each breast also contains blood vessels and lymph vessels which carry colorless liquid and lead to little bean-shaped organs called lymph nodes. Clusters of lymph nodes found near the breast under the arm, on top of the collarbone, and in the chest. Lymph nodes are also originating in various other parts of the body (Everyday Health, Inc., 2010). According to the National Breast Cancer Foundation, “Study has shown that women with risk factors are more prone than others to contain the disease because no one knows the exact origin of breast cancer.” Several risk factors can be traced to better ways of identifying and detecting cancer in an early stage and the effect of changes in the way we live by delaying childbirth, taking substitute hormones and oral contraceptives, eating foods high in fat, or drinking excessive alcohol. More risk factors include early menstruation, late menopause and having your first child neither at an aging period nor given birth, and taking birth control for years if women are under age 35. Cancer Prevention And Advocacy Essay. Other risk factors are a family history of breast cancer and concentrated breast
Cancer advocacy groups—defined broadly as cancer societies, survivor advocates, and other groups of volunteers outside of government, all by definition nongovernmental organizations, or NGOs—are well established in most developed countries. They have been a potent influence in high-income countries in raising awareness about the cancer burden and directing public and private efforts and resources into cancer control. In most low- and middle-income countries (LMCs), where cancer is a low priority, advocacy is also largely undeveloped. As we have argued in this report, cancer control deserves higher priority based on its large and increasing burden of disease. Advocacy has a role to play in bringing the public’s concerns about cancer to decision makers.
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In most developed countries, cancer advocacy begins with national cancer societies, often formed by physicians, other health care professionals, and business leaders (e.g., the forerunner of the American Cancer Society was founded in 1913). Advocacy by the interested public develops later, usually around specific issues. These groups compete for funds and influence, but often develop formal and informal alliances. Cancer advocacy groups in developed countries have proven to be powerful forces for the advancement of cancer control and provide a considerable amount of leadership in the establishment of national cancer priorities. Cancer Prevention And Advocacy Essay.
Independence from government is essential to advocate for something the government is reluctant to do, which means not being dependent financially on government. This is true even if, as occurs in many countries, NGO cancer societies undertake joint projects with government or undertake specific contracts. This principle has been affirmed over and over in the history of tobacco advocacy, where governments are often in receipt of funds from the tobacco industry, and in some countries this extends to individual politicians and even office bearers. Cancer Prevention And Advocacy Essay. Although the tobacco situation is unique, the principle of independence applies to any advocacy group, be it for support for breast cancer patients or for cervical cancer screening programs. Ideally, advocates should be free to use the media, mass volunteer influence, and all other mechanisms of persuasion to achieve their objectives.
It is not possible nor desirable to “control” the advocacy movement, as its very nature is a societal response to a variety of situations often, initially at least, driven by emotion. Success, however, does depend on advocating things that are achievable. A set of priorities and actions must be developed that are feasible economically and politically, and acceptable to society. This, in turn, requires analytical and planning expertise that may not exist among the advocates. Training to develop these skills should be a natural role for successful advocacy organizations in high-income countries. Cancer Prevention And Advocacy Essay.
The International Union Against Cancer is the undisputed leading international umbrella organization for cancer advocacy. Its work is described next. Among national cancer societies, the American Cancer Society (ACS) is the most active in promoting cancer advocacy in LMCs. The ACS work is described later in the chapter. What follows is a brief review of cancer advocacy in LMCs, followed by some basic principles and ideas by which the global community could help LMCs in this area. Cancer Prevention And Advocacy Essay.
AN UMBRELLA FOR ADVOCACY: THE INTERNATIONAL UNION AGAINST CANCER
The International Union Against Cancer, also known as UICC, is the most prominent and inclusive international body dedicated to cancer control. It is a membership organization with a small administrative head office, with controlling committees made up of volunteers. The most visible UICC activity is the World Cancer Congress, held every 2 years in a major city, the most recent in Washington, DC, in 2006. Several thousand participants from all sectors attend these meetings, the great majority from high-income countries, but with increasing representation from LMCs and attention to developing effective cancer control in those countries.
