ASCO members urged to help support cancer care in Ukraine, host countries
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As important as the care of Ukrainian citizens with cancer is to clinicians in that country, this priority has been overshadowed by more immediate concerns.
“At this time, the Russian occupants have destroyed more than 117 hospitals, 43 ambulances were fired up, and six doctors were killed,” Andriy Hrynkiv, MD, surgical oncologist in Ukraine and member of ASCO Central & Eastern European Regional Council, said during an ASCO and European Cancer Organization (ECO) briefing on cancer care during the war in Ukraine. “On March 16, we received information that a Ukrainian paramedic volunteer and ambulance driver were taken as prisoners.”
In addition to the threats to health care professionals, volunteers and patients, supplies of cancer drugs are shrinking amid the destruction of warehouses containing the crucial treatments.
As refugees flee Ukraine, health care systems of neighboring countries have been overwhelmed, as well.
The U.N. refugee agency, United Nations High Commissioner for Refugees (UNHCR), has ramped up efforts to provide health care resources to refugees, but it is generally more focused on emergent and lifesaving efforts than on noncommunicable diseases such as cancer.
“I will say this: for UNHCR, cancer is not at the top of their list,” Julie Gralow, MD, FACP, FASCO, chief medical officer of ASCO, said during the webinar. “It really is up to the ASCOs and ECOs and others listening to this to provide the navigation where it is needed, when it is needed, for our Ukrainian patients and colleagues.”
Situation ‘changing from day to day’
In an interview with Healio, Gralow said the Russian invasion of Ukraine, which began Feb. 24, has taken a devastating toll on the country, its people and the host countries that have taken in large numbers of refugees.
“There are currently 3 million Ukrainian refugees in bordering countries, and another 10 million to 12 million displaced within the country,” Gralow said. “Cancer care is being dramatically affected, with some hospitals and clinics closed due to destruction and others on hold with the situation changing from day to day.”
She added that radiation treatments have been paused with the risk to the power supply and airstrike threats, and surgeries are restricted because of a limited supply of narcotics.
“An oncologist in Odessa informed us that the single [narcotics] manufacturer in Ukraine is located at Kharkiv, which is currently undergoing severe shelling,” Gralow said. “Even in regions more removed from direct attacks, cancer surgeries are being cancelled to make room for a possible influx of of war-related trauma patients.”
The bordering countries of Poland and Romania are receiving the largest number of refugees, and this dramatic increase in patients will likely require cancer centers in Western Europe to become involved.
According to Richard Sullivan, MD, PhD, a member of the WHO Emergency Committee, the overflow of refugees is likely to have a long-term impact on cancer care.
“What we’re seeing here is a nearly 5% increase in the populations of these countries because of refugees. So, the numbers are absolutely astronomical,” Sullivan said during the webinar. “Many refugees are moving on to third-party countries. We know refugees are moving on to Bulgaria, Greece, Austria, Germany, Italy and Turkey, and that’s making it quite tricky, because the UNHCR is responsible for tracking and monitoring refugees. Obviously, the way patients are moving across borders and on to other counties is making the therapeutic geographic potential quite challenging to keep an eye on.”
How clinicians can help
To aid Ukraine and its neighboring counties in the effort to provide ongoing, quality cancer care to residents and refugees, ASCO has partnered with ECO to create the ECO-ASCO Ukraine Crisis Steering Group. The core group of 10 to 12 ECO-ASCO representatives is focused on helping facilitate care and provide support in the region.
Additionally, American Cancer Society has initiated a Clinician Volunteer Corps, which is working in tandem with the ACS National Cancer Information Center (NCIC). NCIC specialists are fielding calls, which are then transferred to Clinician Volunteer Corps representatives. As of March 11, this effort has enlisted 59 fully active clinician volunteers and is seeking more. Clinicians can sign up at volunteerclinicians.cancer.org.
ASCO encourages clinicians to stay engaged and get involved in efforts to assist the oncology community in Ukraine. Clinicians can email international@asco.org or ukraine@europeancancer.org with any questions or comments. Clinicians can also learn of more opportunities to help and receive updates at www.asco.org/ukraine or www.onco-help.org. To suggest other resources, physicians can go to www.research.net/r/asco.ukraine.
“It is heartening to see so many coming together to help in this crisis,” Gralow said. “The EU is providing free medical care for refugee patients with cancer, and clinics in the region are ramping up to accept these patients. We are in regular contact with our ASCO members in Ukraine and the region.”
She said ASCO has been working with WHO to get regular reports on the refugee situation and, through them, the UNHCR.
Gralow also provided a link for clinicians to visit the website of the ECO-ASCO Special Network: www.europeancancer.org.topic-networks/20:impact-war-in-ukraine-on-cancer.html.
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ASCO/ECO briefing: Cancer care during the war in Ukraine (virtual briefing). Presented March 18, 2022.
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