Neuro-oncology in the Philippines: a scoping review on the state of medical practice, deterrents to care and therapeutic gaps

Abstract

Background: Neoplasms of the brain and spine are relatively uncommon compared to breast, lung and gastrointestinal tumours, which occur at higher rates in the Asian population. Updated guidelines in diagnosis and treatment of neuro-oncologic diseases recommend advanced molecular-based precision-medicine; thus the need for increasingly individualised regimens. It is, therefore, necessary to determine whether there are areas of improvement in the provision of care to these patients, especially in low-to middleincome economies like the Philippines. Methods:In this study, we identified gaps in the delivery of medical care to Filipino patients with tumours of the central nervous system. We performed a scoping review on the available literature on clinical experience with treatment of neuro-oncologic cases from the Philippines and performed qualitative analysis viewed through the lens of the existing healthcare system. Results:The medical practice of neuro-oncology in the Philippines lacks robust local data on epidemiology and treatment outcomes. There are existing legislative frameworks to support adequate healthcare delivery and financing to brain tumour patients. However, inequities in the geographic distribution of infrastructure, manpower and medications are roadblocks for accessibility to neuro-oncologic services like specialised molecular markers, neurosurgical procedures, sustained chemotherapy and radiation therapy centres. Conclusion:There are significant treatment gaps in the care of neuro-oncologic patients in the Philippines that need to be addressed. Early detection and initiation of prognosischanging therapeutics through reduction of out-of-pocket expenses, access to readily available diagnostic tools and sustainability of management regimens are the main areas that necessitate strengthened partnership between the public and private sectors of Philippine society.

Autoimmune Encephalitis in the Philippines: A Scoping Review on the Treatment Gaps, Challenges, and Current State of Care

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“…This was highlighted in a review of studies on the health care cost and financing of patients with malignancies (especially for those with central nervous system malignancies). The cost of care (especially in cancer care) in the country is not covered by most insurance companies and is scarcely subsidized by the state, which means that cancer care is an out-of-pocket cost for most if not all Filipinos ( 14 , 15 ).…”

Research Productivity among Filipino Neurologists Associated with Socioeconomic, Healthcare, and Disease Burden Factors: A Bibliometric Analysis

“…Studies exploring treatment gaps for various neurological diseases in the country have shown a want of health information in the form of research. These studies cite a lack of local epidemiologic data and local experience with diagnosis or treatment for autoimmune encephalitis, bacterial meningitis, brain tumors, epilepsy, multiple sclerosis, Parkinson’s disease, and even stroke [ 14 , 15 , 16 , 17 , 18 , 19 ]. By further evaluating research performance, we can identify systemic disparities and guide appropriate solutions and direction for further study.…”