UICC has 270 member organizations in 80 countries. Many of these organizations are typical nongovernment, volunteer-based cancer societies, but many are also government-funded (often national) cancer institutes and research institutions. For example, Fiji and Estonia list only NGOmembers; Egypt and El Salvador list only government-funded cancer institutes. Many countries have only one member. This mix is beneficial for UICC, but government-funded institutes are not usually considered to be true advocacy bodies because they are not independent of government.Cancer Prevention And Advocacy Essay.
Most UICC funding comes from member organization subscriptions that are prorated based on member income. About 20 of the larger national cancer bodies (e.g., the American Cancer Society, the Australian Cancer Society, and Cancer Research UK) pay substantially more than the hundreds of smaller, less well-endowed organizations, but still a very small fraction of their total income. The UICC annual income is a modest $5 million (out of well over $500 million total budgets for the three organizations named above) (International Union Against Cancer, 2006).
Major UICC Activities
UICC has four “strategic directions,” including prevention and early detection, tobacco control, knowledge transfer, and capacity building. Each area is led by a “strategic leader,” a globally recognized expert.
In “Prevention and Early Detection,” UICC promotes public education and the training of health care professionals to understand and act on opportunities. Activities include reviewing available cancer data to identify priorities and to develop training and other programs to address the priority areas; strengthening local capacity through training in epidemiology, cancer registration, and needs analysis; promoting cost-effective, sustainable prevention and early detection strategies, and promoting national policy changes to reinforce the strategies; and establishing networks of professionals and experts at various levels to interact in mutually beneficial ways.
In “Tobacco Control,” UICC continues to support the ratification and adoption of the Framework Convention on Tobacco Control (FCTC), and is taking the next steps by working the strong NGOnetwork to help countries adopt the measures specified in the FCTC. LMCs are a high priority. A tool in tobacco control is UICC’s electronic information source, “GLOBALink,” for tobacco control professionals worldwide. Tools, listservs, web hosting, petitions, and news are all available to members. Other goals in tobacco control include increasing the information base and identifying research needs; establishing standards for best practices in tobacco control; encouraging and facilitating collaboration among UICC members; developing consensus positions on key issues; and representing cancer organizations in interactions with international governmental bodies.
The goal of “Knowledge Transfer” is to narrow the gap between what is known and what is applied in cancer control. Activities include facilitating research and training fellowships for health care and advocacy professionals and volunteers; maintaining a global network of cancer experts; providing forums for information exchange; publishing a range of journals, manuals, and other material for health care professionals; and promoting specific activities that advance the cancer control agenda.
In “Capacity Building,” UICC works with organizations within member countries through a wide variety of programs to increase the capacity in countries to further cancer control through advocacy. Specific activities involve providing training for advocacy leaders to develop skills to effectively influence cancer policy makers; improving fundraising capacity; teaching knowledge and skills to allow advocates to participate effectively in national cancer control planning; developing strategic alliances with other organizations and groups to create synergies; and developing resources for all the educational activities, both online and in other formats. A major recent effort has been in developing resources for NGOs to be involved in, or to spearhead, national cancer control planning (International Union Against Cancer, 2006).
THE AMERICAN CANCER SOCIETY
ACS has taken a leading role in global cancer advocacy by promoting cancer advocacy in countries with emerging cancer societies. Their major activities in this area are mentioned below (American Cancer Society, 2006).
