Cancer is clearly the deadliest disease known worldwide as it is the second leading cause of deaths globally with an estimated prevalence of one in three people developing cancer during their lifetime .
The term Cancer defines a large group of diseases that can affect any part of the body; the pathological mechanism of cancer is the transformation of normal healthy cells that become abnormal and proliferate excessively. These disordered cells eventually form a mass called malignant tumor. Cancer cells tend to invade nearby tissues and become detached from the tumor. They then migrate through the blood vessels and lymphatics to form another tumor (metastasis).
The most commonly diagnosed cancers in the world are lung, breast and colorectal cancer AND The most common deaths are caused by lung cancer, stomach and liver cancer.
The definitive cure for cancer still does not exist nowadays and we can also say that the cancer response will never come from a single miracle pill , but complete remission has been achieved in many cases in response to various treatments.
treatment of cancer requires having a diagnosis of certainty and knowing the type of cancer; evaluation of local and regional extension and the presence or absence of metastases with assessment of the general condition of the patient (age, cardiac and renal function, presence of other diseases).
The classic cancer therapies include surgery, radiation and chemotherapy that aim to remove cancer cells surgically and destroy them by toxic chemicals that are also toxic to normal cells as well, these classic therapies rarely succeed to eradicate every single cancer cell, so even if few cancerous cells survive the therapy, they can proliferate again and produce a relapse of the disease few months or years later
Cancer treatment definetly changed over the last decades with the emerging of new strategies based on better understanding of cancer cell biology , these new therapies include : antibodies ,viral therapy and antiangiogenic drugs that stop tumors from growing new blood vessels
one leading research in the treatment of lung cancer, which is one of the deadliest cancers, is the CimaVax-EGF: a vaccine used to treat patients with lung cancer and as a preventive measure for people at high risk of suffering from this disease. At present, this drug is available in the country’s hospital network, and it has been registered in several countries.
With Trials organized in the United States, the European Union, Japan, and Serbia that showed increased a chance of survival.
CIMAvax is based on a unique mechanism because it starves cancer cells : It does not target the cancer cells directly, but is expected to work against these cancers by denying the cancers the growth stimulus they require.
In addition, Cuban scientists have just completed their research on two other promising cancer drugs: Racotumomab and VSSP. The first acts on a molecule present in all cancer cells, which means that this drug may one day be effective against leukemia and tumors of the lung, breast, prostate and colon, while the VSSP, designed to Originally as a compound to activate the immune response to vaccines, it also seems to stimulate the immune response to cancer.
Nimotuzumab is also used to treat many types of head and neck cancers, including those that form on the mucous surfaces of the mouth, nose, brain and nasopharynx. This drug can bind epidermal growth factor receptors in cancer cells, preventing them from dividing and spreading.
Epidermal growth factor receptor (EGFR) is a key target in the development of cancer therapeutics, it is a signaling protein that normally controls cell division. In some cancers, this receptor is altered to cause uncontrolled cell division, a hallmark of cancer, nimotuzumab works by blocking that receptor and eventually it stops the uncontrolled cell division.
Cuban Approach to Cancer Treatment:
Cancer is one of the leading causes of death in Cuba. This is partly due to longer life expectancy but also to the adoption of unhealthy lifestyles. Too many people abuse alcohol, have an unbalanced diet and consume tobacco
To cope with this situation, Cuba has followed the recommendations of the World Health Organization and has put in place a comprehensive national plan that guarantees access to all levels of health services – prevention, diagnosis, treatment and palliative care. The plan builds on a strong primary care system that allows physicians to see their patients regularly and detect health problems early. Patients suspected of having cancer are referred to specialized centers for diagnosis and appropriate treatment.
To support this approach, the government has invested heavily in biotechnology. In recent years, Cuban scientists have made tremendous progress in finding new treatments for cancer and new tools to improve diagnosis and prevention.
Early detection of cancer remains the ultimate treatment option: Screening in both healthy and high-risk populations offers the opportunity to detect cancer early and with an increased opportunity for treatment and curative intent
Screening for the identification of cancer or precancerous lesions at an early stage of its development greatly increases the chances of successful treatment. It is based on screening, but also on the education of patients with early diagnosis, when it comes to early detection of cancer awareness is the most important factor, some early signs of cancer include lumps, sores that fail to heal, abnormal bleeding, persistent
indigestion, and chronic hoarseness. Certain types of cancer are accessible to simple tests that identify, in a healthy population, subjects who have cancer but do not yet have symptoms. This is particularly the case with breast, colorectal and cervical cancers.
Cuba is at the forefront of orthopedic surgery, continuously evolving, creating new surgical techniques, designing medical devices, and improving patient’s quality of life. Hospitals in Cuba adhere to a strict conduit of hygiene, while also providing patient-center medical care. Due to the high standards of professionalism and efficiency that hospitals and medical staff uphold. Cuba attracts over 25 000 medical tourists each year.
Cuba has brought numerous innovations in the field of Orthopedics and Traumatology over the years, from which the entire world has benefited. Cuba has contributed to numerous advancements in joint replacement surgical techniques, As well as the development of more durable and efficient joint replacement prosthesis.
Total Hip Replacement Surgery
The primary indication for total hip replacement surgery is to relieve pain caused by severe osteoarthritis, inflammatory arthritis and avascular necrosis of the femoral head. Secondary indications include correction of significant deformities and post-traumatic reconstruction. Joint replacement is considered when the pain is disabling and significant or in cases in which joint dysfunction is causing significant reduction in the patient’s quality of life.
The surgery implies removing the damaged joint and replacing it with an artificial prosthesis. The artificial hip joint replacement has traditionally been made with cemented polyethylene cup implants.
However, Cuba has advanced to using “cementless” prostheses. These particular prostheses have microscopic pores which allow bony ingrowth from the normal femur into the prosthesis stem. This “cementless” hip is felt to have a longer duration and is considered especially for younger patients. The prosthesis can also be customized acording to the patient’s needs and anatomy.
Cuba has pioneered the surgical technique for cementless hip replacement surgery that is currently being used world-wide. Although many varieties of these specialized prostheses now exist; the most used model in Cuba is a prosthesis made of metal and polyethylene covered with hydroxyapatite , which is the main mineral component of bone , obtained naturally from coral and also synthetically in the laboratory. It is produced at the National Scientific Research Center, part of the west Havana scientific complex.
Advances in hip replacement surgery have also allowed for a „minimal invasive” surgery technique to be developed. The classical hip replacement surgery technique implies making an 10 to 25 cm cut along the side of the hip. In the minimally-invasive approach, doctors make one to two cuts from 5 to 13 cm long. The same procedure is performed through these small incisions as with standard hip replacement surgery. The aim of the minimal invasive approach is to limit soft-tissue and bone dissection.
Specialized instruments and trained assistants are essential for the success of this technique. The instruments are designed to keep the assistant’s hands out of the operative field while generating less tension on the soft tissues. Robotic or computer guidance can be used to virtually visualize the minimally exposed anatomy.
The use of small incisions, coupled with minimal tissue damage has been shown to lessen blood loss, ease pain following surgery, shorten hospital stays, reduce scar appearance, and speed healing. Moreover, 97% of patients attained standard physical therapy goals (transferring in and out of bed from standing, rising from a chair to standing, moving from standing to sitting, walking 100 feet, and negotiating a full flight of stairs) within 1 day of surgery.
