Dr Tran Thanh Huong
Dr Tran Thanh Huong is vice director of the National Institute for Cancer Control; vice director of the Bright Future Foundation, a supportive fund for cancer patients; and vice head of the department of ethics and health psychology at Hanoi Medical University.
Dr Huong has extensive expertise in developing, evaluating and capacity building for evidence-based identifying risk factors of cancer. She leads the curriculum development on social determinants of non-communicable diseases and health psychology for undergraduate and post-graduate students at the Hanoi Medical University. She currently is co-ordinator for a programme on breast cancer prevention and the programme “Improvement for cancer control in Vietnam: Selection of appropriate techniques for breast and cervical cancer in low-middle income countries”. She also runs several programmes to promote more accessible medicines for cancer patients. More recently, she is expanding her cancer-care interest to look at psychosocial intervention to support cancer patients. She plans to build on this work and integrate her expertise in evidence-based practices for cancer care.
Dr Huong earned her medical degree from Hanoi Medical University in 1996 and completed a PhD on psychosocial medicine at the Karolinska Institutet, Sweden, in 2006.
You are running and coordinating several programmes related to cancer prevention and cancer care in Vietnam. Could you briefly tell us about the ongoing programmes?
Cancer is highly prioritized in Vietnam. It is one of diseases included in the non-communicable disease (NCD) programme. We have National Programme for Cancer Control which approved from the government since 2008. We run the national programme on cancer control with the aim of:
- Improving the awareness of people in community on cancer control
- Improving the capabilities of health care staff
- Improving the quality of cancer registries and surveillance of the cancer
- Running screening programmes for breast cancer, cervical cancer, colorectal cancer and oral cancer
Besides the government, we have Bright Future Foundation which supports for poor cancer patients in Vietnam. In our hospital, National Cancer Hospital, we have National Institute for Cancer Control which carries out research study collaborated internationally with other countries and other organisations.
What is your current role in cancer care and control activities? Are you also involve in cancer research?
Yes, I have several roles to support the cancer care, being the Vice Director of National Institute of Cancer Control and also the Head of Department of International Collaboration and Research at National Cancer Hospital. We implemented many studies, ranging from biomedicine to epidemiological research and clinical trials.
Do you think partnering with other countries will help more in the cancer care and control in Vietnam?
Yes, I think it is very good in partnering for the cancer care. Recently we have a lot of collaborations on cancer treatment. For e.g., we have collaboration with SingHealth. We prepared to sign the Memorandum of Understanding (MOU) concerning to patient treatment and education, and the capacity for healthcare staff and research.
We have collaborations with different research institutes (for e.g. National Cancer Institute) and with different universities. We plan to establish an excellent cancer centre focusing on cancer research and NCD. We also have collaborations with several pharmaceutical companies to run the patient support group.
What is the current awareness level for cancers in Vietnam?
Before we launch the National Cancer Programme in 2008, cancer care knowledge is very limited in the community. At that time, only certain people in the community have correct information and knowledge about cancer care. After we run the National programme for Cancer control, the public’s knowledge on cancer is improving. Now we focus on improving their knowledge in detecting early signs/symptoms of cancer.
The programme is still ongoing, even the funding from government is decreasing over years.
During 2008–2015, a screening programme including cervical, breast, oral and colorectal cancers has been implemented with the support of the National Cancer Control Programme in Vietnam. How was the response and efficiency?
From 2008 to 2015, the cancer screening involved about 500 thousand people. In addition, we also have different programmes. For example, Bright Future Foundation also have screening and awareness programme every year during October for women (October is the Breast Cancer Awareness Month). We also collaborated with IAEA for cervical cancer screening at commune health stations. The response was good but also the challenge is lack of funding, so we can’t do follow-up with patients. This is the limitation of the screening programme. Unfortunately, we don’t have any data for the efficiency now, but in the future we might do data analytics and evaluation.
We are providing free screening for people. As of now the screening is not included in the health insurance. In the future, I think it will be better because the Ministry of Health in Vietnam has a plan to cover cancer screening in a basic healthcare package for the people.
Smoking could cause cancers and there is high prevalence of smoking adult males in Vietnam. Are there any actions being carried out to get more smokers to quit smoking?
We all know that smoking could cause many types of cancers. In Vietnam, the prevalence of smoking in men is 56% in 2008 but currently from national survey on tobacco, the prevalence of smoking is reduced to 47% in men. To achieve better cancer control, we have a lot of tobacco control such as tax increment, smoking ban in restaurants, offices, etc.
How government or support organisations help the cancer patients and ensure more accessible drugs to patients in Vietnam? Are there any subsidies or financial support available?
There are different ways. From the government, the health insurance in Vietnam now covers 65% of the medical oncology drugs and the expenditure for oncology in 2015 is accounted up to 7%. On the other hand, several patient support programmes are operated by NGO to support cancer patients in accessing free medicine. Therefore, the patients have more chance to get access to the drugs.
The selection of the patients depends on the selector based on the national guidance for the treatment. The assessment form will then send to NGO let say the Bright Future Foundation which then supports the medicine for the patients. Now we have a programme to support lung, breast and colorectal cancer patients.
There are some difficulties in running patient support programme because we need to get approval from the Ministry of Health. But from this year, we have new pharmaceutical law, thus we can run the research easier and access the drug easier.
If the drugs can be accessed easier, will their pricing reduce?
No, the drug pricing is related to many factors. Not only is the issue with the accessibility of the medications, it also depends on the patients’ perspective. If patients have adequate knowledge, they will go for the screening for early intervention, which in turn help in reducing the chance of costly treatment. From doctors’ perspective, they provide the service of diagnosis and prescriptions based on the national treatment guidelines. In healthcare system context, the costing for cancer treatment depends on the universal health insurance, innovations, and also the partnership between the industries, society and patients themselves.
What are some other challenges faced by Vietnam in terms of cancer control?
The challenge is lack of funding on cancer control. The funding from national cancer programme is decreasing over the years, so generally we need more partnerships and education. In terms of cancer treatment, the main challenge is to improve the technology and infrastructure and increase the capacity of the building for cancer patients.
Beside cancer control, are you also involved in other disease prevention activities or studies?
Yes, I also involved in the development of NCD programme in the Ministry of Health such as diabetes and hypertension. Now we collaborated with some universities from the U.S. to set up centres for research on cancer and NCD. We focus our studies on cancer and NCD because they have the same risk factors.