Cancer diagnosis is death sentence in today’s Africa

Cancer is a public health problem world-wide, affecting all categories of persons and nearly all growing tissues of the body. It is the second common cause of death in developed countries. The diagnosis of breast cancer, or any cancer whatsoever, should really not be a death sentence anywhere in the world, as there are proven ways to prevent and cure many cancers. 

Sadly, this is not true of Africa. The diagnosis of cancer in today’s Africa is tantamount to a death sentence for the majority of Africans!  There is probably no one reading this article who is not acquainted with the lingering and painful challenges of cancer or has not been deeply touched by the loss of a loved one to cancer.  

A few years ago, there was an alarm by the World Health Organisation (WHO) on the rising global incidence of cancer, especially as it affected developing countries mostly African countries. About 150,000 cancer deaths are recorded annually in Africa but the true figure is probably about 300,000 (African based Medical Research Network). The wide discrepancy is due to under-reporting. 
About 4,000,000 new cases develop yearly but just about 2000,000 are recorded, because most of them die without any diagnosis, the slogan, “The wicked have done their worst,” was at a time, a common feature in obituaries following such undiagnosed deaths. 
It was projected that malignancies will increase by 23 per cent in Africa (as opposed to 9 per cent in developed countries). The bulk of the cancers arising from infections are expectedly related to human immuno-deficiency viruses (HIV), human papilloma viruses (HPV) and hepatitis B (HBV), hepatitis C (HCV) and aflatoxin. Recent advances in the care of HIV will not diminish the health concerns associated malignancies in survivors! 
In real numbers, with the projected population of 900million, we should expect about 5,000,000 new cases per annum by the year 2020. This is just a couple of years away and it is, therefore, worrisome that there are no visible plans to prevent the disease or provide treatment and care for patients. 
The following stories are real but have been modified to protect the identity of the patients and the caregivers who probably gave their best with the available resources. They are recounted, not to frighten you but to highlight the plight of cancer patients and prepare you for the shock if and when you or someone close to you become a sufferer. 
However, if you respond positively to the call at the end of this article, the shock may be averted.      
Mr. A. B. visited in a Teaching Hospital near him, complaining of difficulty with swallowing for about two weeks. Preliminary investigations, albeit limited in scope because of lack of appropriate instruments, after three weeks in agony, could not determine the cause. He had to be fed through a tube passed into his stomach through his nose. 
One day, he suddenly could not breathe and a life-saving hole (tracheostomy) had to be made into his windpipe to pass oxygen into his lungs. During the procedure, a tumour was found blocking his airway. To find out the type of growth, a specimen was sent to a pathology for histology. 
Ordinarily, in developed countries, the result would come within a few days. Relatives were asked to come back for the report in three months. Sadly, Mr. A. B. died about two months later without the report, which should form the basis of his treatment. 

Mrs P. Z had been very finicky about her health. She regularly had annual medical check-up.  Last year, during her medical examination, a lump was found in one of her breasts. A specimen of the breast was promptly removed and sent for histology. Histology confirmed cancer of the breast. She had read about the beautiful work the great daughter of Nigeria, Olufunmilayo Olopade and her colleagues were doing in faraway USA on precision treatment for breast cancer.

Herceptin, she had read, is an effective treatment both before and after surgery for people with HER2-positive breast cancer. She had to know her Herceptin status. She persuaded her physician to send a sample for analysis. After three months waiting for the result, with recurrence staring her in the face, she was advised to commence chemotherapy. 
Now she has completed the course of treatment and was supposed to follow with radiotherapy. Unfortunately, of the seven centers offering radiotherapy in the entire country, only one is functional and the cost is not within her reach. Now in a telephone conversation, she said ruefully, “I have metastasis all over. I am just waiting to die.”  
While writing this article, I was interrupted by a patient who related her experience in India where she had taken her husband for cancer treatment. They had encountered many Africans who had come for similar treatment, many of them too late. Now the question is what will you do IF and WHEN it is your turn?
A proverb says, what is happening to your friends and family is a veiled warning of what can happen to you.


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