A Global Perspective on Cancer

[MUSIC PLAYING] Welcome, everyone. You're watching Cancer in Context. I'm Dr. John Whyte, the Chief Medical Officer at WebMD. Cancer is truly a global disease impacting everyone around the world. So to help provide an international perspective today, I've asked her Royal Highness Princess Ghida Talal. She's the chairperson of the Board of Trustees of the King Hussein Cancer Foundation and Center in Amman, Jordan. Princess Ghida, thanks for joining me today.

Thank you, John. It's a real pleasure to see you again. It's been way too long. And I wanted to take just a minute to say how much we admire and look up to the work of WebMD and the entire team that provides the most essential health resources to millions around the world, credible health resources. And this is an invaluable support and service to so many viewers. Thank you very much.

Well, thank you for saying that. You and I share the same belief that if we give people better information, we'll give them better health. You're on the front lines of cancer care. And I wanted to start off by asking you, how has the COVID pandemic impacted cancer care, particularly screening, in the Middle East?

As we all know very regrettably, the pandemic has devastated communities throughout the world. It has crippled us. And you can imagine, for the developing world, it has had an even larger impact. We have dealt with it as best as we could. I'll give you an example, with regards to screening.

Well, with COVID, of course, came lockdown and came restrictions. Patients were no longer able to get screening, or at least a minimal amount only were able to get screening. And it wasn't only for mammograms and colonoscopies. It was for all kinds of screenings and treatment. They were not also able to get medical opinions that were vital to their diagnosis. So as a result, so many people were diagnosed later.

We felt that as well in all ranges in the cancer field. And the way we responded at the King Hussein Cancer Center, the institution for which I'm responsible for, is to literally face the reality of the situation and immediately develop protocols and operating procedures to deal with it.

So for example, we prohibited visitors immediately and stopped any kind of public events, of course. We also established virtual clinics so that the patients don't have to come to the hospital and be at any risk of infections. We started delivering medications to the patients at home and even had doctors conduct home visits.

We engaged in awareness and informational campaigns as well. As you can imagine, the cancer community is an immunocompromised community. And at the same time, we had to deal with another aspect that is very important to us and is a priority. And that is mental health as well because there was increased anxiety at not being able to get to your screening on time. We also had to, of course, protect all our medical staff and health care professionals who are on the front line and at the greatest risk of infection from COVID.

I wanted to ask you, though, Princess Ghida, are there cultural issues in other parts of the world, perhaps in the Middle East or elsewhere, that make cancer screening more difficult?

We are every day fighting the taboo related to cancer. To some extent, it still remains a little bit in the United States. But thankfully, the United States have gone way ahead at combating the taboo. We at the King Hussein--

Explain that taboo. Explain that taboo that still exists in some areas of the world.

The taboos absolutely still exist. With cancer, for example there is still unfortunately shame associated with it. And when one thinks of cancer in our part of the world, you automatically think of a death sentence, which we know is not the case.

So we work very hard way beyond the campaigns that one usually looks at to really show that cancer does not have to mean the end, especially if we catch it early, that early detection can and will save lives. We spend a great amount of time and financial resources on passing that message of early detection and its importance.

And you're doing a fair amount of work at the King Hussein Cancer Center particularly on mammography, breast cancer screening, isn't that right?

It is absolutely right, John. Breast cancer is the number one cancer in Jordan as it is in so many parts of the world. And so many of our women are dying unnecessarily totally avoidable death. And who are these women? I always say, who are these women? They are our moms, our daughters, our sisters, our girlfriends. And the reason is because they don't get screened on time.

So we realized the urgency of that very early on. And we established the Jordan Breast Cancer Program, which is actually not just a Jordanian program. It's a regional program. When we first established it about 14 years ago, 70%, John, 70% of our women were coming to the doctor at the late stages of their disease at stages three and four of the disease when we know it is unfortunately often too late.

And afterwards, after now, 35% of the women come at the late stages. So we were able to have the statistics and to flip the numbers. And we're still not satisfied. We're not happy. We will only be happy once every single woman presents herself at stages zero or actually precancerous stages. So this is what we have done. We have encouraged our women to come and take the BRCA test in order to have the choice at least of protecting herself and her family in the future.

Another area of research for the center is pediatric cancer, cancer in kids. Tell us what the King Hussein Cancer Center is doing related to pediatric cancers around the world.

We are partners and sister institutions with the best in cancer care worldwide. For example, we have followed the guidelines of St. Jude's, which is an enormous success story. I know you know that. And we have had multiple exchanges, over 20 years of training, of guidance, of secondhand opinions, of telesynergy.

So our pediatric center is huge. And we are planning right now to actually establish a standalone pediatric center as well. The jewel in our crown is our bone marrow transplantation program. We do over 300 bone marrow transplantations every year, which of course often means the difference between life and death for our patients.

