Stephen Michael Apatow – A Global Call to Action for the Millennium Medicine Project Global Cancer Initiative

Currently, in treatment under the Head and Neck Program at Smilow Cancer Hospital and the Yale School of Medicine, [1] Stephen Michael Apatow, founder of Humanitarian Resource Institute and United Nations Arts Initiative [2] advances a global call to action….

According to the World Health Organization: [3]

* Cancer is a leading cause of death worldwide: it accounted for 7.4 million deaths (around 13% of all deaths) in 2004.
* Lung, stomach, liver, colon and breast cancer cause the most cancer deaths each year.
* The most frequent types of cancer differ between men and women.
* More than 30% of cancer deaths can be prevented.
* Tobacco use is the single most important risk factor for cancer.
* Cancer arises from a change in one single cell. The change may be started by external agents and inherited genetic factors.
* Deaths from cancer worldwide are projected to continue rising, with an estimated 12 million deaths in 2030.

What causes cancer?

Cancer arises from one single cell. The transformation from a normal cell into a tumour cell is a multistage process, typically a progression from a pre-cancerous lesion to malignant tumours. These changes are the result of the interaction between a person’s genetic factors and three categories of external agents, including:

* physical carcinogens, such as ultraviolet and ionizing radiation
* chemical carcinogens, such as asbestos, components of tobacco smoke, aflatoxin (a food contaminant) and arsenic (a drinking water contaminant)
* biological carcinogens, such as infections from certain viruses, bacteria or parasites.

Some examples of infections associated with certain cancers:

* Viruses: hepatitis B and liver cancer, Human Papilloma Virus (HPV) and cervical cancer, and human immunodeficiency virus (HIV) and Kaposi sarcoma.
* Bacteria: Helicobacter pylori and stomach cancer.
* Parasites: schistosomiasis and bladder cancer.

Ageing is another fundamental factor for the development of cancer. The incidence of cancer rises dramatically with age, most likely due to a buildup of risks for specific cancers that increase with age. The overall risk accumulation is combined with the tendency for cellular repair mechanisms to be less effective as a person grows older.

Tobacco use, alcohol use, low fruit and vegetable intake, and chronic infections from hepatitis B (HBV), hepatitis C virus (HCV) and some types of Human Papilloma Virus (HPV) are leading risk factors for cancer in low- and middle-income countries. Cervical cancer, which is caused by HPV, is a leading cause of cancer death among women in low-income countries.

In high-income countries, tobacco use, alcohol use, and being overweight or obese are major risk factors for cancer.

Millennium Medicine Project joins the WHO focus on collaboration, international cancer prevention and control to:

* Increase political commitment for cancer prevention and control;
* Generate new knowledge, and disseminate existing knowledge to facilitate the delivery of evidence-based approaches to cancer control;
* Develop standards and tools to guide the planning and implementation of interventions for prevention, early detection, treatment and care;
* Facilitate broad networks of cancer control partners at global, regional and national levels;
* Strengthen health systems at national and local levels; and
* Provide technical assistance for rapid, effective transfer of best practice interventions to developing countries.

As outlined in the Millennium Medicine Project objectives, [4] medical and public health infrastructure, in every UN member country, must be optimized to meet these needs:

Even after half a century of independence, “not more than 20 percent of the population has any access to….. basic surgical services like life saving caesarian section, or a life saving repair of typhoid perforation…” (National Human Development Report 2001). This situation can be improved only if there is adequate number of rural surgeons in India whose surgery is affordable and available near the homes of the patients. — Realising the vital role of rural surgeons in the nation’s health care, Dr. Gazeiry, MD., FRCS., the past Regional Director of W.H.O. East Mediterranean Region remarked that rural surgery be made into a specialty.

The concept of rural surgery has been developed in India in the last thirteen years to make modern surgical care accessible to the five billion havenots of the developing world. Only one billion out the total of six billion population of the world has any access to the type of surgical care seen in the hospital of Western Europe and America. In India, out of the population of one billion as of today, not more than 10% has any access to this type of surgical care. — Association of Rural Surgeons in India. [5]

1. Yale: Head and Neck Program at Smilow Cancer Hospital and the Yale School of Medicine. Url:
2. Stephen M. Apatow: Founder of Humanitarian Resource Institute and the United Nations Arts Initiative. Url:
3. Cancer – Key Facts: World Health Organization. Url:
4. Millennium Medicine Project: Humanitarian Resource Institute, United Nations Arts Initiative. Url:
5. Association of Rural Surgeons in India. Url:


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