T
he International Network for Cancer Treatment and
Research (INCTR) is an international non-governmental
organization (NG0) that was established to address a
neglected global health problem - the ever increasing burden
of cancer in developing countries. The founder members of
INCTR included the former Institut Pasteur in Brussels and the
International Union Against Cancer, now known as the Union
for International Cancer Control (UICC). The National Cancer
Institute in the United States provided financial and technical
support and the organization began its activities in 2000.
INCTR's headquarters are located in Brussels and it has offices
and branches throughout the world. INCTR became an NGO in
Official Relations with the World Health Organization (WHO)
in January 2010.
The need for INCTR: Cancer in developing countries
Approximately 85% of the world's people live in low- or middleincome
countries (LMICs). In 2012, Globocan estimated that
there were approximately 14.1 million new cases of cancer and
8.2 million deaths from cancer in the world, with 65% of deaths
occurring in LMIC. The number of cancer cases continues to
rise across the world, but much faster in LMICs because
development brings decreased mortality and with their higher
fertility rates, this rapidly translates into population growth
and increased numbers of patients with common diseases. The
birth rate subsequently declines, although population growth
continues since people live longer. Eventually birth and death
rates stabilize at a much lower level of both than was the case
prior to development. These demographic changes are
accompanied by the adoption of unhealthy lifestyles practiced
in high-income countries, particularly smoking and
increasingly, overeating and a sedentary lifestyle.
Resources of all kinds for treating cancer are limited in
LMICs, such that patients who develop cancer frequently lack
access to a facility capable of making an accurate diagnosis and
providing appropriate therapy. There is a lack of drugs, a
paucity of radiation therapy facilities and very few cancer
specialists or other health care workers who are needed to
effectively care for cancer patients. Diagnosis may be so
delayed that there is little that can be done even if the patient
does finally reach a facility competent to care for them.
Terminal care is not widely available, and regulations and
attitudes are still largely directed towards preventing the
misuse of opioids rather than relieving the pain of dying
patients, such that most patients die without symptomatic
relief or little or no mental or spiritual comfort. It is estimated,
for example, that less than 1% of patients who need palliative
care in India receive it.
INCTR is unique in that it focuses only on the developing
world. It also works directly with its collaborators, sometimes
visiting them many times in order to achieve its goal of helping
to build sustainable capacity in LMICs in order to assist these
countries in cancer prevention, early diagnosis, treatment and
palliative care. It is not an advocacy organization, and all clinical
projects are coordinated by a health professional. Its output is
information collected in the field, lives saved by cancer
prevention or treatment, and improved quality of palliative care.
Who INCTR works with
INCTR utilizes health-care professionals familiar with the
problems of developing countries to enable it to achieve its
goals. See Box 1.
INCTR develops local capacity within LMICs by training
health-care professionals to establish "centres of excellence" in
the delivery of feasible, affordable and effective care, including
palliative care, that is considered "best practice" so that they, in
turn, can train others within their country or region.
INCTR works through its branches in implementing various
programmes and projects conducted in collaboration with
partner institutions in developing countries and monitored by
field visits.
INCTR integrates research into its programmes by
documenting and evaluating actual data (rather than projected
economic or health benefits, for example). Such research may
include a wide range of projects, from cancer education for the
general public to developing treatment outcomes, including
palliative care. This, in turn, enables health-care professionals
working in LMICs to become familiar with the most pressing
issues and to develop plans to improve efficiency and reduce
cost. Although clearly many countries have limited health
workforces and quantitation of such workforces can be
valuable in terms of planning for the future, it realizes that
INTERNATIONAL NETWORK FOR CANCER TREATMENT AND RESEARCH
‰ To reduce the incidence of cancer in resource-limited
countries through public and professional education about
the causes of cancer and how to use this information in
cancer prevention
‰ To detect cancer early through public and professional
education about the early signs of cancer and what to do if
they appear
‰ To diagnose cancer accurately through pathology training
and, where important and feasible, imaging techniques
Box 1: INCTR's goals - Making a difference
146 CANCER CONTROL 2015
ABOUT INCTR