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Humanizing medicine

On the first Sunday of every June, people around the world pause to honor all those who are living with cancer, and acknowledge the contributions of families, friends, health care providers, and scientist who support cancer victims and survivors in their fight for life.

To celebrate those who have survived and to inspire those who have recently been diagnosed with cancer, NOW talks to Dr. Philip Salem, one of the world’s leading cancer specialists who is of Lebanese origin and whose latest work and research have contributed to best practices for both treating and preventing cancer.

On National Cancer Survivor Day, Salem encourages survivors to be more proactive in the battle against cancer and assures that the strides researchers are making toward developing a cure for the disease is no myth. He shares new findings of how cancer can be prevented and how a national health policy in Lebanon could prevent up to 80 percent of cancer cases.

Salem has also spoken openly on Lebanese public life and politics. He describes himself as a great believer in Lebanon’s future but would like to see the country remain neutral in the conflicts of the Middle East. With its 18 different sects, Lebanon should strive to become an oasis of cultural pluralism and freedom.

Two books have recently been published on Salem: Philip Salem: The Rebel, The Scientist, and the Humanist (Dar al-Nahar/Saqi Books), and Cancer, Love, and the Politics of Hope: The life and Vision of Philip A. Salem, published by Quartet Books Limited and co-authored by Boutros Indari and Frances Mourani.

NOW: What is your message to Lebanese cancer survivors on National Cancer Survivors’ Day?

Dr. Philip Salem: First, I’d like to congratulate them for surviving cancer which is a major achievement, and second I’d like to advise them not to sit idle in the fight against cancer. Cancer survivors should be on the frontlines of the battle; they need to contribute by talking about their experience and by also volunteering to help other cancer patients. Most of those cured from cancer in the Middle East are very silent. This is why there’s an impression that cancer is inevitably a deadly disease. They can make a difference and this is why this is a responsibility that they should not shy away from.

NOW: Many argue that the cure for cancer is a myth, are you saying otherwise?

Salem: The cure for cancer is a reality. Today we can cure up to 60 percent of all cancer patients. The reason people don’t believe this figure is because those who have been cured, as I said before, do not speak out. I will tell you another shocking fact: Right now if we put the knowledge that has been generated from cancer research in the service of the people via a good national health policy we can eradicate the bulk of cancer diseases. I am talking at least 75 to 80 percent. But these policies are not only not available in Lebanon, they are also unavailable in many of the so-called developed countries. It is a fact that many of the cancer diseases are preventable but we actually do very little to prevent them.

NOW: So, can cancer be prevented? And if so, what needs to be done to avoid it?

Salem: Absolutely! So, yes, cancer is a preventable disease to a large extent. The first example is cervical (uterine) cancer, a common type of cancer among women. We have a vaccine by which if girls between the age of 13 and 30 are vaccinated, we can eradicate up to 75 percent of cervical cancer. If we prevent tobacco smoking, we can eradicate up to 80 percent of all lung cancer. Today, a bilateral mastectomy as the one Angelina Jolie recently [underwent], up to 90 percent of women carrying genetic predispositions can avoid breast cancer.

Many cancers are preventable especially those which are the product of chronic infection, so once the infection is cured, the cancer is avoided. Cervical cancer is one of those. The vaccine prevents the infection and consequently the cancer. The H-pylori infection in the stomach can produce cancer, and so if we treat the infection we can avoid the cancer. Same goes for liver cancer.

NOW: What are the most important factors that guarantee the cure of a patient?

Salem: This is an extremely important point. The factors are the following:

To make the right diagnosis. Shockingly more than 30 to 40 percent of initial diagnoses are wrong. To be able to cure the patient you have to pinpoint the exact nature of the cancer. This is the biggest problem cancer [patients] face because unfortunately the pathology laboratories – the venue where the diagnosis takes place – are not equipped with the most sophisticated technologies and with the experts to make the correct diagnosis.

The quality of treatment. In the developing nations we do not have any surveillance system to determine the quality of treatment. In the treatment of cancer we need a team of doctors; cancer is a result of many diseases and so cannot be treated by one single doctor. It requires the skills and talent of a team.

Courage and perseverance, not only on the patient’s part but also on the part of the doctor. Many patients give up early and so do many doctors. The treatment of cancer is a long and brutal journey; a special relationship needs to be built between the doctor and the patient. Cancer patients unfortunately all over the world are treated in an automated mechanical inhumane way. The doctor that does not love his patient cannot cure him.

NOW: As a Lebanese what is your opinion about the situation in Lebanon today?

Salem: The major problem of Lebanon is that it has always been a hostage to the conflicts in the Middle East. As it was a hostage to the Arab-Israeli conflict, today it has become a hostage to the conflict between the West and Iran.

I’m a great believer in the future of Lebanon, but Lebanon has a future only if we adopt a policy of neutrality. Not only as far as the conflicts in the Middle East are concerned but worldwide. Lebanon should be an oasis of culture, an oasis of freedom and of cultural pluralism.

The major challenge to the world now is the development of radicalism, and here I don’t only mean Islam. Any radical approach is an assault on civilization. Lebanon is a manifestation of the world and can be the best example of pluralism. Only in Lebanon you have 18 different sects that could live, survive, and interact, only in Lebanon can Arabs and Westerners live together, only in Lebanon can Islam and Christianity embrace each other.

NOW: Tell me more about the book Cancer, Love, and the Politics of Hope?

Salem: I am not the author of the book. It was written by Mr. Boutros Indari, an Australian journalist of Lebanese origin, and Mrs. Frances Mourani, a journalist from New Zealand. The book speaks briefly about my life story and about my upbringing, but it basically focuses on my ideology and philosophy, and on my views concerning Lebanon and the Arab world.  It contains many of my writings, about both medicine and politics.

NOW: How best would you describe this ideology or philosophy?

Salem: My ideology is twofold: the first is that the right to health – that is, the right to medical care – is the most important right for a human being.  The Declaration of Human Rights was published by the United Nations in 1947 and back then people had no idea about the significance of health. You have to be alive to be able to practice the rights to freedom and to free expression. If you don’t survive, the other human rights are irrelevant. It is important that we adopt a new charter at the United Nations whereby the right to live and the right to health and medical care are recognized as the most important of human rights, and we are working toward it. It is important that we raise awareness of governments toward this responsibility. It is a shame in the US that the government says it has no money to treat its citizens, yet still has trillions of dollars to launch wars.

Second, we need to re-humanize medicine all over the world. Medical care has become more automated and the patient is looked up on as merely a number or an object. The problem in most developed countries, the US being one of them, is that there are so many rules and regulations that have destroyed the divine human relation between the doctor and the patient. We need to restore this relationship between the doctor and the patient. This may sound [strange], but people who are treating patients know what this means, and know how it makes a difference between life and death.

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