Managing cancer calls for aggressive approach

A few days ago, I had the opportunity to meet some cancer patients as well as physicians and social workers involved in management of cancer patients in the region. I was impressed with the kind of work in progress and the goodwill to fight one of the most notorious health challenges on the globe. Lack of specialised cancer wards or clinics in most of African health set-ups reflects a real challenge to policy makers. We need to have health centres with specialised cancer wards or clinics in order to safeguard and plan well for our patients. Cancer wards help to safeguard cancer patients from infections or other contagious illnesses from the surroundings since they are known for compromised immune system. For the malignant or neoplasm to grow, means the immune cells or body defense has been defeated to a certain extent. It is therefore a hazardous mistake to mix hospitalised cancer patients with others. Some cancer patients develop infections that can be contagious to others. Hospitals should at least reserve rooms or isolated rooms for cancer patients. Orientation is another basic component in daily patient management. Cancer is a body illness like any other disease. It’s initial or elementary diagnostic procedures are related to other clinical findings. There are over 500 types of cancer diseases and each present with specific manifestations. The most difficult part in early cancer diagnosis is that most of cancer or malignant illnesses present signs and symptoms similar to other illnesses. Cancer can either be curable or incurable. The curable type of cancer is usually benign and surgery is the only standard care recommended unless there are other associated health factors to avoid or prevent surgery. Sometimes even the benign cancer or lesion can present in an aggressive form depending on the part of body affected. For example, most of the benign brain lesions will present signs and symptoms similar to early neoplastic manifestations mainly due to compression of key brain structures. Sometimes there could be inflammatory process involved in benign lesions but is minimal and largely depends on the general health of the patient. Unlike benign lesions, malignant cells are destructive and inflammation is the key clinical component here. Once there is neoplasm growth in the body, automatically there is an inflammatory reaction taking place. A neoplasm can occur as a result of continued infection, hereditary or genetic factors, and the lifestyle. These are major risk factors and gives oncologist good history, guidance to plan for daily management of patients. In cancer management, we differentiate benign lesions from malignant lesions based on histology and pathological findings. You cannot start cancer treatment unless you have full knowledge of the tumor status. The most important aspect in cancer management is the pathology of the lesion in question. We decide on the type of treatment to manage a patient based on the tumor pathology, and not the size or grade or the part of the body involved. Poor pathological findings can mislead oncologists and good cancer management centres tend to have good pathologists in place. As mentioned earlier, inflammation is the key component for neoplasm’s or malignant cells. Signs of inflammation manifest in cancer patients like in other diseases and this is the reason why management of cancer patients calls for specialised experts to avoid possibility of missed diagnoses. Inflammation makes cancer painful and aggressive. This is why to stop disease progression you need a well-arranged multi-disciplinary approach for proper treatment. In multi-disciplinary approach; oncologists, radiologists, pathologists and surgeons need to cooperate as a team and in shortest period of time possible to determine, decide on the final diagnosis. Imaging, histo-pathological tests and findings should be done as soon as possible to help oncologists’ set-up there treatment plans. We, therefore, should have a health system where tests for cancer suscipicion cases are offered priority and done fast to manage patient problems optimally. An aggressive approach usually facilitates aggressive treatment plan. In modern cancer management protocols, patients with high-grade or aggressive tumors are subjected to aggressive treatment protocols. Fighting cancer is not easy; it is comparable to the fight against an enemy or rebel who is virulent and well-supported when it comes to combat battles. Dr Joseph Kamugisha is a resident oncologist at Jerusalem Hospital, Israel

Insight

Managing cancer calls for aggressive approach