What Are You Doing Towards the Fight Against Cancer?
By Christine Sevume, Re!gnite Africa 2016 Youth Leader
The institute corridors are a gateway into a cluster of beds on either side. Some clients are lying hopelessly on the floor; waiting for their turn. The lifesavers have their heads buried in intricate machinery- working tirelessly to come up with good news for their charges. The aides are running up and down, bed to bed; to ensure that all are comfortable. Some stay longer than others and a few leave with smiles on their faces. But most are crestfallen as they know their time is running out and their meagre resources don’t allow for a longer stay.
This is the situation at the Uganda Cancer Institute; the only cancer care centre in Uganda. It is unfortunate that many of us have lost a loved one to this epidemic or at least know someone who is fighting for their lives.
Christine Sevume
Cancer is considered a public health problem due to the economic burden and years of life lost to morbidity. It is regrettable that, in general, many patients die within ten years of first diagnosis of many forms of cancer. Those that are able to live past this, are not able to return to gainful employment due to the severity of the side effects of the drugs. Most of these drugs are costly and have to be taken for the rest of the patients’ lives.
The growing incidence of cancer in our communities has been attributed to a number of factors such as longevity. According to the United States National Library of Medicine, cancer is considered a disease of the genes in which malformations accumulate in the core structure of the cell (DNA). These formations become cancerous and are manifested in the later years of life. However, some of these are inherited- which explains the manifestation in younger patients.
Another factor is the lifestyle. Due to rapid urbanization and technological advancement, there has been an increase in pollutants in the air. One of these pollutants is tobacco which contains nicotine, responsible for effects such as euphoria, addiction, and cancer. The annual World Health Organisation report of 2014 affirms that nicotine is associated with about ten different types of cancer including lung, oesophageal, oral, squamous cell carcinoma, stomach, and kidney.
The change in diet is another contributing factor. The western diet is characterized by a high caloric diet, rich in fat, refined carbohydrates, and animal proteins. This, combined with low physical activity results in overall energy imbalance. According to the International Agency for Research on Cancer, energy imbalance is associated with cancers of the breast, colon, uterus, gall bladder, kidney, and esophagus.
However, not all hope is lost. The United Nations has encouraged governments worldwide to develop a National Cancer Control Program in order to reduce cancer incidence and improve the quality of lives of cancer patients.
Regular exercise and frequent consumption of fruit and vegetables may reduce the risk of developing cancers of epithelial origin such as cancers of the pharynx, lung, stomach, esophagus, and colon as per the WHO guidelines.
Furthermore, a third of known cancers can be prevented by treating predisposing infections. These are infections caused by microorganisms like H.Pylori (gastric ulcers), Human Papilloma Virus (genital warts) and hepatitis viruses. Chronic infections of H.Pylori predispose to stomach cancer and hepatitis infections are a risk factor for cancer of the liver. Routine vaccination against hepatitis virus and Human Papilloma Virus are strongly recommended by WHO.
Another third of cancers can be cured by early screening and adherence to medication. Early screening is especially considered for cancers of the cervix and breast. Many of the cancers can be cured if the diagnosis is made in time to allow adequate medical intervention. Thus, adherence to the treatment is paramount and this includes proper management of the side effects.
The remaining third of cancers can be managed by providing palliative care. This is aimed at providing comfort and psychosocial support to patients suffering from advanced stages of disease, with little chance for cure. Hospice Uganda has been providing pain relief and emotional comfort to 42,000 patients in 66 districts for the past 22 years.
In 2014, the Ministry of Health launched an initiative to vaccinate up to 140,000 young girls against the Human Papilloma Virus. The government, with the help of the Fred- Hutch Cancer research centre upgraded the Uganda Cancer Institute into a centre of excellence in 2015.
Despite all this, the interventions in place are not satisfactory because the country is yet to establish a National Cancer Control Program. This policy would help prevent, cure, increase survival and quality of life for cancer patients by converting the knowledge gained through research, surveillance and outcome evaluation into strategies and action. The public is highly encouraged to demand accountability from the government in order to reduce the bureaucracy involved in establishing these national policies.
Rotary Uganda holds an annual marathon to raise funds to facilitate cancer treatment and raise awareness about the disease. It has been five years since the first marathon was held and participation has increased over the years.
Rotary cancer run (August 2016)
Some individuals have held campaigns on social media to raise funds for patients who require advanced treatment abroad for example #SaveCarol campaign. These campaigns run several activities like car washes, concerts, and dinners.
In your capacity as an individual, do whatever it takes to reduce the risk factors: Maintain a healthy diet rich in fruits and vegetables, limit nicotine exposure by avoiding/ quitting smoking and appropriately treat predisposing infections. Offer emotional support to any cancer patient you know; encourage them to take their medication and help them follow up their medical appointments. Encourage the people in your social circle to carry out screening and go for regular medical check-ups. In the developed countries, early screening had reduced the burden of disease by 75%. We hope that one day; cancer shall be considered a disease that was eradicated worldwide.