While the technique is certainly an advancement in hip replacement surgery; it is difficult and requires highly trained medical team. Smaller incisions mean poor visibility of the area. Surgeons need to have excellent understanding of the anatomy of the region and have access to specialized hands-on training by operating on cadavers and by visiting experienced surgeons.
Specialized instruments and trained assistants are also essential for the success of this technique. The instruments are designed to keep the assistant’s hands out of the operative field while generating less tension on the soft tissues.
Total Knee replacement surgery
The primary indication for total knee replacement surgery is relief of significant, disabling pain caused by severe arthritis. Generally, it is indicated in older patients with more modest activities. It is also clearly indicated in younger patients who have limited function because of systemic arthritis with multiple joint involvement.
Significant advances have occurred in the type and quality of the metals, polyethylene, and, more recently, ceramics used in the prosthesis manufacturing process, leading to improved longevity. As with most techniques in modern medicine, more and more patients are receiving the benefits of total knee arthroplasty. In Cuba, an average of 140 total and revision knee replacement surgeries per 100.000 population are performed annualy.
For total knee replacement surgery Cuba now uses the KALISTE prosthesis model, manufactured by the French company FHorthopedic. Kalisté Total Knee System is a tricompartmental resurfacing prosthesis that allows the surgeons to begin the knee replacement surgery with either the tibial stage or the femoral stage. This prosthesis can be customized to the patient’s anatomy and has been designed to admit posterior cruciate ligaments PCLretaining or posterior stabilized PS Knee prosthesis.
The use of this knee replacement prosthesis coupled with the excellent surgical techniques that Cuban surgeons employ have led to excellent success rates. Statistics show that 91% of patients that have undergone the technique attained standard physical therapy goals within 2 day of surgery.
In addition to providing excellent medical care, Cuba has extremely affordable prices for various orthopedic surgeries, including total hip and knee replacement. A standard that should be upheld all over the world as medical care is a right, and not a privilege.
Professor Ricardo A. Gonzales MD Ph.D. DSc founded back in 1976 Cuba’s first health facility for substance abuse treatment at the Eduardo B. Ordaz Psychiatric Hospital in Havana. During his carrier of 40 years, he founded 17 similar facilities throughout Cuba making the hospital in Havana a national reference center for substance abuse treatment. The Cuban approach to drug abuse is open for international patients as well. The legendary soccer player, Diego Maradona is certainly, the most well-known patient of Cuban program.
What’s a Cuban approach?
The program lasts for 97 days (14 weeks) and during that time, the patient goes through the process of detoxification and rehabilitation. All the details are worked out- the therapy is carried out in a natural environment, overseen by a team of highly trained professionals (multidisciplinary approach to the treatment is must!). Upon the conclusion, the re-evaluation and follow up visit are scheduled.
The facilities that accommodate patients are secured and reserved only for patients on a drug abuse treatment. The treatment principle applied relies on “therapeutic communities” where patients get a chance to talk and encourage each other, share their hopes, dreams, and frustrations, which altogether contributes to the recovery.
During the first week, the team of specialists decides if the patient should stay in the program or not. In case of excessive aggression, if the patient changes his mind (patients are admitted under their own free will) or because of other medical or non-medical reasons, the team releases the patient with a recommendation about further treatment. The patients who get admitted (a vast majority of them), undergo a series of lab tests, X-ray, ECG, and other necessary medical examination procedures. After the initial assessment, a personalized therapeutic plan is made.
During the three months period, the patient is undergoing individualized physical and psychological rehabilitation program to achieve behavioral changes that will allow him a healthy (long-term sustainable) rehabilitation. Specifically, the patient learns about how to control withdrawal symptoms, how to cope with cravings, new healthy lifestyle, how to eliminate harmful behaviors and accept responsibilities and develop his or her intellectual and labor potential to its maximum.
The problem of drug abuse is complex and requires a team of many specialists- experienced internal medicine specialists, neurologists, psychologists, psychiatrists, nurses- all to be trained specifically for the treatment of drug abuse.
Drug abuse in some cases leads to a vicious, never-ending cycle of psychiatric problems- the drug abuse damages the brain which leads to psychiatric conditions (paranoid psychosis or schizophrenia for example), which deepens the problem of drug abuse and makes it even harder to quit. The art of treatment is to recognize and put under control the “layers of the problem” that developed into autonomous psychiatric conditions over time and target the treatment specifically towards addiction (once the problem of addiction is solved, other aspects of patient’s psychological condition are resolved much easier).
A number of neurological conditions due to brain damage develops in abusers over time. Recognizing and putting those under control is also very important.
To put it in simple words- drug abuse treatment is like a walk through the minefield. To get on the other side of it you need a trained and experienced team behind, otherwise, it’s just a guessing game (with low chances for success).
What happens after the patient has been admitted to the program?
After admission, each patient gets introduced with the program (the first week, personalized treatment, methods, goals, and other relevant info). After introduction procedure, the patient signs a therapeutic contract. Also, the patient writes his or her personal history, with self-assessment- this document helps the team of specialists to design a treatment plan and later on, after the rehabilitation is over, will help the patient understand the extent of treatment intervention he went through.
Most often, on the day of admission, the patient is introduced to the community and attends all activities with others. In case of severe withdrawal symptoms, the patient may be under intense medical attention until his or her condition stabilizes. After stabilization, the patient is integrated into the community.
Long-term goals of rehabilitation
The goal is lifelong abstinence from drugs and rehabilitation of consciousness, personality, and behavior. The program helps the patient make lifestyle changes that will incur the risk of relapse- patients are encouraged to avoid places, activities, and people that are cues to drug use, to identify, understand and resolve inside conflicts that may be misinterpreted as cravings (or have lead to drug abuse earlier).
Drug addictiveness is a complex problem that affects not only one’s health, but his or her social relations, family, and all other aspects of everyday life. The Cuban program is optimized to cope with all of these aspects and prepare a patient for a new drug-free life.
Besides drugs, the Cuban program deals with other addictions as well
Drug abuse is just one of the problems when it comes to addictive behaviors and substance abuse. Alcohol, tobacco use, marijuana and opiates abuse are also problems the Cuban program successfully deals with. Of course, the approach is optimized for each of these programs.
Readers take away
The Cuban substance abuse treatment programs are developing since 1976. Professor Ricardo A. Gonzales, founding the father of substance abuse treatment on Cuba and internationally recognized expert is active even today as a consultant, but what’s even more important is his legacy to Cuba- a National Reference Center for Substance Abuse in Havana and 17 more facilities throughout Cuba that deal with the issue. Besides Cubans, these programs are available to international clients as well.
The rehabilitation process takes 3 months (sometimes more), and a rough price of the entire process with all expenses included is $26.000 (the price may differ at the point you read this article, for more info, contact the National Reference Center for Substance Abuse in Havana. During those three months, the patient is under constant attention of a team of experts.
The Cuban biotechnology industry is known worldwide. The human and veterinary vaccines, bio-products, drugs, diagnostic means and monoclonal antibodies created by brilliant scientists, in top-level facilities, place Cuba as one of the developing nations, together with India and Brazil, with more advances in this sector.
