Of cancer and late diagnosis

Experts: early diagnosis key to surviving cancer

 Experts say women must be regularly screened for breast and cervical cancer.

 

By Moses Magadza

Maybe (not his real name) contorts his face into a grimace of exasperation and pain when he recounts the last few months of his late mother-in-law’s life.

“She died from cancer of the breast. Her niece came to visit her one day because she (the niece) had been told at the local clinic that a lump in her breast could be cancer. She was therefore referred to Windhoek,” Maybe says during a recent interview.

Upon learning the purpose of her niece’s visit, the mother-in-law who had been moving around with a lump in her breast for a while too, decided to join the younger woman on her visit to the hospital for check-up. At the hospital, health experts confirmed the two women’s worst fears: they were suffering from breast cancer.

Said Maybe: “The long and short of it is that from the day that my mother-in-law said that there was a lump in her breast to the time that she died was no longer than six months. She was taken to South Africa. Everything possible was done; the breast was removed and chemotherapy was instituted, but she died.”

Maybe’s mother-in-law’s case is typical of the scenario that plays out in most parts of Africa where experts say late diagnosis is largely responsible for widespread mortality and morbidity among countless people suffering from breast cancer, cervical cancer and prostate cancer, the latter which affects men.

To address the problem, First Ladies of Africa are expected to meet in the Namibian capital Windhoek from the 20^th to the 22^nd of July as part of ongoing efforts to create awareness on these three cancers.

President Hifikepunye Pohamba is expected to open the conference, which will be held for the first time in Namibia. Expectations are that all First Ladies of Africa will attend. For Lady Pohamba, who will be the host First Lady, this important conference is like a swansong. It will be one of the major remaining activities that she will host in her capacity as First Lady.

Health experts say cervical cancer and cancer of the breast are growing problems in Africa.

Professor Peter Nyarango is Dean of the Faculty of Health Sciences as well as Founding Dean of the University of Namibia School of Medicine. He says the major problem is that these cancers – including prostate cancer - are diagnosed late.

“Therefore, the affected women don’t benefit as much from scientific advances,” he says, adding that in other countries, medical science has advanced so much that these cancers are detected in microscopic stages and treated effectively with high level techniques.

 “In Africa, many women often self-diagnose when it is too late because often they are the only ones who first notice that there are lumps in their breasts.”

 Nyarango explained that  by the time the women detect these lumps the cancer would be out of control and even when they eventually go to hospital, they - like Maybe’s mother-in-law - die despite gallant efforts to save their lives.

Experts say breast cancer is to a large extent a silent killer with a long gestation period from the pre-cancerous stage (the stage where physicians can detect that cells are behaving abnormally) to the time that symptoms develop and treatment is started).

The same story goes for cancer of the cervix and prostate cancer, which affects men.

“People do not go for regular check-ups because they do not think they are at risk,” Nyarango says.

One man, speaking on condition he was not named, opined that apart from widespread ignorance of risk factors, costs could be preventing some people from going for routine check-up.

“Even I have not gone for my regular check-up this year because the last time I tried to make an appointment, I was told that I needed to pay consultation fee of N$1700 just for the appointment,” he confided before asking:  “How many Namibians can afford these regular check-ups?”

It appears that due to many reasons, some people go to health facilities late, by which time nothing can be done to save their lives. 

Nyarango explains that fortunately, for cervical cancer and for the first time in human history, there is a vaccine that can be given to young girls.

“This is because cervical cancer is to a large extent associated with virus infection in the cervix. Therefore, vaccination can reduce the incidence of this disease appreciably.”

The First Ladies of Africa have identified three principal cancer killers among men and women.  They have now set up a foundation to facilitate women’s ability to access early diagnostic services.

The conference that will be held in Namibia will be the 8^th one on screening for cancer of the cervix, breast and prostate. 

Well-placed sources say the immediate objective of this conference is to create awareness among women of Africa and to highlight the fact that these cancers are to a large extent preventable and treatable.

In addition to creating awareness, sources say the First Ladies also want to make services accessible. Access in terms of distance and geographical access to the nearest qualified person who can diagnose remain key challenges. Cost is also a major issue. Sometimes there are cultural barriers that prevent women and men from accessing diagnostic and treatment services.

Nyarango says in some countries diagnostic services have been rolled out and people do not have to travel long distances for services or medication. An ordinary villager can go to the nearest health facility, and even if there is nobody present who can interpret symptoms, that person can take digital pictures and send them to someone who can interpret them somewhere.

Taking the point of service nearer to the household and ensuring that there are competent people dealing with these cancers so that both men and women in need of diagnostic and medical services are treated with dignity and given quality care seems the major objective of the First Ladies’ initiative which seeks to prevent more people suffering a similar fate to that of Maybe’s mother-in-law.

The presentation of scientific papers around access, prevention, treatment and on-going research will form part of the highlights of the upcoming conference.

-moses.magadza@gmail.com