Page 0012



particular radiation therapy, chemotherapy (4). Infections may

also be related to an immunosuppressed state due to changes in

the immune system caused by some haematologic malignancies

(5). In the case of solid tumours many factors contribute to an

increased risk of infection, including obstructions caused by the

tumour itself and the disruption of natural barriers such as skin

and mucosal membranes (6). Furthermore, surgery, catheters

and other devices used in treatment often increase the risk

of infections (7). Sepsis and Pneumonia are among the most

common causes for admission to intensive care units for cancer

patients. It is estimated that 8.5% of cancer deaths are due to

severe sepsis (8).

AMR and its impact on cancer care outcomes

Antimicrobial resistance is a global public health problem,

especially as antimicrobial treatment options are becoming

limited. Antimicrobial resistance (AMR) happens when

microorganisms (such as bacteria, fungi, viruses and parasites)

change and are still able to grow, even when they are exposed

to antimicrobial medicines that are meant to kill or limit

their growth (such as antibiotics, antifungals, antivirals,

antimalarials and anthelmintics). As a result, the medicines

become ineffective and infections persist, increasing the risk

of spread to others. Currently, an estimated 750,000 people

die every year from drug-resistant infections (9).

Although multi-country studies to provide comparable

data on a global level is lacking, several in-country hospital

surveillance studies suggest an increase in AMR in cancer

patients. For example, a study in India showed that 73% of

patients with blood cancers were colonized with carbapenemresistant bacteria in the gut (10).

A 2017 study in Ethiopia,

showed that bacterial infections in cancer patients was 19.4%,

and that multi-drug resistance was not uncommon (11). These

studies indicate that key advances in medicines, including

the newer targeted therapies for cancer patients, could be

undermined by the increasing threat of AMR.

To address the impact AMR has on negative cancer care

outcomes, a series of actions have to be put in place to ensure

that cancer patients have access to the right treatment at the

right time. For this to happen, we need to build strong and

effective partnerships.

Better addressing AMR for improved cancer care

outcomes through partnerships

The critical need to address AMR to improve cancer care

outcomes is finally starting to get the attention it deserves.

However, the current global response is still far from reaching

the scale and urgency required to address the problem of

AMR effectively. For this reason, the Union for International

Cancer Control (UICC), which is one of the oldest and largest nongovernmental organizations dedicated to cancer control,

has prioritized AMR and is committed to addressing this issue

within the cancer community and beyond.

Three priorities for UICC have been identified, which need to

be addressed simultaneously. These are (i) evidence generation

that effectively mobilizes policymakers, (ii) raising awareness

and increasing knowledge within the cancer community and (iii)

uniting the cancer and infectious diseases communities towards

a joint goal in supporting access to affordable medicines and

responsible use of antibiotics (neither overuse nor misuse).

In 2020, UICC and the Wellcome Trust participated in the

London Global Cancer Week (LGCW), an annual event (12)

that provided the ideal platform to bring together experts from

the fields of cancer and AMR to discuss what action needs to be

taken. The objective was to raise awareness on AMR and ensure

its prioritization in the global cancer agenda. At this event,

the UK Government's Special Envoy on AMR, the Norwegian

Cancer Society, the International Society for Paediatric

Oncology (SIOP), the Wellcome Trust and others called for

increased collaboration to raise awareness and ultimately

ensure strategies are in place to control AMR, including access

to and rational use of treatments.

Partnerships to improve and disseminate data on

AMR and cancer care

Review of the existing evidence shows a lack of data on the

impact of AMR on treatment outcomes for cancer patients. A

recent report commissioned by the Wellcome Trust found that

cancer patients who developed drug-resistant infections had

a greater risk of dying and were more likely to need additional

medical support. But the report also mentioned that this

evidence was weak and more systematic research is needed

to quantify the impact of AMR on cancer care outcomes (13).

It is important that clinicians and policymakers know which

negative outcomes including mortality in cancer care are due

to AMR and how often these occur (14). This data is needed

not only to help shape a more comprehensive response at the

political level and clinical level, but to also increase awareness

at grassroot and patient levels (15).

Many initiatives and partnerships are aimed at addressing

AMR, such as the UK's Fleming Fund which supports low- and

middle-income countries (LMICs) with building laboratory and

surveillance capacity to ensure quality data (16). The Fund has

provided training and laboratory equipment to a number of

countries to strengthen national AMR surveillance systems

(17). In 2015, the World Health Organization (WHO) launched

the Global Antimicrobial Resistance and Use Surveillance

System (GLASS) to improve knowledge through surveillance

and research. It is the first global collaborative effort to

standardize AMR surveillance. However, Dr. Abdul Ghafur,


  1. Page 0001
  2. Page 0002
  3. Page 0003
  4. Page 0004
  5. Page 0005
  6. Page 0006
  7. Page 0007
  8. Page 0008
  9. Page 0009
  10. Page 0010
  11. Page 0011
  12. Page 0012
  13. Page 0013
  14. Page 0014
  15. Page 0015
  16. Page 0016
  17. Page 0017
  18. Page 0018
  19. Page 0019
  20. Page 0020
  21. Page 0021
  22. Page 0022
  23. Page 0023
  24. Page 0024
  25. Page 0025
  26. Page 0026
  27. Page 0027
  28. Page 0028
  29. Page 0029
  30. Page 0030
  31. Page 0031
  32. Page 0032
  33. Page 0033
  34. Page 0034
  35. Page 0035
  36. Page 0036
  37. Page 0037
  38. Page 0038
  39. Page 0039
  40. Page 0040
  41. Page 0041
  42. Page 0042
  43. Page 0043
  44. Page 0044
  45. Page 0045
  46. Page 0046
  47. Page 0047
  48. Page 0048
  49. Page 0049
  50. Page 0050
  51. Page 0051
  52. Page 0052
  53. Page 0053
  54. Page 0054
  55. Page 0055
  56. Page 0056
  57. Page 0057
  58. Page 0058
  59. Page 0059
  60. Page 0060
  61. Page 0061
  62. Page 0062
  63. Page 0063
  64. Page 0064
  65. Page 0065
  66. Page 0066