The Bio Cuba Pharma Business Group, one of the most economically powerful in the country, is responsible for leading the biotechnology and pharmaceutical industries. This organization has registered products and exports to more than 50 countries, has 1,800 patents abroad and its annual income exceeds 2,000 million dollars. Among the institutions attached to the huge Group, which employs more than 22,000 workers, are the Center for Genetic Engineering and Biotechnology (CIGB), the Center for the Production of Laboratory Animals (CENPALAB), the National Center for Biopreparations (BIOCEN), the Center of Immunoassay and the Center for Molecular Immunology (CIM).
What are the medications, made in Cuba, with the most international prestige? Pan American World proposes to approach five creations, unique in the world, born of the brilliance and long years of research by Cuban scientists.
HEBERPROT-P, THE BEST TREATMENT FOR DIABETIC FOOT ULCERS
According to the World Health Organization, some 300 million people suffer from diabetes, and of these, between 15% and 35% may suffer amputation of one of their extremities. The Cuban drug Heberprot-P, the only one of its kind in the world, has been able to reduce amputations by diabetic foot ulcer in Cuban patients more than four times. Born from the creative genius of a team of scientists, led by Dr. Jorge Berlanga, at the CIGB, the drug is used in more than 20 countries.The treatment includes injection into the affected area of the person and accelerates the healing process of the skin, so that the wound would be closed in a period of approximately three months.
The chances of survival for people diagnosed with lung cancer at an advanced stage are very low; However, with CimaVax-EGF a new hope has appeared. This vaccine was created by researchers from the CIM who took 25 years to develop the product. The treatment slows down the growth of cancer cells and, therefore, prevents the disease from spreading throughout the body and thereby prolongs people’s lives. The scientists clarify that it is not a preventive vaccine, but therapeutic, although it has also been used in those with higher risks of suffering from the disease.
The CIM also developed the VAXIRA vaccine (known as Racotumomab) that works on a molecule found in all cancer cells. Scientists hope that, in the future, the drug may be effective against leukemia and other tumors that accompany lung, colon, prostate and breast cancers.
CimaVax-EGF caught the attention of scientists from the Roswell Park Cancer Institute in New York who continue to evaluate the possibility of taking this medication to the United States, which would be a milestone, because the Washington Blockade has prevented access to Cuban inventions.
POLICOSANOL (PPG), A NATURAL PRODUCT TO LOWER CHOLESTEROL
This drug, made from the wax of sugar cane, is used mainly to lower cholesterol, although the product also has other applications, since its antiplatelet, anti-ischemic and antithrombotic effects have been demonstrated; In addition, some take the medication because they consider that it invigorates the male genital tract. The PPG, being natural, has few contraindications, unlike what happens with other drugs on the international market for cholesterol.
Venezuela is one of the biggest consumers of PPG and Cuba also markets it in Serbia, Slovakia and Spain, among other nations.
VA-MENGOC-BC, VERY EFFECTIVE VACCINE AGAINST MENINGOCOCCI B AND C
During the 80s of the last century, Cuba suffered an outbreak of meningococcal disease. The scientists worked intensely to find a solution and the Finlay Institute of Havana created VA-MENGOC-BC, a bivalent vaccine composed of meningococcal B outer membrane vesicles and meningococcal C capsular polysaccharide. It is currently the only commercially available drug in the world that attacks meningococci B and C.
In Cuba, more than 60 million doses of the vaccine have already been applied. The drug has proven to be very effective and with a high safety profile, as recognized by the World Health Organization.
NEUROEPO, A MEDICATION TO SLOW THE PROGRESSION OF ALZHEIMER’S
Population aging is one of the biggest problems facing Cuba. Currently, Alzheimer’s is the sixth cause of death in the country, among people over 60 years of age and, by 2040, this disease could affect 2.7% of Cubans. Today, more than 35 million people in the world have Alzheimer’s and there is no medication that is able to cure or stop its progression. In this context, the CIM scientists created a drug, called NeuroEpo, that delays the expansion of this disease.
“It would be the first time it is used on people and we have to wait for the results. This compound does not prevent Alzheimer’s disease, nor does it eliminate it, but the preclinical results are encouraging in that it could help to change the course of the disease, that is, slow down the deterioration that the patient inevitably suffers. Alzheimer’s is a neurodegenerative disease without regression, she will move forward. What we want is to help delay this degenerative process and improve the quality of life of that person, and of the family, “acknowledged CIM researcher Leslie Pérez Ruiz.
Cuban scientists are working on a clinical trial with Heberferon, which acts on renal carcinoma and in patients with malignant brain tumors.
Since you’re reading this article, the chances are, you are thinking about assisted living or nursing home care facility for the beloved elderly in the family. The decision is not easy- standards of care and prices across different facilities vary a lot. Also, no matter how cheap they claim to be, they’ll still put tremendous strain on your budget. Nevertheless, you would compromise on the price for the sake of higher quality of care. And finally, the decision comes with a sense of guilt. It’s normal, and it’s ok.
This article aims to give you a new idea, a different perspective, and solution that will put you at ease, so keep reading! The future is brighter than it might seem at the moment.
Today, about 2.5 million people in the US use services of assisted living and nursing homes. According to the statistic, the number of users by 2050 is going to triple. Longer life expectancy, growing population, improvements in healthcare quality, and availability did its thing- the population of elderly grows at a staggering rate. They need a kind of care that overgrows the capabilities of the family home surrounding. Some are dealing with physical disabilities that require expensive home modifications to maintain normal daily functioning. Others suffer conditions that require the use of specialized medical equipment and procedures. This is where assisted living and nursing homes come into play.
Assisted Living VS. Nursing Home Care- the Cuban way
Just like its name says- residents in assisted living need a helping hand in everyday activities. Someone to take care of their diet, personal hygiene, or maybe help them get into and out of a vehicle.
On the other hand, Nursing Home Care is for people whose health is severely impaired so they cannot take care of themselves or function normally without specialized healthcare.
The World Health Organization defines health as not only the absence of disease but a state of physical, social, and mental well-being. That is precisely what we do on Cuba- help our users to achieve an as healthy lifestyle as possible, giving the limitations of their health impairment.
The Cuban program offers these two major categories of care. However, there are many shades in between. Since no two humans are alike, flexible, and individually tailored integrative approach is what we offer. After the Initial Needs Assessment that includes consultations with doctors of various medical specialties and comprehensive medical examination, we make the program that fits the user’s needs the best way.
You can find more info about the whole procedure of admission at the end of this article.
Additional healthcare costs
Our assisted living and nursing home care facility provides medical services to a certain extent. If needed, our staff coordinates the appointment of the users to a closest hospital or outpatient clinic. The expenses of the hospital stay and medical treatments carried out there are not included in the price of our program. However, with the medical support we provide at the facility, such situations are rare and prices of medical treatments on Cuba is at least half the price compared to the US.
How much assisted living and nursing homes cost across the US – Why Cuba?
According to the American Seniors Housing Association, the median price for a one-bedroom apartment in the assisted living in 2017 was $48,000 annually, with a projection of 3% price increase over a five-year period. Depending on the part of the US, annual expenses of assisted living can go up to $72,000 (NY).