American Cancer Society University
The centerpiece of the ACS global effort is training international cancer control leaders through the “American Cancer Society University (ACSU)” in all aspects of running a community-based cancer control organization or program. The ACSU program begins with a week-long course, which is held a few times each year in different parts of the world, followed by support of participants in home countries. Key aspects of the training include:
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Building an organization and defining its mission
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Developing a successful cancer control message and getting the message out
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Identifying and working with the various collaborators necessary for cancer control
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Raising funds to support the organization and its advocacy messages
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Promoting cancer control needs assessment and planning
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Recruiting and involving volunteers
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Assessing the status and importance of existing cancer services, including prevention and treatment
When participants return home, ACS provides “seed grants” to help them launch new initiatives. They have been used, for example, for the following activities:
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Establishing a tobacco and cancer study unit in Ethiopia
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Creating and training a network of tobacco and cancer control advocates in India
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Starting a prostate cancer awareness program in Jamaica
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Producing a tobacco- and cancer-related, youth-focused mini magazine in Nigeria
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Translating cancer and smoking information into Romanian
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Holding a workshop on building and effectively running a cancer organization in Vietnam
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Recruiting and training volunteers to serve as educators in Bolivia
After participating in activities, ACSU participants are brought back together in regional meetings to share their experiences, including reporting on activities funded by the seed grants. More than 250 people from about 60 LMCs have completed the ACSU training.Cancer Prevention And Advocacy Essay.
International Partners Program
The International Partners Program (IPP) creates collaborations between ACS units in the United States and cancer organizations in LMCs to build advocacy appropriate to the setting in specific areas, and to strengthen and support the organizations on both sides of the partnership. Programs in tobacco control, cancer prevention and early detection, cancer information, and fundraising are all part of the IPP agenda. In addition to the capacity building benefit to the lower income partner, those associated with the ACS units (volunteers and others) learn about conditions in other countries, which could have direct benefits in serving immigrants to the United States. The linkages also create bridges to establish additional programs in cancer control.
The two most successful partnerships currently are between the ACS South Atlantic Division and Bolivia, and the ACS California Division and the Philippines. In Bolivia, the emphasis is on improving cancer awareness among women. In the Philippines, the focus has been promoting universal immunization against the hepatitis B virus to prevent liver cancer.
International Grant Programs
ACS offers grants in tobacco control in LMCs, for which ACS acts on its own and collaborates with the UICC, Cancer Research UK, The Canadian Tobacco Control Research Initiative, and others. The work of individual campaigners and advocacy groups is supported by several different grant programs.
ACS supports the development of tobacco control infrastructure in LMCs by supporting groups that hold meetings and workshops for local advocates, work with governments, produce information for the public, and other activities. Programs are active in Guatemala, India, China, and the Latin American region. In addition to these specific partnerships and programs, ACS is active around the world in tobacco control in many other ways.
CURRENT STATUS OF CANCER ADVOCACY IN LMCS
No worldwide inventory of cancer advocacy groups exists outside of the UICC members. Undoubtedly, many small ones lie beyond the reach of organized information systems. Of the 270 UICC members in 80 countries, nearly all can be categorized as NGOs or government cancer institutes.
Information to categorize specifically the ways in which these NGOs arose is not available. Based on observation, however, a major driving force—perhaps the driving force—has been the need to improve palliative care. Once started, however, most of the organizations have broadened their focus to encompass treatment and in due course, the full spectrum of cancer control activities. The NGOs in LMCs are all small resource organizations. Their cancer institutes almost invariably have poor resources. There are rare exceptions, such as the Cancer Institute in Lima, Peru, that was built by funds derived from tobacco taxes.
Apart from the drive arising from the desire for palliative care, a number of NGOs were started through government initiative, and office bearers include relatives of government officials. The next most common type of organization is the support group, mostly for breast cancer.Cancer Prevention And Advocacy Essay. In low-income countries, a number of these have been started by expatriate cancer survivors currently living in the country.
Determining how effective these organizations are in the field is simply not possible. Some organizations distribute pamphlets, often using text derived from materials from developed countries. Others do not publicize their activities. Few are likely to have substantial reach within their communities and for most, finances are invariably fragile (Gray, 2005). Cancer Prevention And Advocacy Essay.