Princess Ghida, I want to ask you about the role of prevention. So we know screening is very important to catch early. We know treatment and having the best treatment available is critical in terms of survival. But really, it's about prevention.

Now, I've sat next to you at a dinner, so I know you eat healthy. I see you on Instagram biking. But how hard is it to get people to practice healthy lifestyles, exercising, being physically active, eating more fruits and vegetables, decreasing the amount of red meat, getting adequate sleep? Is it harder to do in some areas of the world than others?

You know, John, with regards to food and exercise, I don't see a terrible alarm bell. Middle Eastern cuisine-- I hope you've had the chance to taste it because it's absolutely delicious-- is actually very healthy. Where we have a huge problem on our heads is with tobacco, is with smoking. I am embarrassed to say and very sad to say that Jordan ranks amongst the highest countries in the world for smoking and knowing that of course smoking is the leading cause of cancer.

And we have lost our beloved late king, King Hussein, to smoking. And we are continuing to lose so many of our youth to smoking. And we have laws. We have enacted laws, but they're not being implemented. And it's really an uphill struggle. And I wish I could tell you that we are in any way improving. But so far, we are still at a standstill with regards to smoking.

What do you think cancer care will look like in five years? Will it be more care delivered in the home? Will it be blood tests that we can use to detect cancer? What's that five-year mark that we expect to see cancer care?

We all know that the future of cancer lies with research and research breakthroughs. I am very optimistic in one way that we keep seeing major developments with regards to cancer breakthroughs such as immunotherapy, such as personalized medicine. And of course, the major breakthroughs are happening in the world of research.

Are we going to see cancer care being taken care of more in the home? To be honest, right now I don't really see it. But, but, the pandemic has shown us that we absolutely can do that. I mean, right now so many of our patients even before the pandemic, John, would take their chemotherapy at home. They would take their dose, and they would take it at home.

So this is going to happen, of course, more and more. But as you said earlier, we have to keep pouring our energy into early detection, into prevention, into research. And whether we are in the hospital or whether we are at home, the important thing is to be given a chance to fight.

And I know that some cancers unfortunately catch us when it's already too late. But so many others we can prevent and we can attack if caught early and survive. We always hear about the millions who have died of cancer. And one death is too many, John.

Cancer is in every household, in every single house. So each one of us has suffered from living with cancer with either directly or through a loved one. So it is important to remember and to think of these millions not as random numbers and statistics but that each number represents a human being who has a family, who has a community, who belongs to a nation.

Absolutely. And we need to do more to screen, to prevent, to treat early. Princess Ghida, tell our viewers around the world how they can learn more about the King Hussein Cancer Foundation and Center.

I just want to say like I said before that the King Hussein Cancer Center and Foundation-- one is a hospital. One is a foundation that supports the hospital, the mission of the hospital, which is to offer the most advanced cancer care to their patients. I would be grateful if listeners would learn more about us. Go to our website khcf.jo, J-O for Jordan.

I wanted to just mention that we are the cornerstone for cancer care in our region. And we do need support. There is one issue that I didn't mention, John, that I know is of great interest to the people of America. And it's the fact that we also take care of displaced people and refugees.

We are a small country, Jordan. But we have refugees from war zones and from troubled areas, from Syria, Peloton, Iraq, Yemen, Sudan, all over the region. And they have cancer. And they come to us for treatment. So the King Hussein Cancer Foundation has established a goodwill fund because they cannot afford cancer care. And they don't have any government to be able to subsidize them. So this is one area that maybe viewers can support us with is the displaced people and the refugees.

We have also tried to attend to countries in desperate needs. Right now, Lebanon, my country of origin, is suffering greatly and is at the brink of a meltdown. This country that used to be the magical place of the Middle East, it has enormous shortages of medications. And us, the King Hussein Cancer Foundation USA, which is our US branch. We have the US branch, King Hussein Cancer Foundation USA, have again opened a fund to channel cancer medications to our sister institutions in Lebanon who simply no longer have these medications.

So it would be truly wonderful and essential if you could only help raise awareness if nothing else. In a nutshell, the King Hussein Cancer Center and Foundation have changed the landscape of cancer care in the region. They care for the entire region. And they offer the most advanced cancer care.

This is where we are right now. Us and you, anyone interested in cancer care, you know what? We have no choice. We just have to move forward. We simply have no choice. We have to keep fighting tobacco. We have to keep breaking taboos around the world.

And at the same time, we have to keep the message shining that early detection can save lives. And why do we have to, John? Because millions around the world are counting on us to support them. And we cannot let them down.

No, we can't. And Princess Ghida, I want to thank you for your advocacy, for your passion in making access to cancer care more equitable as you point out, getting everyone treatment that they need, and for all you're doing in terms of raising funds for research.

Thank you, John. It was a real pleasure.

And viewers, I want to thank you for watching. If you have questions about cancer, please feel free to email us at [email protected], or post on Instagram, Facebook, or Twitter. Thanks for watching.

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