Nursing homes are even more expensive throughout the US – median monthly price for a private room is $8,121 with a projection of 13% price increase over a five-year period. Depending on the part of the US, monthly expenses of nursing home care can go up to $12,927 (NY).
The good news is – treatment costs and our program prices are just a fraction of the price throughout North America
Cuba has been internationally renowned for its high-quality medical care at affordable prices. According to the Association of Caribbean States, the number of people from North America seeking for medical help in Cuba skyrockets every year- from 3,500 foreign patients in 2001 to 20,000 in 2005. The trend of medical tourism in Cuba kept growing up to this day. The list of available interventions is quite long- from minor fixes such as dentistry to major surgical procedures such as hip replacement.
Generally speaking, the bigger the intervention, the higher the price discrepancy between Cuba and the US is. The prices are at least 50-80% lower than those in the US; for some procedures, patients pay 3-5 times less than in the US.
Can you rely on the Cuban healthcare system?
Numbers show that Cuba matches first-world health statistics. The primary healthcare in Cuba operates through more than 450 outpatient clinics, which makes it one of the most proactive healthcare systems in the world.
Back in 1985, Cuba pioneered the vaccine against meningitis B. Since then, the country’s scientists developed medical treatments of unmatched efficacy in the world of medicine. Hepatitis B, diabetic foot, psoriasis, vitiligo, and lung cancer are just some of the conditions whose prognosis and treatment outcomes improved thanks to Cuba.
In 2015 WHO recognized that Cuba is the first country in the world to eliminate HIV and syphilis transmission from mother to child.
Airplane tickets to Cuba – it’s easier to get here than you might think
Arriving in Cuba is not expensive- depending on where you’re located in North America the ticket price ranges from $200 to $450, and the flight time ranges from 1h30min (from Miami) to about 4h (from Toronto).
Our assisted living and nursing care home can organize pick off and drop out to the airport. We take care of our users and their families from the moment they touch the soil of Cuba until they leave (transportation, correspondence with authorities, and all other necessary logistic support).
We look forward to hearing from you soon!
If you have any questions or you need additional info about the program, feel free to reach out to us (link to contact form and links to the programs)
Medical Tourism In Cuba Is Becoming Increasingly Popular
Why are so many US and other nations becoming so interested in Cuba’s medical tourism? Well Cuba has well trained doctors and nurses and excellent health facilities and that these facilities are funded by their government. This type of funding is vital to the medical facilities to ensure excellent care to their patients.
Cuba’s medical facilities are well equipped for all kinds of medical treatments and their doctors and medical staff charge a fraction of the cost than a regular medical facility. This is another huge factor why medical tourism is becoming more popular in this island.
Another reason why Cuba’s Medical tourism is rising. Cuba’s doctors are well versed in all types of medical conditions that can arise which makes it even more desirable to come to Cuba for medical care. The only issue for US citizens is that the US has more rules that its citizens have to follow. For instance they can go and visit Cuba but they have to follow rules that the government provides. US citizens also may be audited as to their visit in Cuba so they have to keep a strict record of why they were there.
Other countries like Canada for instance don’t have this restriction like US citizens do, so they can go and receive medical treatment. Tourism in Cuba is becoming more popular among other countries because of their affordable medical care and if needed surgical care.
There are medical professionals in the US that are hoping that these regulations will be waived so that their patients can receive excellent care and treatment. So far the negotiations towards that are looking to become more favorable which will help Cuba be able to fund more of their doctors salaries to further help cuba’s health tourism.
There is a website that can help with the pricing of cuba’s medical tourism. Cuba offer all kinds of packages so that choosing the right one that fits within your budget is attainable and desirable. health tourism in Cuba helps with them being able to give their doctors and staff a more stable income and that in turns helps Cuba out immensely.
Cuba’s medical tourism is a great asset to those that are needing specific healthcare. Cuba’s doctors have a more hands on approach to help their patients achieve their long term goals, which is great let’s say for an addict to overcome their addictions. The medical tourism in the republic of Cuba is gaining more notoriety and popularity among other countries.
Is medical tourism a good thing for Cuba? The answer is yes. The more popular it is becoming the more of an asset medical tourism is to Cuba. The more money that Cuba gains for their doctors, nurses and medical centers the more funding they can get for their patients as well. Medical tourism is really good for Cuba. It will help achieve more revenue and prove that their medical care is exceptionally great for everyone.
Current Challenges in the Treatment of Retinitis Pigmentosa
CubaHeal Research Department
Retinitis pigmentosa (RP) represents a rare and severely debilitating group of disorders affecting vision that have a genetic background and are slowly progressive by nature (1). Despite the continuing efforts of the scientific community directed towards the understanding and treatment of the disease, RP still remains incurable. Management of RP was investigated in various preclinical models, as well as in numerous clinical trials on humans in the United States, however, the effective and safe solution to this problem was not yet found.
Retinitis pigmentosa causes a progressive and irreversible vision damage caused by deterioration of photosensitive cells (especially rods) in the retina (2). Early symptoms usually represent the loss of the peripheral visual field, followed by further vision narrowing, which may eventually result in complete blindness. Treatment options in the United States are currently quite limited. The management of RP mostly includes vitamin supplementation, aiming to hold off the progression of the degenerative process. However, even vitamin supplementation, besides its’ limited effectiveness, has its safety concerns. Vitamin A supplementation is not recommended in certain individuals since it may cause fertility issues and severe osteoporosis (3). Preventative measures, such as avoiding light exposure in the early phases of the disease did not prove to be highly effective.
When reviewing the current treatment options, it seems that RP still represents a challenging task. In order to improve the quality of life of patients suffering from this degenerative and progressive disorder, Cuban experts have developed a sophisticated and effective method for the management of RP.
Solution Offered by Cuban Experts
The main treatment objective is to limit the disease progression by improving the vascularization of the retina. The management of RP in Cuba practiced now, that is focused on eye vascularization, has been developed and improved for more than two decades. The milestone of therapy is to bring as much blood, oxygen, and nutrients as possible to the eye. This is being performed by encouraging the development of blood vessels. There have been some attempts in Russia to transplant the stem cells that would develop into the healthy retinal tissue, however, scientists were mostly frustrated by failure since the stem cells could not successfully engraft due to the lack of the healthy vascular supply (4). Cells remodeling was also attempted; however, this study was suspended due to the lack of efficacy. Cuba offers a sustainable treatment option that focuses on limiting or completely inhibiting the progression of degenerative vascular changes in the retina. There are several treatment approaches that are being applied to the overall management plan. They include eye surgery, ozone therapy, electrostimulation and drugs (5).
A very sophisticated and unique surgical technique is used to increase the blood flow within the part of the eye responsible for providing blood supply to the retina. When this technique is performed, retina remains adequately nourished and oxygenated. This allows normal retinal function and prevents further deterioration of vision. By stimulating the blood flow within the retina, visual acuity increases, and retina is encouraged to grow, and not deteriorate. The final result is stabilization of the disease and rapid improvement in both central and peripheral vision (6). Ophthalmologists from all over the world refer their patients to Cuba, for this surgery to be performed due to its’ efficacy and safety.
