While the Cuban Prime Minister, Manuel Marrero Cruz, praises on social media the supposed strength of the Cuban healthcare system and congratulates family doctors for their role in primary care, the reality in the country’s hospitals is different, with cancer patients arriving without timely diagnosis, and in many cases, without access to treatment.
“The majority arrive too late and many times we do not have treatment,” said Dr. Jorge Álvarez Blanco, head of the Provincial Medical Oncology Group in Sancti Spíritus, in an interview with the official media Escambray.
His words, filled with concern and resignation, depict the silent collapse of a critical specialty that, as he himself asserts, came to absorb up to 90% of the hospital budget in that province.
In Sancti Spíritus, for example, about 2,000 new cancer cases are reported each year, and more than 1,000 annual deaths from this cause.
“Most cancers are being diagnosed in stages that are not curable,” warns Álvarez. He explains that early detection does not fall directly under oncology, but rather under other specialties that, due to a lack of diagnostic resources such as CT scans, often identify tumors in advanced stages.
A dramatic example is colon cancer, which has up to an 80% chance of being cured if detected early. However, many cases arrive when the patient already shows signs of intestinal obstruction or liver metastasis, indicating stage 4, which is nearly irreversible.
Once cancer is diagnosed, the treatment should be immediate and precise. However, according to the specialist, many patients cannot undergo surgery in time, and the chemotherapy regimens, which should include several medications simultaneously, cannot be completed due to a lack of availability.
“Many times we don't have the treatment at the right moment. The regimens consist of four medications and there are no possible substitutions: it's either all four or none. This complicates a disease that does not allow for delays,” laments the doctor.
Additionally, 60% of patients require radiation therapy, a service whose coverage in Cuba is critical. Although the country has eight radiation therapy units, for nearly a year, no patients have been able to receive treatment in Villa Clara, and other provinces face similar situations. At times, even Havana has not had operational equipment, which further exacerbates the decentralized care.
Recently, the newspaper Escambray revealed that cancer patients in Sancti Spíritus must pay up to 70,000 Cuban pesos informally to access radiotherapy, a treatment that should be free of charge.
Immunotherapy has demonstrated greater stability in its availability, thanks to the local development of medications such as the CIMAvax-EGF vaccine for lung cancer, which has allowed for the extension of life in patients with advanced stages. However, the new molecular targets used worldwide are still beyond Cuba's reach, primarily due to their high cost.
Regarding clinical trials, Dr. Álvarez emphasizes that the country is beginning to regain momentum in studies of new molecules approved in early phases of research, which could open new therapeutic avenues.
“We feel well supported, but our specialty depends on all the others”, summarizes the head of oncology. To combat cancer, an efficient chain is needed that includes early diagnosis, availability of medical technology, specific drugs, and coordination between specialties. Without that structure, even the greatest efforts are insufficient.
Despite the commitment of the professionals and the ongoing institutional support, the situation is critical. Dr. Álvarez's call is a wake-up call regarding a healthcare system that, in its most expensive and sensitive specialty, is fighting against an adversary that does not wait.
According to data from the Ministry of Public Health, between 30,000 and 36,000 new cases of cancer are diagnosed in Cuba each year, and 60% of these patients require radiotherapy.
The doctor Elías Antonio Gracia Medina, head of the National Group of Medical Oncology, has reported that cancer is the leading cause of potential years of life lost among the Cuban population aged 1 to 74, impacting individuals in the prime of their economic activity.
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