Radiation therapy for prostate cancer in Syrian refugees: facing the need for change

Abstract

PurposeTo report the utilization of radiation therapy in Syrian refugee patients with prostate cancer residing in Turkey.Methods and materialsA multi-institutional retrospective review including 14 cancer centers in Turkey was conducted to include 137 Syrian refugee patients with prostate cancer treated with radiation therapy (RT). Toxicity data was scored using the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0. Noncompliance was defined as a patient missing two or more scheduled RT appointments.ResultsAdvanced disease, defined as stage III or IV, was reported in 64.2% of patients while androgen deprivation therapy (ADT) was only administrated to 20% of patients. Conventionally fractionated RT with a median number of 44 fractions was delivered to all patients with curative intent (n = 61) while palliative RT (n = 76) was delivered with a median number of 10 fractions. The acute grade 3–4 toxicity rate for the entire cohort was 16%. Noncompliance rate was 42%.ConclusionMost Syrian refugee prostate cancer patients presented with advanced disease however ADT was seldom used. Despite the low treatment compliance rate, conventional fractionation was used in all patients. Interventions are critically needed to improve screening and increase the use of standard-of-care treatment paradigms, including hypofractionated RT and ADT.

Burden of prostate cancer in the Middle East: A comparative analysis based on global cancer observatory data

“…A confluence of unique circumstances and socio‐economic conditions within the Middle East could elucidate the paradox of higher prostate cancer mortality despite lower incidence rates in the region. One primary factor is the alarming rate of advanced prostate cancer diagnoses 7,9,18 . While the incidence of prostate cancer is increasing, data on the stage at diagnosis and treatment outcomes remain scarce, potentially leading to increased mortality rates.…”

“…One primary factor is the alarming rate of advanced prostate cancer diagnoses. 7 , 9 , 18 While the incidence of prostate cancer is increasing, data on the stage at diagnosis and treatment outcomes remain scarce, potentially leading to increased mortality rates. Concurrently, lower incidence rates might be attributed to biological features of male populations in the Arab World, as suggested by several studies.…”

“… 5 A multitude of factors contribute to this knowledge gap including limited resources for comprehensive cancer registries, cultural barriers to healthcare access, and varied healthcare systems across the countries in this region. 6 , 7 , 8 The available small institutional data suggest a consistent increase in the incidence of prostate cancer in this region over the last decade. 9 This increasing trend, combined with a rapidly aging population, has raised serious concerns about the future healthcare burden and costs that the region will have to bear.…”

“…In contrast to regions like Europe and North America, where extensive research has been conducted to elucidate the disease's characteristics and its impact on populations, the status of prostate cancer in the Middle East is significantly less understood 5 . A multitude of factors contribute to this knowledge gap including limited resources for comprehensive cancer registries, cultural barriers to healthcare access, and varied healthcare systems across the countries in this region 6–8 . The available small institutional data suggest a consistent increase in the incidence of prostate cancer in this region over the last decade 9 .…”

Effectiveness of a telehealth patient education intervention for breast cancer awareness and screening uptake among Afghan refugee women: a cross-sectional survey and feasibility study

“…3 These disparities have fatal consequences: Refugee populations have abysmally low rates of cancer screening and, when diagnosed with cancer, overwhelmingly present with advanced-stage disease. 4 , 5 , 6 , 7 , 8 , 9 , 10 Refugee populations have lower cancer-related knowledge compared to both citizen and non-refugee immigrant populations in their host countries, and there is a correlation between lower cancer awareness and lower use of screening in these populations. 11 , 12 , 13 , 14 …”