The main reason for this advancement of the second edition of our book is the covid19 pandemic and the impact on cancer patients. With all the adverse effects they make the delay in the diagnosis and treatment of cancer patients. The covid19 pandemic transformed reality. Rarely have we had cancer operations labeled as urgent, during this time it has become a norm, rather than an exception: to deal with lockdowns, delays in detection and diagnosis, delays or interruptions in cancer treatments. Surgery, unless urgent due to bleeding, perforation or obstruction, was initially limited to avoid patients or medical personnel contagion with the virus 21st century Pandemic. Lung cancer and those caused by infections will be those with the greatest increase. In the rich area of the planet, prostate, colon and breast cancer will continue to have the highest incidence. Developing countries will suffer the evils of tobacco, which generates 12 percent of their cancer cases, a percentage that continues to grow. Another 25 percent of cases find their origin in chronic diseases. Researchers estimate that by the year 2030, 1.7 million cancer cases will be diagnosed in Latin America and the Caribbean and more than one million deaths from cancer. Panama, like many other Latin American countries was affected by The covid19 Pandemic. The impact will be seen on a short, medium and long range. In order to save our patients, we are implementing a Damage control strategy(DCS) : first Stratification of our patients in Urgent, Priority and non-priorities.
The stratification can be with letters or numbers. During our General Surgery Residency Training a classification of priorities that worked well was CIDUR (Spanish Acronym for CIRUGIA DE URGENCIA) ( Dr. Enero Aviles personal communication). Multiple technologic changes, multiple virtual conferences and meetings were developed during the 2020 and the 2021. This Book has 57 chapters, the last tells the History of Oncology in Panama, linked to the History of Panama and the World.