It has been recognized that ozone improves cell metabolism, boosts the cell energy levels and exhibits antioxidant properties (7). The ozone is either administered rectally or being injected into the bloodstream. Ozone provides detoxification effects by blocking the harmful lipid peroxidation that occurs in retinal cells affected with retinitis pigmentosa. The ozonotherapy also promotes the blood flow surrounding retina, thereby directly improving the retinal function. In order to ensure the best possible results, the patient should receive 14 cycles of treatment during the course of the whole therapy.
Electrical stimulation produces a micro-massage effect that stimulates micro-circulation and lymphatic drainage. These effects promote electro-ionic balance and provide an additive effect to the ozonotherapy (8). This method has demonstrated a high efficacy. Another benefit of this treatment modality includes reinforcing the process of the perception of visual stimuli within the brain. The electro-stimulation includes the application of pleasant therapeutic electrical currents on the head, neck, soles of the feet, and palms of the hands. For the complete and best possible effect, 10-15 treatment sessions are needed to be performed. During the full treatment course, drugs including immune-modulators, oxide-reductive substances, minerals, and vitamins are administered to boost the treatment effects.
Cuban scientists investigated the effects of ozone treatment on the visual field in participants that had retinitis pigmentosa. This was a controlled, randomized and double-blind study, with the study design that ensures a high level of evidence. 68 participants were enrolled in the trial. Half of the subjects received ozone treatment, while the other half received placebo. The study demonstrated that three times more subjects in the ozone group experienced a significant improvement in the visual field, compared to those who received placebo. Subjects with early stages of the disease experienced greater improvement with more long-lasting effects, which underlines the importance of early intervention. Subjects at early phases of the disease also experienced more stable and sustainable treatment effects. In conclusion, this study showed that ozone treatment had beneficial effects on patients with RP.
Another double-blind, placebo-controlled study also evaluated the effects of ozone treatment in patients with retinitis pigmentosa. This study had an even greater number of participants (168). This study also demonstrated the significant improvement in patients treated with ozone therapy compared to patients that received placebo. Interestingly, approximately a half of the patients that had treatment response also succeeded to maintain the response for the longer period of time (9).
A study that investigated the redox-balance in patients with RP receiving ozone treatment concluded that ozone therapy represents a safe therapeutic modality since no side effects related to treatment were observed during the course of the trial. Therefore, ozone therapy can be safely administered to patients with RP without any risk of side effects (10).
Treatment of RP still represents a challenging task in the western countries. Vitamin supplements and avoiding excessive light are just not sufficient enough to provide any benefit to patients suffering from this severely debilitating illness. Various treatment approaches including stem cells transplantation and remodeling of the retinal cells have failed to demonstrate effectiveness. Stem cells failed to engraft, and retinal cell remodeling was not possible both because of the vascularization impairment that occurs in this serious illness. Cuban researchers and medical experts decided to target exactly this disease characteristic by improving the blood flow in the eye, which allows retina to properly function. Improvement of eye circulation ensures the adequate oxygenation of retinal tissue and postpones or completely stops the degenerative processes within the retina. Clinical trials and plenty of satisfied patients worldwide guarantee treatment success. Thousands of international patients referred to Cuba for the treatment of RP have experienced benefits following treatment. Clinics in Cuba still represent the only hope for people suffering from this genetic disorder. Cuban experts have found a solution to postpone or completely stop the development of the negative effects on the quality of life of patients suffering from RP.
Baumgartner, W. (2000). Etiology, pathogenesis, and experimental treatment of retinitis pigmentosa. Medical Hypotheses, 54(5), 814-824. Medline Plus Encyclopedia. Retrieved on July 1st, 2018, from http://www.nlm.nih.gov/medlineplus/ency/article/001029.htm Jayashree N Sahni et al. (2011). Therapeutic Challenges to Retinitis Pigmentosa: From Neuroprotection to Gene Therapy. Curr Genomics. 12(4): 276–284. Health Services International (Servimed) Inc. Retrieved on July 1st 2018, from http://www.healthservicecuba.com/retinitis-pigmentosa/ Centro Internacional de Retinosis Pigmentaria Camilio Cienfuegos de Cuba. Tratamiento cubano para la Retinosis Pigmentaria. Retrieved on July 1st, 2018, from http://www.infomed.sld.cu/instituciones/retinosis/quienesomos/quienesomos.html Garcia Layana, A. (2003). La cirugía de la retinosis pigmentaria en Cuba. Communication presented at Archivos de la Sociedad Española de Oftalmología, Madrid. Copello, M., Eguía, F., Menéndez, S., & Menéndez, N. (2003). Ozone Therapy in Patients with Retinitis Pigmentosa. Ozone: Science & Engineering, 25(3), 223-232. Berson, E., Remulla, J., Rosner, B., Sandberg, M., & Weigel-DiFranco, C. (1996). Evaluation of patients with retinitis pigmentosa receiving electric stimulation, ozonated blood, and ocular surgery in Cuba. Arch Ophthalmol, 114(5), 560-563. Pérez, L. J. (2004). Ozone therapy in retinitis pigmentosa. Communication presented at 4th International Symposia on Ozone Applications, Cuba. Menéndez, S., Hernández, F., & Copello, M. (2004). Ozone therapy and redox balance in patients with Retinitis Pigmentosa. Communication presented at 4th International Symposia on Ozone Applications.
During the decades of very rigorous sanctions brought by the United States, Cuba has managed to develop one of the biggest machineries for drug research and development. Due to the embargo, Cuba was practically forced to invest a substantial amount of funds into the medical research, in order to address the issue of the overall health of the population. Today, Cuba possesses a strong and sophisticated system for the production of state-of-art medicinal products. A large biotech and pharmaceutical group called BioCubaFarma gathers over 30 enterprises that are focused on investigating, developing and producing high-quality medicinal products intended for supplying domestic and international markets. Cuba currently markets the products 49 countries worldwide. A very resilient approach of Cuban experts in the field of drug research and development provides impressive results and continues to surprise the international scientific community with innovations and ideas.
Vaccination represents one of the public health medical interventions that has shown tremendous benefits in prevention, eradication and significant reduction of incidence of severe and debilitating infectious diseases worldwide. Due to the significance of vaccination for the public health, several leading organizations in the field of vaccination including the World Health Organization (WHO), Global Alliance for Vaccines and Immunization (GAVI) and the United Nations Children’s Fund (UNICEF) developed strategies to increase the immunization rate worldwide and disseminate the new technologies in the field of vaccination globally. All three organizations advocated for the research and development of polyvalent vaccines covering multiple diseases in order to make the process of vaccination more simplified and to cover more pathogens with only a single vaccine administration. In order to respond to the recommendations given by the leading organizations in the field of immunization, Cuba started with the challenging research and development program of vaccines.
Trivac HB is a polyvalent (combined) vaccine containing diphtheria anatoxin, tetanus anatoxin, B. pertussis whole cells and hepatitis B surface antigen. It provides protection against all the above-mentioned pathogens and represents the second ever produced tetravalent vaccine worldwide. Several years of sophisticated research regarding vaccine formulation, potency, safety and tolerability resulted in the successful registration of this medicinal product in 2004. Since then, Trivac HB has been successfully administered in children for the purposes of prevention of the aforementioned infections. This vaccine represents a state-of-art medicinal product due to several reasons. The tetravalent formulation allows the protection against the multiple pathogens, decreasing the need for multiple vaccinations resulting in the better acceptance of the immunization program both by the families and the sanitary personnel.
