General Oncology Care in Syria

Abstract

The first entity dedicated to cancer was established named “Nuclear Medical Center” with a single radiotherapy unit in 1969. Since then, the concept of oncology has rapidly progressed with the establishment of a division of oncology in the University of Damascus, School of Medicine with six staff members at that time. In 2001, a National Cancer Registry was established with the help of the World Health Organization. Many civil societies related to cancer awareness, early detection, and care of patients bloomed, first being the Syrian Cancer Society.Now cancer diagnosis and treatment facilities are spread all over the county but mainly concentrated in Damascus, Lattakia, and Aleppo. All three main government related medical entities that are the Ministry of Higher Education, Ministry of Health, and the Medical Corps are involved in the process with the help of the private sector also. This progress of course was slowed due to the bloody aggression that engulfed Syria for 10 years of conflict. However, it did not halt the country’s goals and achievements.In 2006, Nuclear Medicine Centre was developed into a comprehensive institution for cancer, Al Bairouni University Hospital (ABUH) to provide free standard of care treatment for all citizens. The Syrian National Committee for cancer control (SNCCC) was established in June 2019 with a mission of strategic planning for better cancer management in collaboration with all stakeholders aiming to raise cancer services to the best possible standard in the post-war era. The chapters’ focus is to discuss cancer care services being provided in the country and future challenges that need to be addressed for high quality oncology care services in Syria.

Clinical Characteristics and Outcomes of Cancer Cases Among Syrian Refugees From Southern Turkey

“…The Syrian Registry reported the most frequent cancers were lung, colorectal, and leukemia among men and breast, colorectal, and leukemia among women, with an estimated mortality of 52 per 100 000 for females and 76 per 100 000 for males in 2009. The most common cancers among children were leukemia, central nervous system tumors, and lymphoma . Globocan estimated 20 959 new cancer cases for 2020 in Syria, and the most common cancers were breast, lung, colorectal, prostate, and leukemia…”

“…The most common cancers among children were leukemia, central nervous system tumors, and lymphoma. 14 Globocan estimated 20 959 new cancer cases for 2020 in Syria, and the most common cancers were breast, lung, colorectal, prostate, and leukemia. 15 The prevalence of cancer among Syrian refugees in Lebanon was reported as between 0.6% and 2%.…”

Lung Cancer Diagnoses and Outcomes During the Syrian War, 2011-2018

“…This is a retrospective cohort study performed at the lung cancer unit of Al-Beiruni Cancer Center in Syria, which became the main cancer center in the country after the destruction of Al-Kindi Oncology Center in Aleppo in 2016 22 and has since been receiving about 60% of all patients with cancer in Syria (around 11 000 cases per year). 23 This Damascus University–affiliated public hospital provides free-of-charge care to patients from across the country, including medical consultancy, medications, chemotherapy, radiotherapy, surgeries, and hospital and intensive care stays. However, like the rest of the country, this center experienced scarcity of oncologists during the war, as the best ratio was in Damascus with 20 oncologists for a population exceeding a million.…”

“…This number increased to almost 21 000 in 2020, encompassing 1976 patients with lung cancer . Meanwhile, Al-Kindi Hospital, formerly the largest hospital in northern Syria, was entirely destroyed during the conflict, compelling most patients with cancer throughout the country to converge on one major center in Damascus for specialized cancer care . Accessibility to this center still faced constant disruptions due to escalating armed conflicts that fragmented the country into territories with varying political influences.…”

“…21 Meanwhile, Al-Kindi Hospital, formerly the largest hospital in northern Syria, was entirely destroyed during the conflict, compelling most patients with cancer throughout the country to converge on one major center in Damascus for specialized cancer care. 22 , 23 Accessibility to this center still faced constant disruptions due to escalating armed conflicts that fragmented the country into territories with varying political influences. These circumstances compounded the challenges in registering, diagnosing, reporting, and managing patients with cancer, 22 , 24 , 25 and the consequences of Syrian war on the prognosis in patients with lung cancer, the most lethal oncological condition, remains unexplored.…”