Three years ago, I lost my mother to
what was described as renal cell carcinoma or the cancer of the
kidneys. Four years prior to her demise, she had complained of low back
pain. We got her into one of the best hospitals in the city to have
her checked.
Clinicians concluded that she had
some degenerative disease along her spinal cord. We were satisfied with
the prognosis. She was put on pain killers and was made to exercise
her back-side daily. Four years down the road, the pain was getting
worse to the extent that she could not stand.
A simple
scan revealed she had cancer but we had lost time. How could we have
missed this very simple test four years earlier? How did the experts
miss this simple test in the first place? What was the basis of their
conclusions? These were the questions that ran through my mind as we
began to fight a hopeless war on cancer.
TRIAL AND ERROR
Clinicians by nature start their investigations by trial and error. This is why most pain killer adverts warn, maumivu yakizidi muone daktari
(if the pain persists, see a doctor). I should have asked questions on
how these clinicians arrived at their initial conclusions four years
earlier.
Global Cancer facts and figures from the
International Agency for Research on Cancer (IARC), show that “there
were 12.7 million new cancer cases in 2008 worldwide, of which 5.6
million occurred in economically developed countries and 7.1 million in
economically developing countries. The corresponding estimates for total
cancer deaths in 2008 were 7.6 million (about 21,000 cancer deaths a
day), 2.8 million in economically developed countries and 4.8 million in
economically developing countries.
By 2030, the
global burden is expected to grow to 21.4 million new cancer cases and
13.2 million cancer deaths simply due to the growth and aging of the
population, as well as reductions in childhood mortality and deaths from
infectious diseases in developing countries”.
IARC
estimates that future burden could be much larger than given above due
to the adoption of western lifestyles, such as smoking, poor diet,
physical inactivity, and reproductive factors, in economically
developing countries. Cancers related to these factors, such as lung,
breast, and colorectal cancers, are increasing in economically
transitioning countries. Rates of cancers common in Western countries
will continue to rise in developing countries if preventive measures are
not widely applied.
The American Cancer Society
contends that “more than half of all cancer cases and deaths worldwide
are potentially preventable. Tobacco use, heavy use of alcohol, and
obesity can be most effectively prevented through a combination of
education and social policies that encourage healthy behaviors and
discourage unhealthy practices”.
In Kenya, cancer ranks
third as a cause of death after infectious and cardiovascular
diseases. Data availability that is key to fight against the disease is
scanty and mainly hospital based. The true burden of cancer in Kenya
is unclear. In 2005 an attempt to compile the data shows that
approximately 18,000 deaths were as a result of cancer and most of them
under the age of 70. The government in 2012 enacted a cancer law to
help ease the burden of the affected families.
CONTAMINATION OF GROUND WATER
Leading
types of cancer in Kenya among the women are cancers of the cervix and
breast while with men, cancers of prostrate, esophagus, neck and head
are more common. In children, the commonest cancers are blood cancers
(leukemia) and lymphomas. Cancers of the digestive tract such as
stomach, liver, colon and rectum are on the rise.
Although
we can deduce the causes of cancer from this write up, it is not
enough. We need more research to establish local causes and solutions.
Our academics ranging from social scientists to environmental
scientists to engineers to hard core scientists are virtually sleeping
on the job. There is simply not enough curiosity to establish the use
of Nairobi River to irrigate vegetables that end up on our dinner
table. There is no research on contamination of ground water through
over-utilization of land (mainly due to excessive subdivisions). We
simply do not attempt to look into causes of many of our problems.
There
is need for statistics on current cancer incidence, mortality, and
survival statistics and information on cancer symptoms, risk factors,
early detection, and treatment. With statistics, we can then devise
informed methods of dealing with the cancer problem. More importantly,
we must get into the culture of checkups through partnerships with
equipment suppliers spread throughout the country. This will help
create the necessary critical mass for lowering the cost significantly
for the poor to afford.
Even as we know that early
diagnosis of most cancers is key to successful treatment, most Kenyans
give priority to their vehicle checkups to their own life. Our doctors
too need a lesson. In most parts of the world, when a patient sees a
doctor, there are basic standard operating procedures commonly referred
to as SOPs. Twice as many people are dying in developing countries as
they are in developed economies. Just as we have adopted western type
of lifestyle, we must begin to closely watch our health in the same way
it is done in developed economies.
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