A careful process of selection of each component’s formulation resulted in inadequate protection in 97% of tested children, which is an impressive result. Safety of the vaccine was vigilantly monitored during the clinical trial process in each child. Less than half of the children experienced an adverse effect following administration of the vaccine. All reactions were mild in nature, with reversible fever being one of the most frequently reported systemic side effects. The vaccine was very well tolerated in children and the overall safety profile of the vaccine was assessed as non-toxic. Administration of the vaccine resulted in the production of high concentrations of antibodies against each pathogen conferring the high protection to the immunized children.
Haemophilus influenzae type b represented one of the main causes of severe bacterial meningitis in plenty of the countries worldwide until the introduction of a vaccine against this pathogen. The vaccine production includes the expensive process of extracting the capsular antigen prior to conjugation. Cuba has made an effort to develop a less costly method of vaccine production that would keep the vaccine potency. Cuban experts proposed the model of production of a synthetic bacterial antigen that would exhibit the same efficacy and would have an acceptable safety profile.
The safety, tolerability and preliminary efficacy of Quimi-Hib were investigated in two major Phase I clinical trials that were double-blinded and randomized in order to produce the highest level of evidence for obtained results. Populations investigated were adults and children (4-5 years old). Studies were conducted on healthy volunteers. The primary endpoints were safety and tolerability of the vaccine. The occurrence of local and systemic adverse events was monitored following the administration of the vaccine during 72h post-administration. The safety profile of the vaccine included the anticipated risks that were mild to moderate in nature and completely reversible. Vaccine efficacy was monitored using the contemporary methods of immunology for the screening of vaccine immunogenicity. The results obtained demonstrated high immunogenicity of the vaccine, meaning that the efficacy of the Quimi-Hib was comparable and equivalent to the traditional vaccine. With this vaccine, Cuba has successfully resolved the issue of high complexity and costs that was the main issue of the traditional vaccine. Quimi-Hib represents the innovative approach to vaccine development. Excellent results resulted in the registration of the vaccine in Cuba. This particular vaccine is now the part of the countries’ National Immunization Program.
The incidence of tick-born diseases is increasing worldwide in both humans and domestic animals. It has been estimated that approximately half of all ticks are Boophilus species. Therefore, an effective prevention of tick-borne diseases should target the control of infestation by this specific species. Cuba has developed an efficient method for the protection against tock-borne diseases, which directly resulted in significant reduction of tick-related infestations. This vaccine offers the cost-effective method for the prevention of tick-born diseases that is benevolent for the environment. The development of the so called Bm86 gut antigen, which is the active ingredient of the Gavac vaccine, has brought the feasible solution to control the tick infestations. The investment of knowledge, expertise, and funds to develop such a sophisticated method of prevention in Cuba will also contribute to further research and development of other molecular technologies towards the discovery of new methods for inhibition of tick infestation.
Heberbiovac HB represents a vaccine developed for the prevention of hepatitis B infection. This vaccine demonstrates also a therapeutic potential and can be used as an adjunctive treatment for patients suffering from hepatitis B infection. This vaccine was developed in Cuba according to the recommendations tailored by the World Health Organization. The vaccine contains hepatitis B surface antigen, an active ingredient responsible for effective prevention of the hepatitis B infection. This vaccine has also shown efficacy in the treatment of both acute and chronic forms of the disease, as well as in the management of hepatocellular carcinoma. Interestingly, when receiving the vaccine, 95% of newborns of infected mothers are protected during life.
Heberviron was developed in Cuba for the treatment of hepatitis C infection. Not only that it has a significant cure rate, but it also exhibits a very good protection against the recurrence of the infection. The treatment duration when using Heberviron lasts for 7 days. This is quite important since the shortened treatment duration reduce the risk of serious side effects that may occur with the use of this drug. The combination of interferon and antiviral drug ribavirin as the active ingredients of Heberviron allow the better treatment outcomes and increase the success rate of treatment against the hepatitis C infection. Heberviron represents the state-of-art product of Cuban drug research and development.
Heberon Alfa R
Cuba has an advanced biotechnology industry. The development of interferon alfa-2b designed for intramuscular, intralesional, intravenous or subcutaneous injection confirms this statement. Heberon Alfa R structure is adapted so that the drug can be used in different modes of administration as stated above. Heberon Alfa R contains anti-tumor and anti-virus properties. It is intended for use in patients suffering from serious diseases such as chronic hepatitis B and C, HIV-induced Kaposi’s Sarcoma, malignant melanoma and many other neoplastic disorders. This drug is also approved for the use in children, where administration of Heberon Alfa R was proven safe and effective in children and adolescents.
Heberkinasa was created using the recombinant technology in order toprovoke a rapid and more effective thrombus degradation. Heberkinasacauses thrombus dissolution and recanalization of the affected vessel. The drug also prevents the tissue affected by ischemia to undergo necrosis. It has been demonstrated in clinical trials that recombinant streptokinase restores the ventricular function of the heart following myocardial infarction. The drug decreases the risk of pulmonary embolism and facilitates the elimination of embolus. The formulation of this drug does not contain immunogenic albumins, which directly reduces the risk of hypersensitivity and immune-mediated reactions, improving the drug’s safety profile.
Cuba produces the so-called highly active antiretroviral therapy (HAART). This treatment is intended for those infected with the HIV virus and other less common retroviruses. The formulation of the drug is specifically designed to reduce the side effects of conventional HAART drugs. This formulation reduces the abnormalities in blood cells and reduces the trend of hemoglobin depletion during treatment, which improves the overall tolerability profile of the drugs. Cuban antiretrovirals also have need shown to increase the number of virus-free CD4 lymphocytes. Decreased mortality and mortality from HIV infection has been also demonstrated in clinical trials.
Hebertrans is a highly sophisticated product containing the extract of leucocytes derived from human leucocytes that are used as the modulator of the defective immune response. The main characteristic of this medicinal product is that Hebertrans produces no side effects. It may be used in patients with defect immune system such as those receiving cytotoxic cancer treatment, those with immune deficiency (both acquired or congenital) or patients with autoimmune and allergic conditions. Hebertrans leads to the effective stabilization and normalization of the immune response.
Heberitro is a recombinant human erythropoietin. It stimulates the natural production and maturation of red blood cells, increasing the mass of red blood cells within the bloodstream. It is effective in various types of anemia caused by iron depletion. Its’ effectivity has been especially demonstrated in patients suffering from chronic kidney failure, those on HAART anti-HIV therapy, as well as in patients undergoing radiotherapy.
The sophisticated technology in Cuba allowed the development of so-called granulocyte colony stimulating factor (GCSF). Hebervital directly increases the production and maturation of granulocytes, especially neutrophils. Neutropenia is a serious risk in a patient receiving chemotherapy and may lead to the development of severe infections, even sepsis. GCSF successfully increases the number of granulocytes necessary for the effective immune response against infections. Hebervital directly decreases the risk profile of chemotherapy by mitigating the risk of severe neutropenia or bone marrow failure.
