While Cuban Prime Minister Manuel Marrero Cruz praises the supposed strength of Cuba's healthcare system on social media and commends family doctors for their role in primary care, the reality in the country's hospitals tells a different story. Cancer patients frequently arrive without timely diagnosis, and in many cases, without access to necessary treatment.
"Most patients come to us too late, and often we lack the treatment they need," stated Dr. Jorge Álvarez Blanco, head of the Provincial Medical Oncology Group in Sancti Spíritus, during an interview with the official media outlet Escambray. His comments, filled with concern and resignation, highlight the silent collapse of a critical specialty that, according to him, once absorbed up to 90% of the hospital budget in the province.
The Dire Situation in Sancti Spíritus
In Sancti Spíritus, nearly 2,000 new cancer cases are reported annually, with over 1,000 deaths each year. "Most cancers reach us at stages that are not curable," warns Álvarez. He explains that the initial detection does not fall directly on oncology but on other specialties that, due to a lack of diagnostic tools like CT scans, often find tumors in advanced stages.
A dramatic example is colon cancer, which has up to an 80% cure rate if detected early. However, many cases are only identified when a patient already suffers from intestinal blockage or liver metastases, indicating a stage 4 cancer, nearly impossible to reverse.
Challenges in Treatment Availability
Once cancer is diagnosed, treatment should be immediate and precise. However, as the specialist notes, many patients cannot undergo timely surgery, and chemotherapy regimens, which should include several medications simultaneously, often cannot be completed due to lack of availability.
"Many times, we don't have the treatment at the right moment. The regimens require four medications, and there are no substitutes: it's all four or none. This complicates a disease that doesn't allow for delays," laments the doctor.
Radiotherapy and Financial Barriers
Additionally, 60% of patients require radiotherapy, a service whose coverage in Cuba is critical. Although the country has eight radiotherapy units, for nearly a year, no patients have been irradiated in Villa Clara, and other provinces face similar challenges. Sometimes, not even Havana has operational equipment, worsening the decentralized care situation.
Recently, Escambray reported that cancer patients in Sancti Spíritus must pay up to 70,000 Cuban pesos informally to access radiotherapy, a treatment that should be free.
Hope in Immunotherapy and Challenges Ahead
Immunotherapy has shown somewhat more stability in availability, thanks to local development of medications like the CIMAvax-EGF vaccine for lung cancer, which has extended the lives of patients in advanced stages. Nonetheless, new molecular targets used worldwide remain out of Cuba's reach, mainly due to high costs.
Regarding clinical trials, Dr. Álvarez highlights that the country is beginning to regain momentum in studies of new molecules approved in early research phases, potentially opening new therapeutic avenues.
"We feel well-supported, but our specialty depends on all others," summarizes the head of oncology. To combat cancer, an efficient chain is needed, including early diagnosis, availability of medical technology, specific drugs, and coordination among specialties. Without this structure, even the greatest efforts are insufficient.
Despite the dedication of professionals and the institutional support that still exists, the situation is critical. Dr. Álvarez's call is a warning about a healthcare system that, in its most costly and sensitive specialty, is battling an unyielding foe.
According to the Ministry of Public Health, between 30,000 and 36,000 new cancer cases are diagnosed in Cuba each year, and 60% of these patients require radiotherapy. Dr. Elías Antonio Gracia Medina, head of the National Medical Oncology Group, has reported that cancer is the leading cause of potential years of life lost among Cubans aged 1 to 74, affecting individuals during their economically active years.
Frequently Asked Questions about Cancer Treatment in Cuba
Why do cancer patients in Cuba often receive late diagnoses?
Many cancer cases in Cuba are diagnosed late because initial detection falls on specialties without adequate diagnostic tools, such as CT scans, leading to tumors being found in advanced stages.
What challenges do Cuban hospitals face in providing cancer treatment?
Cuban hospitals often lack the necessary medications for complete chemotherapy regimens and face critical shortages in radiotherapy services, leading to delays and inadequate treatment for cancer patients.
How is the availability of immunotherapy in Cuba?
Immunotherapy availability in Cuba is somewhat stable due to local development of medications like the CIMAvax-EGF vaccine for lung cancer, although many advanced therapies remain inaccessible due to high costs.