Our website uses cookies to improve your on-site experience. By using the website, cookies are being used as described in our Policy Document
Warning: To log in you will need to enable cookies and reload the page (Policy Document)
My ePortfolio Register   
 

Abstract | Full HTML Article | PDF ecancer 14 1018 / https://doi.org/10.3332/ecancer.2020.1018

Research

Cancer care in times of conflict: cross border care in Pakistan of patients from Afghanistan

Armed conflict in Afghanistan has continued for close to 40 years and has devastated its health infrastructure. The lack of a cancer care infrastructure has meant that many Afghans seek cancer care in neighbouring countries, like Pakistan. There remains a significant lack of empirical data on the new therapeutic geographies of cancer in contemporary conflicts.

This retrospective single centre study explores the therapeutic and clinical geographies of Afghan cancer patients who were treated at the Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) in Lahore, Pakistan over a 22-year-period (1995 to 2017) covering major periods of conflict and relative peace.

Data was available for 3,489 Afghan patients who received treatment at SKMCH&RC. The mean age at presentation was 42.7 years, and 60% were men. 30.2% came from Kabul and Nangarhar districts of Afghanistan, which have relatively short travel times to Pakistan, but patients from all parts of Afghanistan migrated to SKMCH&RC for treatment. Overall, 34.1% were diagnosed with upper gastrointestinal malignancies and 55.7% presented with late stage III/IV cancer. A wide range of treatments were provided, with 25.4% of patients receiving a combination of chemotherapy and radiation treatment. 52.7% of all patients were lost to follow-up. Outcomes were more favourable for children with cancer, 42% of whom had a complete response to therapy.

Complex migration patterns, mixed political economies (refugees, forced and unforced migrants) and models of care that must be adapted to the realities of the patients rather than notional international standards all reflect the new therapeutic geographies that long-term conflict creates. This requires significant new domestic and international (e.g., United Nations High Commissioner for Refugees) policy and practises for providing cancer care in today’s contemporary conflict ecosystems that frequently cross national borders.

Keywords: Afghanistan, Pakistan, cancer, migration, conflict and health, global health

Loading Article Metrics ... Please wait

Related articles

Short Communication: COVID-19 and treatment with NSAIDs and corticosteroids: should we be limiting their use in the clinical setting?

Abstract | Full Article | PDF Published: 30 Mar 2020 / https://doi.org/10.3332/ecancer.2020.1023

Review: Associations between immune-suppressive and stimulating drugs and novel COVID-19—a systematic review of current evidence

Abstract | Full Article | PDF Published: 27 Mar 2020 / https://doi.org/10.3332/ecancer.2020.1022

Clinical Study: Prospective study to assess the survival outcomes of planned irradiation of ipsilateral subventricular and periventricular zones in glioblastoma

Abstract | Full Article | PDF Published: 26 Mar 2020 / https://doi.org/10.3332/ecancer.2020.1021

Research: Impact of HER2 status in resected gastric or gastroesophageal junction adenocarcinoma in a Western population

Abstract | Full Article | PDF | Español Published: 24 Mar 2020 / https://doi.org/10.3332/ecancer.2020.1020

Clinical Study: Sequential chemotherapy followed by radical thoracic radiotherapy (50 Gy in 25 fractions) in limited stage small cell lung cancer

Abstract | Full Article | PDF Published: 09 Mar 2020 / https://doi.org/10.3332/ecancer.2020.1019



Founding partners

European Cancer Organisation European Institute of Oncology

Founding Charities

Foundazione Umberto Veronesi Fondazione IEO Swiss Bridge

Published by

ecancer Global Foundation