LeucoCIM is a granulocyte colony-stimulating factor (G-CSF) used for the treatment of neutropenic patients. Drug use has been proven beneficial in patients having myelosuppression following cytotoxic treatment, patients with myeloid leukemia and those with neutropenia caused by HIV/AIDS. The drug also prevents the development of bone marrow suppression in patients undergoing bone marrow transplantation.
Gilda Torano et al. Phase I Clinical Evaluation of a Synthetic Oligosaccharide-Protein Conjugate Vaccine against Haemophilus influenzae Type b in Human Adult Volunteers. Clinical Vaccine and Immunology. September 2006 vol. 13 no. 9 1052-1056.
Dania Bacardí et al. Preclinical safety testing of the Quimi-Hib® vaccine adjuvanted with aluminum phosphate during product development. Biotecnología Aplicada 2013;30:118-124.
Néstor S. Expósito, Daniel Cardoso, Eduardo Martínez, Yanelis Herrera, Karelia Cosme, Pablo A. Díaz4, Yayrí C. Prieto, Zoe Núñez, Mabel Izquierdo, Orestes Mayo, Joel Pérez, Luis C Hidalgo. TrivacHB: A Cuban Polyvalent Vaccine. Biotecnología Aplicada 2006; Vol.23, No.2.
Jose de la Fuente et al. A ten-year review of commercial vaccine performance for control of tick infestations on cattle. Animal Health Research 2007. 8(1):23-8.
Castañeda Guillot C, et al. Long term study of the treatment with recombinant alfa 2b interferon in chronic active hepatitis due to B virus in children and adolescents. G E N. 1994 Oct-Dec;48(4):219-25.
CECMED. Resumen De Las Características Del Producto. Estreptoquinasa recombinante. Last revision: 27 Dec 2013.
It has been estimated according to the data published by the World Health Organization that 1 in 160 children worldwide suffers from autism. The exact number is quite challenging to estimate for various reasons. It is presumed that Cuba has a lower rate of children with autism spectrum disorder when compared with the United States. Yet, Cuba has taken autism quite seriously and constantly develops and improves strategies aimed to increase the quality of life of children with this serious medical disorder and their families. The country has established specialized centers focused both on the treatment of children and inclusion of the families in the society, which is of course absolutely costs free. In 2013, Cuba was the country to host the First International Forum on Autism and Inclusion. This conference gathered the globally recognized experts in the field of autism spectrum disorder (ASD). The focus of the conference was to establish methods and discuss the significance of an early diagnosis of ASD and effective inclusion of such families in the society. The conference alone mirrors the country’s efforts to seek for the best possible ways to make the lives better for children with ASD and their families.
It has been estimated according to the data published by the World Health Organization that 1 in 160 children worldwide suffers from autism. The exact number is quite challenging to estimate for various reasons. It is presumed that Cuba has a lower rate of children with autism spectrum disorder when compared with the United States. Yet, Cuba has taken autism quite seriously and constantly develops and improves strategies aimed to increase the quality of life of children with this serious medical disorder and their families. The country has established specialized centers focused both on the treatment of children and inclusion of the families in the society, which is of course absolutely costs free.
In 2013, Cuba was the country to host the First International Forum on Autism and Inclusion. This conference gathered the globally recognized experts in the field of autism spectrum disorder (ASD). The focus of the conference was to establish methods and discuss the significance of an early diagnosis of ASD and effective inclusion of such families in the society. The conference alone mirrors the country’s efforts to seek for the best possible ways to make the lives better for children with ASD and their families.
Treatment of Autism in Cuba
The program aimed to increase the quality of life of persons living with ASD is coordinated by the Cuban Ministry of Public Health and Ministry of Education. Other public sectors including culture, media, and sports institutions are also involved in the program for helping ASD individuals to reach the best of their abilities. The program consists of individualized, multi-disciplinary training aimed at developing and empowering skills. The ASD individuals also receive specialized education and advocacy support. The individualized treatment is tailored by the specialized Diagnostic Commission when the type and severity of the disease are taken into consideration. Treatment is focused on early intervention.
The treatment for ASD is conducted in the peaceful and comfortable environment in order to ensure the best possible effects of the treatment plan and to allow the improvement the patient’s mental and physical abilities. The objective of each individualized treatment plan is to ameliorate the symptoms of the disease and improve the child’s learning capacity. As already mentioned, the treatment is tailored according to the individual needs of each child.
Each medical facility that deals will the treatment of autism is equipped with rooms that resemble those in a hotel (cable TV, phone, dry cleaning services). The facility contains sauna, pool, gym, internet access, shops, and pharmacies.
Treatment Stage 1: Assessment
The first stage of treatment consists of detailed assessments and evaluations that include laboratory and imaging analyses, and consultations with different specialists. The child is examined and evaluated by a pediatrician, neurologist, psychologist, speech therapist, and psychiatrist. The laboratory panel consists of hemogram, serology testing, serum glucose, sedimentation, urine analyses, creatinine and liver functions tests. Additionally, specific testing consists of magnetic resonance brain imaging, evoked potentials, and electroencephalography. Each patient undergoes logopedic assessment, neuropsychological evaluation, Brunet-Lezine scale evaluation as well as psychotherapeutic treatment assessment. Within the first stage, parents are also introduced to the team of experts and the treatment plan is referred to the parents once completed. The phase duration is approximately one week, depending on the patient’s characteristics.
Treatment Stage 2: Therapy and Rehabilitation
The duration of actual treatment is approximately 30 days, but this may vary depending on the patient’s characteristics. The tools that are used in the treatment of autism include equine therapy, occupational treatment, language therapy, sensorial stimulation, ozone treatment and trans-cranial electric stimulation if needed (in hyperkinetic patients). Language treatment is carried out each day. In the beginning, the language rehabilitation sessions last one hour during the day, but this is extended later to two sessions each day.
Language rehabilitation usually lasts 20 days. During this treatment, the child is being constables evaluated by the experts and the progress is being monitored. Based on the effects of treatment, the language rehabilitation process is further re-tailored based on the response of each child. Therefore, each treatment protocol is being adjusted by the characteristics of each child. Language rehabilitation is broad and intensive. During each treatment, specialist conducts sensorial stimulation techniques such as facial massage. Specialized teams also work with family members or companions in order to ensure the best possible communication results. Family members or companions are taught to conduct language exercises and sensorial stimulation as continuing the language training after the child leaves the facility is essential for obtaining good treatment results.
Occupational treatment is also a very important feature of the overall rehabilitation program. This treatment aims to help the patients overcome the obstacles of physical and mental barriers present within the ASD, which restrict the everyday activities such as self-care, productivity, and participation in leisure activities. The treatment is conducted each day in two sessions. Specialists work with object identification, images projection and touching through interactive and didactic games.
