It Is A Cancer: You Are Dying!

First of all, let me start by apologizing to the forum for responding to Engr. Auwal Sani Auwal’s invitation to contribute some few words on “Synopsis Feedback Series”. I was actually at a loss on what I should write until something akin to what happened to Archimedes suddenly also happened to me. Eureka! I stumbled on this article which I wrote last year as part of my contribution to celebrate or rather more aptly to agonize ‘World Cancer Day’ which habitually comes up on every 4^th February. Now that we are set to witness another 4^th February, I just felt that I should update both the content and the title to open another window for discussion.

It Is A Cancer: You Are Dying!

The word cancer is a dreaded name that sends jitters down the spine of the bravest you could imagine. In actual sense it is not one disease but a group of heterogeneous disorders that share common characteristic of uncontrolled proliferation of abnormal cells. It can affect any part or organ of the body, and the nomenclature of each particular type of cancer is thus derived based on so many factors, according to the International Classification for Diseases in Oncology.

I will attempt to debunk some of the few myths about this disease which formed the flesh of last year’s theme of ‘World Cancer Day’. In the first place it is a myth that cancer is all about health. Yes, it has a lot to do with health, but cancer is much more than just a health. It has both social and economic implications on the growth and development of any nation. It has been strongly established as both a cause and outcome of poverty. Of the global cancer burden, the under-developed countries account for 47%. This is expected to increase in manifold by 2030 to about 81%. The scary part is that the same developing countries take lion share of 55% cancer death globally. It is a double jeopardy considering that almost all of these countries are still being ravaged by communicable diseases like HIV/AIDS, Tuberculosis and Cholera, coupled with unusual epidemiologic transition of rising cases of non-communicable diseases like cardiovascular disorders and metabolic disorders.

By 2030 the cost of cancer care is estimated to rise up to $458 billion dollars per year, which is in sharp contrast with only $2 billion required for preventive measures. Can developing countries afford this exorbitant care with their already precarious economy as evidenced by poor health/developmental indices? The answer is not too difficult to imagine. In my four years of practice in the specialty of haemato-oncology, I can safely conclude that about 90% of the cancer patients which we have managed failed to afford full course of treatment. It was really frustrating that even the few philanthropists that we usually fall back on to support this category of indigent patients have developed donor fatigue. At a point we wanted to co-opt Nigerian celebrities to lead the cause for these patients just like their counterparts in Hollywood have been doing by organizing concerts to raise funds and awareness to fight this dreadful disease. However, it did not work as we thought it would. I will leave the details of how we failed in some of our attempts to make healthcare free to this category of patients for another day. Some of the problems are actually structurally built in the Nigerian system of rent seeking economy which is apparently deficient in several perspectives.

Another myth is the prevailing belief that cancer is only a disease of the wealthy people, elderly and mainly seen in the developed countries. This is perhaps one of the biggest fallacies that need to be rebuked, because it has been shown that up to 50% of the cancer cases are seen in the age group less than 65 years. The productivity of any nation depends largely on the population of its young and agile citizens. And cancer is the leading cause of mortality in the age group 5-14 years. This is in addition to the man-hour loss, school dropout rate, and so many other challenges posed by the disease that can impede on growth and development of any given nation.

Perhaps the name cancer is even synonymous with death sentence in some quarters. This is also far from the truth as it is just a myth. Modern screening and diagnostic tools have made it possible to pick up cancers early and treat them with precision. In America alone there are 12 million people living with cancers, and available records have shown that cancer death rates have reduced by 20% from its peak in 1991, by 2009. This is by no means a small feat. Simple and reliable tests like Pap smear, and radiological investigations like Mammography have succeeded in saving the lives of many women with cervical and breast cancers; which account for the death of 750, 000 women worldwide every year. In addition to this, several antibody panels, tumor markers and diagnostic tools like PET scan/MRI are playing great role in early diagnosis and even in guiding treatment of cancers. Perhaps if there would be more commitment and concerted global efforts to support this fight against cancers, these deaths would drastically drop to a tolerable level in the near future.

The last but not the least of these myths is what has been observed to be an unwritten consensus that cancer is just a fate. No, far from that! Cancer may have its mysteries and idiosyncrasies but it is substantially preventable by taking a holistic approach towards conquering it. Simple life style modification like avoiding tobacco smoking and alcohol consumption can reduce the likelihood of cancer significantly. Tobacco smoking alone is associated with Lung cancer deaths by 71% and 22% of all cancer deaths are related to smoking habit. Other measures to curb cancer, include among others, the universal vaccination program against chronic infections (Hepatitis B and C, Human Papilloma Virus, Epstein Bar Virus, Helicobacter pylori etcetera, which are estimated to cause almost 23% of cancers in developing countries), improved diagnostic capacity, adequate training of medical staff, and universal access to free medications/therapy/care. These should go in tandem with high investment in human capital development with priority to education, research and job creation, to have better informed societies.  It is high time we put heads together to tackle these challenges of cancer care. The world can’t afford to fold its arm and lose its future Steve Jobs to the myths of cancers. Let us fight this stereotype!