COMMENTARY

Ukrainian Refugees With Cancer: Where Does the Burden Go?

David J. Kerr, CBE, MD, DSc

Disclosures

February 23, 2023

This transcript has been edited for clarity.

I'm David Kerr, professor of cancer medicine at University of Oxford. As many of you know, I'm a past president of the European Society for Medical Oncology (ESMO). One of our greatest leaders and a great friend of mine, Professor Heine Hansen, when he was president of ESMO, made a very particular drive to bring in our colleagues from Eastern Europe and maintain very strong links with our colleagues along that whole Eastern European crescent.

There was an article and some correspondence published recently in The Lancet Oncology about the burden of cancer in Ukrainian refugees and the pressure that is putting on the healthcare systems from those Eastern European countries that have been incredibly welcoming of those Ukrainian refugees pushed out by this extraordinary war pursued by Vladimir Putin.

Joanna Didkowska and colleagues at the National Polish Cancer Registry have estimated — I think, fairly — that over the coming years, the prevalent burden of cancer from Ukrainian refugees will amount to between 50,000 and 55,000 individuals, with 3300 new cases coming to Poland every year. These are already somewhat stretched healthcare systems, so you imagine that the magnitude of effect will have potential knock-on effects on the delivery of cancer care for the citizens of Poland, and the use of already limited resources to meet this new influx of patients with cancer.

An old friend of mine, Christoph Zielinski, has written in The Lancet Oncology about some work that his Central European Cooperative Oncology Group have done, in which they surveyed some of their members in the East who have been involved in the frontline of care, if I could use that term.

They found that patients coming from Ukraine often come with a well-documented disease portfolio —pathology results, radiology images — which is a very useful packet of information on which to build care. The majority of members of the cooperative group are looking after Ukrainian patients. This doesn't surprise us, given that sense of community, fraternity, and sorority that we have between our colleagues in East and West, but also their commitment to caring for any cancer patients that come their way.

It's a burden, though. There are two things I wanted to say. One was to pay homage and to say thank you to our colleagues in the East who have taken on this burden of care and who are doing it honorably and to the very best of their ability. Resources are stretched.

The second point is that if we in the West are looking to provide support for Ukrainian cancer refugees, as we want to do, then working with groups like the Central European Cooperative Oncology Group could provide a focus of effort for fundraising and delivery of drugs, if any of us wanted to volunteer to provide additional support, and so on.

It's possible that Christoph Zielinski and colleagues could help to provide the network that is already existing here and perhaps act, in a way, as traffic policemen to direct our support — whether it's financial, drugs, or human volunteers — to those areas where it is most needed.

I think it's a burden that's going to be with us for some time. The war has not reached a stalemate; it looks as if it's going to be prolonged and bitter, with increasing destruction of Ukrainian infrastructure, something that isn't going to go away in the immediate short term.

Although much of the work that I've done in the past, thinking about refugees from cancer, has been in the Middle East, from Syria, Iraq, Erbil, and so on, isn't it extraordinary that we're having this discussion about what was once a stable European state and the necessity for us to provide as much truly emergency support as we can?

A thousand thank-yous to our colleagues in the East. For those of you who are watching and listening, please think if there's anything that you might do to help contribute to this. We'd be very grateful for your thoughts and ongoing support.

Thanks for listening, as always. I'm very grateful for any comments that you might have. For the time being, Medscapers, over and out. Thank you.

David J. Kerr, CBE, MD, DSc, is a professor of cancer medicine at the University of Oxford. He is recognized internationally for his work in the research and treatment of colorectal cancer and has founded three university spin-out companies: COBRA Therapeutics, Celleron Therapeutics, and Oxford Cancer Biomarkers. In 2002, he was appointed Commander of the British Empire by Queen Elizabeth II.

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