Can Cancer Patients from Other Countries Receive Treatment in the USA?

Joana Ramos, MSW

Disclaimer: This fact sheet is intended for general informational purposes only and is not legal advice. The contents of this fact sheet was accurate at the time of publication, and the author cannot be responsible for changes or different information that is given to patients and families by specific health care facilities. Likewise the author is not responsible for the outcome of the quest of any individual to receive medical care in the USA or any other country. The inclusion of names of organizations and businesses is for informational purposes only and does not constitute endorsement. The opinions expressed herein are solely those of the author.

This Fact Sheet may not be reproduced in whole or in part without the author's prior written permission.

Background

We now live in both the best of times and the worst of times in which to be diagnosed with cancer. In industrialized countries of the world, most people with cancer have access to well-established standards of care, including state-of-the art, expensive, treatment modalities. For childhood cancer in particular, this has meant that now some 70% of children stricken with many forms of the deadly disease survive or are cured. In developing and transitional countries, however, the cancer picture continues to be quite bleak and cancer is expected mean death. In these nations, it is estimated that 90% of children with cancer die, and only some 10% have access to treatment at all.

Greatly improved access to information and the development of electronic media worldwide, now mean that most literate people are aware that modern cancer treatments exist. When a loved one anywhere is diagnosed with cancer, families naturally want them to be able to receive the best treatment possible. But if they live in a country where treatments are not available or are priced beyond their reach, they look for other alternatives.

This improved information access has created cruel dilemmas for many families. While the well-off of developing countries have always sought treatment abroad, mostly in the USA or Europe, this option is usually not possible for ordinary citizens. Expectations are further raised by news coverage that highlights extraordinary high-tech medical procedures and treatments performed in the USA. Rarely however are mundane matters like the fact that the USA is also unique as the only industrialized nation in the world without a national health system, ever mentioned. The reputation of the USA for innovation, resources, technological advances, and the generosity of its people has been well known throughout the world. Therefore people believe that miracles are possible if only one can come to this advantaged nation.

In the developing and transitional countries of the world that have any form of national health system, health care services may be provided, but patients must purchase their own medications and supplies. Many basic chemotherapy drugs, for example are either not available or are so astronomically expensive, that patients cannot afford them.

It is also of note that due to the changing immigration patterns in recent years, it is likely that patients from any part of the world may have family or friends living in the USA. Therefore, a normal response for patients diagnosed with cancer in a resource-poor country is to seek care in the USA.

Developing adequate cancer control programs worldwide is a challenge that won't be met for some time to come, although incremental progress is being made. The most practical and cost-effective long-term goal is for patients to be able to receive necessary care in their home country or region. However, the patients of today need help now. This fact sheet attempts to address the issues and to present a realistic picture of treatment possibilities.

Realities

The realities that face international patients, however, are harsh. It is often the job of social workers to explain to inquiring families just what these possibilities are. To be blunt, it all comes down to money. In general, cancer patients seeking treatment in the USA must be aware of the following:

What can be done?

Given the above factors, it is still possible that some international patients will be successful in arranging to be treated in the USA. A lot depends on luck, patient's age (more possibilities exist for children) geography, organizational skills, and the availability of family, friends, and/or strong support networks in the USA that are willing to go the extra mile on behalf of a particular patient. Some possibilities include:

Other avenues for treatment for patients in their home countries should also be considered. These include:

Other considerations

Conclusions

It is a difficult time for patients with cancer who live in countries where they do not have access or treatment, and it is also quite difficult for them to come to the USA where treatments exist but access does not. It is a problem that will not be quickly resolved, so it is very important that families be given information that will help them develop realistic expectations for the care of their loved ones. Medical facilities and cancer organizations in the USA can help work towards solutions by participating in efforts to increase collaboration and involvement in countries of the Two-Thirds world. The following selected resources may be useful to families and those who work with them in trying to find help.

Selected Resources

Clinical Trials Information

National Institutes of Health
Clinical Trials Call Center
1-800-411-1222 (US only)
http://www.clinicaltrials.gov

National Cancer Institute
Clinical Trials Support Center
1-888-624-1937 / 1-888-NCI-1937 (US only)
http://ccr.ncifcrf.gov/trials/cssc/default.asp

NCI Ped-Onc Branch
1-877-624-4878
http://home.ccr.cancer.gov/oncology/pediatric/

International Cancer Research Portfolio
http://www.cancerportfolio.org/

St. Jude Children's Research Hospital
http://www.stjude.org

Coalition of National Cancer Cooperative Groups
http://www.cancertrialshelp.org

Centerwatch
http://www.centerwatch.com

Access to Medicines

Management Sciences for Health, Center for Pharmaceutical Management
International Drug Price Indicator Guide
Publishes annual prices guide from nonprofit drug suppliers and procurement agencies, with supplier contact information
http://www.msh.org/what_MSH_does/cpm/resources.html

International Dispensary Association (IDA)
http://www.ida.nl/en-US

Information about Compassionate Use (CU) of drugs in development
Cancer Action Now
http://www.canceractionnow.org

Patient Assistance Programs
http://www.rxassist.org
http://www.needymeds.com

Pharmaceutical Research and Manufacturers of America (PhRMA)
http://www.phrma.org/

Novartis Glivec International Patient Assistance program (GIPAP)
http://www.glivec.com/content/home.jsp.

Travel Resources

US Department of State
http://UnitedStatesVisas.gov

Official information for citizens of other countries desiring to travel to the USA for any purpose. Explains visa process, links to embassies and consulates of all nations, and to relevant US government agencies.
http://unitedstatesvisas.gov/

National Patient Air Transport Hotline (NPATH)
Information clearinghouse regarding travel assistance for patients in North America and internationally.
(800) 296-1217
(757) 318-9107
Fax: (757) 318-9107
http://www.patienttravel.org

Information & Referral to International Treatment Centers and Cancer Organizations

International Network for Cancer Treatment and Research
http://www.inctr.org

International Union Against Cancer (UICC)
International Directory of Cancer Institutes and Organizations http://www.uicc.org/index.php?id=578&L=0

Cancer Index
Guide to Internet Resources for Cancer
http://www.cancerindex.org/clinks1.htm

Guia de Recursos sobre el Cancer Infantil
Guide to Childhood Cancer Resources for Spanish and Portuguese-speaking countries
http://www.neuroblastomainfantil.info/

Bone Marrow Donors Worldwide
International bone marrow stem cell, and cord blood member registries
http://www.bmdw.org

National Marrow Donor Program
International NMDP Transplant Centers
http://www.marrow.org/NMDP/international
_transplant_centers.html

World Health Organization
Cancer: Related links
http://www.who.int/cancer/media/links/en/