As a part of occupational treatment, the children are engaged in outdoor activities. Engaging and stimulative games and exercises are being tailored for each child in order to learn about the surroundings. This treatment is also tailored based on the child’s preferences. Children are stimulated with colors, various physical activities including swimming in the pool, soccer, horseback riding etc. The specialists carefully monitor the children and adjust the program based on the child’s response to each stimulation. The length and duration of occupational therapy are also assessed based on the child’s characteristics and the progress being made with this treatment approach. This treatment has a goal to improve the patient’s productivity, physical performance, and sensorial activity.
Final Report and Recommendations
Once the treatment is considered completed, the experts will tailor the final report consisted of the diagnosis, severity, and prognosis of the ASD. Based on the vigilant monitoring of the child during each stage of treatment, the experts will issue the comprehensive recommendations for each child regarding further treatments and ASD management approaches.
Cuba is investing a lot of effort in advancing the management of children suffering from ASD. Prestigious medical centers in Cuba have programs based on the extensive international experience in autism management. Treatment protocols for ASD are in line with the globally accepted international medical standards. Cuba invests in the training of staff that deals with kids suffering from ASD. There is still a lot to be learned about ASD in order to provide the best possible treatments for ASD patient and their families. Cuba has proven to take this issue seriously and professionally.
Life expectancy of Cuban population has increased significantly over the past decade. In 2014, an average life expectancy was shown to be 78.5 years (1). It is predicted that approximately a third of the entire population in Cuba is going to reach the age of 60 by the year 2030 (2). The increased life expectancy, increase in the prevalence of elderly population combined with an unhealthy lifestyle represents a significant risk of increased cancer burden for the people living in Cuba. In 2012, cancer became a leading cause of death in Cuba, counting for approximately a quarter of all fatal outcomes (3). Due to these data, Cuba has developed strong mechanisms of cancer prevention, management, and research that are comparable to those in the developed countries. A comprehensive and systematic approach to cancer prevention, early diagnosis, treatment and palliative care has shown results including increased survival and better quality of life in patients suffering from cancer (4).
The strategy of fighting cancer in Cuba has been established a decade ago. The main objectives include education and communication of cancer risk factors to the general population, early detection of cancer in the primary healthcare setting, treatment and supportive care in highly specialized institutions, as well as research and development of innovative therapeutic modalities against various types of cancer (5). A very developed network of primary healthcare institutions enables the physicians to discover cancer in the early stages. These patients are then referred to specialized institutions where an adequate diagnostics and staging are being made, followed by cancer management techniques. Following the implementation of the abovementioned strategy, cancer survival rates in Cuba have shown increasing trends, which are comparable to those in developed countries.
Due to an increased prevalence of cancer, Cuba has invested a significant amount of funds to cancer treatment and research in order to achieve the highest standards in cancer management. Some of the fascinating achievements of Cuban approach to cancer will be reviewed in this article.
NATIONAL INSTITUTE OF ONCOLOGY AND RADIOBIOLOGY (INOR)
INOR serves as an international medical center that provides advanced and highly sophisticated medical care for cancer patients from all over the globe. Highest standards in the management of cancer are implemented at this institution with the goal to cure, improve and increase the quality of life of each patient that seeks medical attention. Advanced treatment modalities, holistic approach to each patient, integrative rehabilitation techniques combined with the use of natural healing methods are just some of the services aimed to increase patient welfare at this institution. INOR conducts scientific and educational activities related to the nature and biology of cancer. Various clinical trials are being conducted at this facility in order to investigate and evaluate novel and promising cancer treatment regimens (6). Patients from more than 50 counties worldwide including Europe, USA and Canada have been treated at this institution with exceptional quality of care.
SUCCESSFUL MANAGEMENT OF LEUKEMIA
In Cuba, the overall survival of kids suffering from acute lymphoblastic leukemia following standard therapeutic protocols is approximately 85% in standard risk patients (7). The improvement after the application of last generation cytotoxic treatments is seen in approximately 98% of children. Bone marrow transplants are performed with high success rates. Additionally, Cuba performed transplantation of cord blood hematopoietic stem cells in order to treat various forms of leukemia. All of the treatments are totally free of charge for all Cubans.
NON-MELANOMA SKIN CANCER
Skin cancer is among the most frequent cancers in Cuba (8). The challenges in the treatment of nonmelanoma skin cancers include non-resectable, aggressive and recidivant forms, which are difficult to treat and often lack in proper and effective therapeutic modalities. The successful management of nonmelanoma skin cancer in Cuba is reflected in the application of the novel combination of two interferons. More than 400 patients have been treated with this combination with high rates of success, reaching clinical remission in approximately 65% of cases (8).
Oral cancer was among the most frequent forms of cancers in Cuba. The development of preventative actions including regular oral examination of individuals at least once a year led to significant decrease in the incidence of advanced oral cancer. The vigilant approach to early detection of oral cancer resulted in significantly higher detection rates of low-grade oral cancers that are more sensitive to treatment and have much better prognosis (9).
Early detection of cancer remains the focus in the fight against malignancy in Cuba. Highly developed primary health care system represents a pillar stone of Cuban medical care. The early detection of malignancy on a primary health care level directly resulted in significantly better therapeutic outcomes in patients suffering from various types of cancer. The increasing aging of Cuban population increased the risks of developing malignancies. Therefore, Cuba has developed tertiary centersfor cancer diagnostics, staging, treatment and research. These centers are operating with the highest international standards in cancer management and offer innovative approaches in cancer treatment that are completely free of charge for any Cuban, rating the success of cancer management in Cuba to be among those in highly developed countries.
1. Oficina Nacional de Estadistica. Anuario demográfico 2014. http://www.one.cu/anuariodemografico2014.htm. [Online] 2. National Statistics Bureau (CU). El envejecimiento de la población cubana. http://www.one.cu/publicaciones/cepde/envejecimiento/ envejecimiento2008.pdf. [Online] 3. Dirección Nacional de Registros Médicos y Estadísticas de Salud. Anuario Estadístico de Salud de Cuba. http://files.sld.cu/dne/files/2015/04/anuario-estadistico-de-salud-2014. [Online] 2018. 4. WHO. Cuba – Battling cancer with biotechnology. http://www.who.int/features/2013/cuba_biotechnology/en/. [Online] 2018. 5. Teresa Romero Pérez, Yaima Galán Alvarez and Rolando Camacho Rodríguez. THE BURDEN OF CANCER IN CUBA AND CURRENT STRATEGIES FOR CANCER CONTROL. http://www.cancercontrol.info/cc2016/the-burden-of-cancer-in-cuba-and-current-strategies-for-cancer-control/. [Online] 2018. 6. INOR. National Institute of Oncology and Radiobiology. http://instituciones.sld.cu/inor/. [Online] 2018. 7. Results of the treatment of child Acute Lymphoid Leukemia in Cuba. Alejandro, González-Otero et al. s.l. : Revista Cubana de Hematologia, Inmunologia y Hemoterapia, 2014, Vol. 30(1). 36-46. 8. HeberFERON, formulation based on IFNs alpha2b and gamma for the treatment of non-melanoma skin cancer. Lorenzo, Anasagasti-Angulo et al. 10(6), s.l. : Australasian Medical Journal, 2017. 9. Research on cancer prevention, detection and management in low- and medium-income countries. R. Sankaranarayanan, P. Boffetta. 10, s.l. : Annals of Oncology, 2010, Vol. 21. 1935–1943.
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