Key stakeholders commit to work together in addressing barriers to breast cancer care

• Key stakeholders expressed their commitment to work together in addressing barriers to breast cancer care in the country during the final roundtable of the “Inspiring Conversations on Breast Cancer in the Philippines” series held on August 31, 2023 at The Manila Peninsula with virtual participants joining via Zoom.
• Organized by the Swiss Chamber of Commerce of the Philippines on behalf of the Philippine Cancer Society and ICanServe Foundation, with the support of Novartis Healthcare Philippines, the roundtable series aims to help meet the Global Breast Cancer Initiative targets and motivate stakeholders to support the implementation of the National Integrated Cancer Control Act.

Key stakeholders expressed their commitment to work together in addressing barriers to breast cancer care in the country during the final roundtable of the “Inspiring Conversations on Breast Cancer in the Philippines” series held on August 31, 2023 at The Manila Peninsula with virtual participants joining via Zoom. 

Organized by the Swiss Chamber of Commerce of the Philippines (SwissCham Philippines) on behalf of the Philippine Cancer Society (PCS) and ICanServe Foundation, with the support of Novartis Healthcare Philippines, the roundtable series aims to help meet the World Health Organization (WHO) Global Breast Cancer Initiative (GBCI) targets and motivate stakeholders to support the implementation of the National Integrated Cancer Control Act (NICCA). 

PCS President Dr. Corazon Ngelangel reiterated her appeal to the Department of Health (DOH) and local government units to support their organization’s ACT NOW Breast Cancer Early Detection Program which is currently being piloted in Quezon City with the support of Mayor Joy Belmonte. She underscored the importance of early detection in facilitating breast cancer treatment, lowering cost, and improving survival outcomes. 

“Our Breast Care Clinic caters to 20,000 consultations a year and identifies 3,000 new cases of breast cancer annually representing a third of all cancers seen in our hospital,” said Dr. Gerardo Legaspi, Director, University of the Philippines-Philippine General Hospital (UP-PGH). Located in the UP-PGH Cancer Institute, the clinic is sustained in partnership with private donors, and is currently the only clinic of its kind in the country that is accredited by the Association of Breast Cancer Centers in America.

Dr. Legaspi identified the lack of nationwide breast cancer screening as the barrier that stakeholders need to work on, noting that mammography in UP-PGH has a 2% pick-up rate. To help address this barrier, the UP-PGH Cancer Institute in partnership with the HARI Foundation launched the “Alagang Breastfriend” breast cancer mobile diagnostic clinic in 2018 to broaden access to breast cancer diagnosis in underserved communities. The state-of-the-art mobile van is equipped with a digital mammogram and ultrasound that provides medical and surgical oncology evaluation and biopsy with a 6% breast cancer pick-up rate in the community.  

Dr. Legaspi presented an overview of the planned UP-PGH Cancer Center which is a Public-Private Partnership (PPP). The six-billion-peso, 20-storey, 300-bed specialty hospital will provide international-quality comprehensive cancer treatment, with a dedicated 150-bed area for sponsored public patients and a clinically separate dedicated 150 bed area for self-paying private patients. 

Dr. Alfonso Nuñez III, Chief of the East Avenue Medical Center, and Interim Executive Director of the planned Philippine Cancer Center, discussed the patient journey through the Health Care Provider Network (HCPN), a group of primary to tertiary care providers, whether public, private or mixed, offering people-centered and comprehensive care in an integrated and coordinated manner with the primary care provider acting as the navigator and coordinator of health care within the network. He also presented government financing support for cancer care through Cancer Assistance Fund (CAF); Cancer, Supportive Care, and Palliative Care Medicines Access Program (CSPMAP); PhilHealth benefit packages; and Malasakit Centers, among others. 

“We need to work together in providing organized and accessible screening programs, accurate data collection and research, enhanced supportive and palliative care, and long-term survivorship care plans,” Dr. Nuñez said.

Dr. Kenny Jun Demegillo, Training Officer, Section of Medical Oncology, Southern Philippines Medical Center (SPMC), said that patient enrollment in the PhilHealth Z-benefits package and CSPMAP is fast and accessible at their institution, with regular multidisciplinary team conferences for breast cancer patients, which are well-attended by doctors from all subspecialties concerned.

On the other hand, Dr. Demegillo noted that 64% of patients seen at the SPMC Adult Cancer Institute outpatient department are diagnosed with advanced or metastatic cancer; only 34% are diagnosed at stage 1 or 2. There is also a long queue for patients scheduled for surgery and chemotherapy. Moreover, Z-benefits package do not adequately cover adjuvant hormonal and anti-HER2 treatment of enrolled patients, and only allow partial mastectomy/lumpectomy but do not cover radiotherapy. To help address these pain points, Dr. Demegillo said that SPMC appealed to donors who donated infusion chairs for outpatient chemotherapy patients and allotted additional operating rooms dedicated to breast surgery.

To address their hospital’s pain points, Dr. Demegillo presented a “wish list” which includes a dedicated diagnostic unit for cancer patients with CT scan, bone scan, and MRI; additional nursing personnel to cater to more patients; more beds at the oncology ward and more chairs in the infusion unit; and bigger Z-benefits coverage for breast cancer patients to cover for adjuvant hormonal therapy, anti-HER2 treatment and radiotherapy for breast cancer patients.

Dr. Solidad L. Balete, Head, Section of Medical Oncology, Jose R. Reyes Memorial Medical Center (JRRMMC), highlighted the importance of primary prevention programs, particularly population-wide breast cancer screening programs that can reduce breast cancer deaths through early detection and effective treatment. 

“All stakeholders must continue to collaborate to enhance the patient journey. Cancer care is not just about medical treatment. It is about being side by side with the patient and their caregivers as they navigate the complicated and challenging cancer journey,” Dr. Balete said.

“Promoting health literacy is the most cost-effective and impactful way to help breast cancer patients make the best decisions, giving them the best chance at living longer and living well,” said Mr. Joel Chong, Country President, Novartis Healthcare Philippines.

“We support the continuing dialogue on improving breast cancer survivorship in the country. With the support and collaboration of key stakeholders in the government, private sector and civil society, we aim to promote early breast cancer detection and diagnosis, as well as expand access to treatment,” said Ms. Christine Fajardo, SwissCham Philippines Chairperson and Communications & Engagement Head, Novartis Healthcare Philippines. 

Ms. Kara Magsanoc-Alikpala, Founding President of ICanServe Foundation; and Rachel Rosario, Executive Director of the Philippine Cancer Society, issued the “Call to Action: Manifesto of Support for Patient Survivorship”.