Early in his career, Dr. Corey Casper developed a stirring vision. He knew that infectious diseases cause about 25 percent of all cancers around the world. And he believed most of these cancers could be prevented using technology and tools that are available today. But he needed to find the best place to study these cancers and new strategies to prevent and treat them.
So, in 2004, Casper traveled to Uganda. His first stop was the Ugandan capital, Kampala, where he visited the Uganda Cancer Institute (UCI) – the sole cancer treatment facility in a country of 32 million people.
The number of people with cancer in developing countries outnumbers those with HIV, malaria and tuberculosis combined. At the UCI, Corey saw that six out of 10 patients had cancers that were triggered by infectious diseases such as HIV, Epstein-Barr virus, viral hepatitis, and human papillomavirus (HPV). Many of the patients were children with advanced cancers that left them little chance of survival.
“It was a terrible situation,” Casper said. “But I knew we could fix these problems through a partnership that focused on innovative research, capacity-building and clinical care.”
Developing tools to prevent cancer worldwide
Each year, infection-related cancers cause about 1.5 million deaths and account for approximately 3 million new cancer diagnoses. Roughly two-thirds of these cases are in developing countries where patients can’t afford expensive treatments. Those facts aren’t widely known, and are something that World Cancer Day, held each year on Feb. 4, is helping illuminate with a campaign to raise awareness.
In 2008, Casper and his Ugandan colleagues launched the UCI/Hutchinson Center Cancer Alliance to improve care and develop affordable treatments and prevention approaches that could save millions of lives worldwide. Conducting research in a place where malignancies like Kaposi Sarcoma and Burkitt lymphoma are common means Casper’s team can easily find patients to participate in clinical trials and can quickly complete those trials.
“People in Uganda see these cancers every day and they’re extremely invested in finding cures,” Casper said.
To highlight this research’s potential, Casper points to the success of the vaccine that prevents HPV, which causes cervical cancer. The HPV vaccine proves that an inexpensive medication can save hundreds of thousands of people from cancer, and it was developed with key contributions by Fred Hutch’s Dr. Denise Galloway.
“A lot of cancer research focuses on incremental steps toward solutions that might not materialize for decades, but we know how to make vaccines to wipe out infection-related cancers,” Casper said. “We can do it within our lifetimes.”
Improving clinical care
In 2008, Uganda was home to only one oncologist, making it impossible for most cancer patients to get the care they need. Fred Hutch and the UCI launched a program in 2007 that brings Ugandan doctors to Seattle to complete an oncology fellowship, and trains other medical specialists at the UCI.
The program has so far trained 16 cancer specialists and more than 200 support staff including nurses, pharmacists, research and lab technicians, and clinical and administrative staff. This helped increase the UCI’s treatment capacity to 35,000 patients, up from 10,000 patients when the program started.
The UCI/Hutchinson Cancer Center Alliance also developed a treatment protocol for Burkitt lymphoma, the most common life-threatening malignancy among Ugandan children. Burkitt lymphoma is curable in the US but only about 10 percent of patients in the developing world survive the disease. The new protocol means that all children with Burkitt lymphoma at the UCI will be treated according to standardized care guidelines that could be implemented by clinics around the world.
“It’s a step toward our goal of increasing survival rates for Burkitt lymphoma and other common infection-related cancers,” said Erica Sessle, managing director of Fred Hutch’s Uganda program.
Building a state-of-the-art facility
The UCI’s capacity will increase even more next fall, when it opens a state-of-the-art research and treatment facility in Kampala. The new facility will include adult and pediatric cancer care clinics, specialized diagnostic laboratories and an infrastructure to support clinical trials. It will be the first cancer center jointly constructed by U.S. and African cancer institutions in sub-Saharan Africa.
The facility is being funded by two grants totaling $1.4 million from the United States Agency for International Development’s American Schools and Hospitals Abroad program and a multi-million dollar investment from Fred Hutch.
“Cancer, especially childhood cancer, is a growing threat to Uganda’s next generation and must be addressed with equal vigor as HIV/AIDS," said Dr. Jackson Orem, director of the UCI and co-scientific director of the UCI/Hutchinson Center Cancer Alliance. “The new facility will help us do this.”
Reach writer Justin Matlick at email@example.com.