Why cancer is everyone's concern

As the world marked World Cancer Day last week, a call was made for people to increase awareness about the disease. Fifty-four-year old Oda Nsabimana is a cancer survivor who thought that it was the end of the road for her 13 years ago after discovering that she had breast cancer. “It was the worst scenario I could ever imagine. I discovered after responding to a call over the radio urging people to go for breast cancer screening. When I tried to check myself, I felt a lump inside my breast but I could not immediately conclude that it was cancer,” she says. After too much suspicion, Nsabimana went to Butare where they checked and confirmed that she had breast cancer. The news was just bad enough, but she stood strong to begin treatment. Unlike most diseases, treatment of cancer follows phases and regularly requires certain tests, some of which require going abroad. “Several times I travelled to Belgium and other parts of the world just to ensure that my treatment is successful,” she says. The chemotherapy she got also left its side effects but this is a battle that she overcame. Many people around the world share Nsabimana’s ordeal. Some still think that those who have cancer are just steps towards the graveyard. Others say the pain during treatment increases with the probability of depleting all financial resources. Dr Aimee Muhimpundu, the head of non-communicable diseases at Rwanda Biomedical Centre, says the fight against cancer requires more involvement at the individual level more than ever. “People should take the initiative of going for early screening and diagnostic services. It should not stop at just that because those who are found with the disease need to adhere to treatment and consume health diets,” says Dr Muhimpundu. Similarly, Dr Achile Manirakiza, a clinical oncologist at Muhimbili University of Health and Allied Sciences in Tanzania, believes that it is an issue of awareness that is missing within the population. “People are not aware that most cancers, especially breast cancer, can only be detected through subsequent screenings. This alone remains a huge challenge,” says Dr Manirakiza. Cancer and family background Manirakiza adds that even during awareness programmes, information linking cancer to family background is not clearly elaborated for the public to understand whether they are at risk. “We are not telling our people that breast cancer has a hereditary part in its beginning and as people die, it becomes another death story but none in the family really looks into investigating what caused the death and if they are at risk. Any female offspring or relative to a breast cancer patient is at risk,” he says. Manirakiza, however, advises that women ought to develop curiosity and start searching for possible lumps in their breasts at an early stage. “Consequently, simple rules as breast palpation at least every month starting with younger women are not as widespread, and sadly, patients are seen at a late stage. Breast cancer when known early can heal successfully,” he advises. Manirakiza notes that cancer predisposition from a family background is also complemented by one of the latest studies, which revealed that presence of cancer in one twin increases the risk of the disease in the other twin. The study published in the Journal of American Medical Association shows that since twins share same genes, having cancer in one subjects the other to a higher risk of getting sick but does not mean when one twin falls ill, the other gets that cancer or any other type. Cancers that were most likely to be shared among twins were skin melanoma (58 percent), prostate (57 per cent), non-melanoma skin (43 per cent), ovary (39 per cent), kidney (38 per cent), breast (31 per cent) and uterine cancer (27 per cent). Reproductive cancer On the other hand, reproductive cancers are also on the rise. These cancers affect more women than men and figures from the health ministry reveal that a big number of people is at risk in Rwanda. At least 2.72 million women are at risk of developing the disease, which results from a genital infection caused by the humana papilloma virus (HPV), according to the statistics. Between 2011 and 2014, 986 women were diagnosed with the cancer and 678 of them (almost 70 per cent) died. Globally, those who engage in unethical sexual practices are not safe either because researchers found that people who had HPV-16 in their original mouthwash samples were as much as 22 times more likely to develop oral pharyngeal cancer. Oral sex can spread viruses that can cause head and neck cancers, according to a scientist at the Albert Einstein College of Medicine in New York. The research published Online in ‘JAMA Oncology ‘shows a strong connection between the human papillomavirus (HPV), which can be spread through oral sex, and head and neck cancer. However, Dr Jean Claude Nyiringwaya, a gynecologist at La Croix du Sud Hospital, remarks that with more efforts reproductive and other cancers in women can be reduced. “We need to remain hopeful. Long ago cancer used to be the most feared disease but these days interventions are cropping up and we are yet to see more reduction in the disease,” says Dr Nyirinkwaya. He, however, emphasizes that huge progress can only be registered if approaches are holistic. “We cannot do what the rest of the world does but we can get somewhere if we work hard at the individual level and join hands at the national level,” he adds. During cancer treatment, several methods are used but majority of cancers are detected microscopically and these account for 68.5 per cent of the cases. This means that immense analyses have to be conducted depending on the doctors’ prescriptions. John Masilia, a laboratory technologist in Kigali, affirms that although most cancers require early screening for immediate treatment the success of detection is very high even during early stages. “There are no major challenges in screening either, ovarian, prostate, breast or colon cancer; it is simply a question of timely interventions,” he explains. Breakthrough in cancer treatment Ordinarily, cancer is caused by an uncontrolled division of abnormal cells in a part of the body and sometimes in its late stage it appears as a malignant growth. Recently, researchers for the first time witnessed how a single cell can change and give rise to cancer, a development that raises hopes that could enable scientists discover ways to inhibit tumors before they grow. The studies were published in the Journal of Science at Boston Children’s Hospital and are based on zebra fish that developed melanoma. According to the study, when a cell reverted to a stem-cell state and began dividing, it became cancer. The spark for that change was in the crestin gene, which should only be active in embryonic tissue but became inappropriately activated again, resulting in melanoma. According to the authors, certain cells in the body can have mutations but not yet fully able to behave like cancer cells but cancer occurs after activation of an oncogene or suppressor and involves a change that takes a single cell back to the stem-cell state. editorial@newtimes.co.rw **************************************** About challenges in treating cancer Joseph Muganda Joseph Muganda,a gynecologist: It is difficult to treat cervical cancer. Most women are not willing to go for screening, including those who are aware of its dangers. That alone makes it a challenge for us to prevent it. Daniel Niyonshuti Daniel Niyonshuti, an internal medicine at CHUK: Gastric cancer, for instance, when in advanced stages, cannot be cured. Patients normally give up which makes the situation worse. More awareness should be created to inform the public about how to prevent cancer. Eugene Harerimana Eugene Harerimana,a clinical psychologist: In most cases, cancers that are diagnosed in late stages have no cure. In treating any type of cancer, there is a big challenge in trying to convince both the patient and their families about the reality. Faith Batamuriza Faith Batamuriza,a medical student at UR: I think the most challenging part is getting good treatment, especially in Africa. It is hard to get proper treatment for the late stages of any type of cancer, meaning patients would have to go abroad to look for medication. Compiled by Lydia Atieno