Reggie Mutia Lambo Drilon, President of the Cancer Survivors Organization at the Philippine General Hospital (PGH), says that the government will be risking lives—and incurring more costs for cancer treatment in the long run—if there is any reduction to the proposed budget for the school- and community-based HPV immunization program spearheaded by the Department of Health (DOH).
Given that HPV vaccination coverage post-pandemic is still low among women and girls, the possibility of further decreases in vaccine allocation (from 1 million doses in 2023, with the Department of Budget and Management providing a baseline proposal of only 750,000 doses for 2024) will be a costly setback to the elimination of cervical cancer in the Philippines.
Ms. Drilon is reacting to ongoing national budget deliberations on the DOH’s National Expenditure Program for next year, reminding lawmakers and other relevant stakeholders that the lives of cancer patients and at-risk women and girls, are hanging in the balance.
“Parang lagi niyo pong ipinapangako na healthy ang Pilipinas, healthy tayo, e talagang kung gusto niyo po ng healthy, mag-invest po tayo sa mga programang pang cancer prevention. Alam po natin na sa tulong ng bakuna, protektado ang kinabukasan ng mga batang babae. Protektado sila at hindi na mangangamba na matutulad sila sa sitwasyon ko na nagka cervical cancer,” she added.
Guaranteed protection vs. an uncertain cure
Ms. Drilon has had a decade-long fight with cancer, having been initially diagnosed with a malignant cervical tumor in 2010. She underwent what she terms an “open-close surgery” followed by several cycles of chemotherapy with radiation therapy, including brachytherapy (a cancer treatment wherein radioactive material is implanted in the body). Post-therapy, screening and colposcopy testing revealed that cancer cells were still present in her cervix, which were subsequently removed via hysterectomy.
In 2018, Ms. Drilon also had to undergo additional aggressive chemotherapy to treat cancer cells that had spread to her abdomen (mesenteric lymphoma) and bones. She was cleared of cancer in February 2020, but is still required to take positron emission topography (PET) scans every six months to screen for any recurrence.
In between treatments, Ms. Drilon lost a cousin to cervical cancer. She also aided her ailing sister, Nethel, through two years of cervical cancer therapy, before the latter lost the fight at just 38 years old. Now a cancer survivor at 48 years old, Ms. Drilon is a staunch supporter of improved cancer awareness and education; increased financing for cancer prevention, screening and treatment; and, most particularly, an expanded scope for HPV vaccination among the youth.
More than 95% of cervical cancer is due to the human papilloma virus, which can be transmitted via sexual contact, skin-to-skin contact and very rarely, through objects exposed to the virus. HPV vaccination and early detection via screening are still the best protection from cervical cancer. Under the immunization program, two doses of HPV vaccine are given to female learners aged 9 to 14.
Immunogenicity studies have shown that the vaccine given to the younger set provides better protection, and that the vaccine is also more effective if given before exposure to HPV. Thus, Ms. Drilon is appealing to the government to support and sustain its HPV immunization program—even suggesting that they expand it to include males.
“Pumapalakpak talaga ’yung puso ko nung nalaman ko na nagkaroon ng vaccine para sa mga kabataan. Kaya ang sakit ngayon malaman na may posibilidad na mababawasan mga batang babae na maaring bakunahan at maprotektahan. Siguro bawasan kung nakikita nilang napakarami nabakunahan na, e kaso hindi naman,” said Ms. Drilon.
Current numbers are stacked against the Filipina—this needs to change
About 11 Filipino women die daily from cervical cancer, which is the second most frequent cancer and third leading cause of cancer-related death among women between 15 and 44 years old.
To eliminate cervical cancer by 2030, the World Health Organization recommends that 90% of girls be fully vaccinated with the HPV vaccine by the age of 15; 70% of women screened using a high-performance test by the age of 35, and again by the age of 45; and 90% of women with pre-cancer treated and 90% of women with invasive cancer managed.
The Philippines, which initiated its HPV immunization program in 2015, has been lagging in its goal to fully vaccinate at least 90% of the target population. According to an APEC Report, PH vaccination rate is low compared to other APEC countries in terms of HPV vaccination coverage by age 15 (first dose among females) which is only at 28%. Lowered budget allocations will further contract the numbers, when it is imperative that the country recover lost ground.
Ms. Drilon is quick to share her cancer journey because she does not want her children, relatives, or any other woman to experience the same physical, emotional, mental, and economic toll. As a working class citizen, she lacks the financial capacity for a prolonged battle against a deadly disease. She is grateful for handouts from her boss and good-hearted Samaritans who contributed to an online fund-raising drive. She is reluctant to accept help from family, feeling that this is tantamount to taking food away from their table.
Instead, she has primarily relied on PhilHealth insurance and pieced-together financial and medical assistance from various government offices—among them the Philippine Charity Sweepstakes Office (PCSO), Senate Public Assistance Office, Department of Social Welfare and Development (DSWD), and even the newly established Presidential Help Desk—to fund her diagnostic tests, surgical operations, and cancer therapies.
In between bouts of chemotherapy, she would stake out government buildings to be ahead of competing petitioners. “Kailangan kong gumapang kung saan-saan. Ito na yung time na natutulog ako ng PCSO, madaling-araw nandoon na ako. Nakakatulog din ako dito sa may Senate. Kasi pipila ka, kailangan makaabot sa quota, “ said Ms. Drilon, who also speaks of fainting spells in transit to and from her home and these offices.
According to Drilon, her initial surgery cost P15,000, first six cycles of chemotherapy cost more than P100,000, and every PET scan she takes costs P60,000 (considering this is required every 6 months, that amounts to P1.2 million for 10 years). Ms. Drilon is reluctant to do the math, considering every donation a blessing, but estimates having spent at least more than a million pesos in her battle against cancer.
In comparison, an HPV vaccine, estimated at around P4,000 to P12,000 per dose (dependent on brand and package), comes cheap.
“Sa P60,000 na PET scan, ilang ma-co-cover nun? Gubyerno din ang gumagastos sa akin sa PET scan…Kung maaga palang mapupuksa na ang sakit, kokonti lang yung gagastusin nila, hindi pa hahantong sa may mamamatay,” said Ms. Drilon.
“Kung nagkaroon na ng HPV vaccine, baka hindi na ako humantong sa ganito. Sana ipagpatuloy ng DOH at ng mga mambabatas natin. Sana dagdagan pa nga nila, hangga’t maaari, yung vaccine, para macover nila ang lahat ng kabataan – babae maging lalaki na rin. Yun lang po yung inaasahan ko sa kanila,” noted Ms. Drilon.