The lancet oncology
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The lancet oncology · Apr 2013
Randomized Controlled TrialEffects of enobosarm on muscle wasting and physical function in patients with cancer: a double-blind, randomised controlled phase 2 trial.
Cancer-induced muscle wasting begins early in the course of a patient's malignant disease, resulting in declining physical function and other detrimental clinical consequences. This randomised, double-blind, placebo-controlled phase 2 trial assessed the efficacy and safety of enobosarm, a selective androgen receptor modulator, in patients with cancer. ⋯ GTx.
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Non-communicable diseases, including cancer, are overtaking infectious disease as the leading health-care threat in middle-income and low-income countries. Latin American and Caribbean countries are struggling to respond to increasing morbidity and death from advanced disease. Health ministries and health-care systems in these countries face many challenges caring for patients with advanced cancer: inadequate funding; inequitable distribution of resources and services; inadequate numbers, training, and distribution of health-care personnel and equipment; lack of adequate care for many populations based on socioeconomic, geographic, ethnic, and other factors; and current systems geared toward the needs of wealthy, urban minorities at a cost to the entire population. ⋯ Prompt and deliberate actions must be taken to avoid this scenario. Increasing efforts towards prevention of cancer and avoidance of advanced, stage IV disease will reduce suffering and mortality and will make overall cancer care more affordable. We hope the findings of our Commission and our recommendations will inspire Latin American stakeholders to redouble their efforts to address this increasing cancer burden and to prevent it from worsening and threatening their societies.
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Until recently, the Malawian capital of Lilongwe was without diagnostic pathology services, which left many patients with cancer facing serious diagnostic delays. Through collaboration with the University of North Carolina and other partners, a pathology laboratory was successfully established at Kamuzu Central Hospital in July, 2011, providing an essential foundation for cancer diagnosis and research in the country's largest city.
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The lancet oncology · Apr 2013
Developing cancer control plans in Africa: examples from five countries.
The creation and implementation of national cancer control plans is becoming increasingly necessary for countries in Africa, with the number of new cancer cases per year in the continent expected to reach up to 1·5 million by 2020. Examples from South Africa, Egypt, Nigeria, Ghana, and Rwanda describe the state of national cancer control plans and their implementation. Whereas in Rwanda the emphasis is on development of basic facilities needed for cancer care, in those countries with more developed economies, such as South Africa and Nigeria, the political will to fund national cancer control plans is limited, even though the plans exist and are otherwise well conceived. Improved awareness of the increasing burden of cancer and increased advocacy are needed to put pressure on governments to develop, fund, and implement national cancer control plans across the continent.
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Ethiopia has a population of more than 84 million people and is expected to become the ninth most populous country in the world by 2050. The growing population coupled with lifestyle changes will mean an increasing burden of cancer. However, oncology services are wholly inadequate--no cancer registry exists, and only one cancer centre, with a handful of doctors and nurses, struggles to serve the entire country.