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Cancer, the untold story

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Michelle Madzudzo

CANCER is going unnoticed and affects hundreds, and unless the government, the corporate world and everyone else come together to act soon, thousands will pay the price.

While it may not be the latest outbreak of a novel or exotic disease attracting global attention like COVID-19 at the moment, it is worth remembering and should get the priority it deserves.

It has been suggested that by 2030 in Africa there will be a 70% increase in cancer cases due to population growth and aging.

Cancer is an emerging health problem in Zimbabwe  that needs to be addressed appropriately in order to control increased incidence and mortality rates.

In Zimbabwe cancer has co-existed with more recently discovered communicable diseases such as malaria, Ebola, Aids and COVID-19.

Even though the cancer death rate has surpassed those of Aids, tuberculosis, and malaria combined, there remains a lack of commitment to fight cancer in Zimbabwe.

Indeed, most attention goes to communicable diseases while disregarding the challenge posed by this non-communicable disease.

Despite rising mortality rates, cancer has been accorded low priority in the research field and in healthcare services.

Cancer  cases continue to be exacerbated by lack of awareness, preventive strategies, and increased life expectancy.

Additionally, due to the cost of care and the absence of facilities, the cancer mortality rate is rising and this is going unnoticed.

The country generally suffers from a shortage of medical equipment, research resources and epidemiological expertise.

In a resource-constrained country like Zimbabwe, the most cost-effective way to reduce the burden of cancer is to strengthen preventive efforts. Cancer prevention is more efficient, more effective and less expensive.

Recognising cancer-risk factors  helps to identify specific preventive and therapeutic options in Zimbabwe.

It is important to note that  while cancer-risk factors increase chances of getting cancer, they do not cause cancer at all times.

Simply put, a carcinogen does not always cause cancer in every person.

Some may be carcinogenic if a person is exposed in a certain way.

Some may only cause cancer in people who have a certain genetic make up.

Some lead to cancer after only a small exposure.

Others require intense exposure over many year.

So what is really the story behind cancer and what are the major cancer-risk factors in Zimbabwe?

Age

As you grow older, your chances of getting cancer increase because of the aging process. For example, prostate cancer is more prevalent in elderly men.

Infection

While cancer itself is not infectious, there are a number of infections that either directly cause or increase the risk of cancer. Major cancer-causing infection agents in Zimbabwe are:

Human papiloma virus: Main causative agent for cervical cancer which is transmitted through oral, anal and vaginal sex, the virus also causes cancer of the private parts and base of the tongue.

  • Hepatitis B and C: Chronic infection with hepatitis B or C is the main risk-factor in cancer of the liver.
  •  Parasitic infections: Patients, who are chronically infected with schistosomiasis, a bacteria which causes bilharzia, are at risk of developing bladder cancer.
  •  Bacterial infections: Infection of  the stomach lining by a bacterium helicobacter pylori known to cause peptic ulcer disease and gastritis can also cause stomach cancer.

HIV

The fact is HIV does not cause cancer, but it weakens your immune system, making your body more prone to cancer. Most common cancers in HIV-positive people are cervical cancer, non-hodgkins lymphoma and Kaposi sarcoma.

Diet

Eating patterns in developing countries are shifting towards the Western lifestyles especially in urban areas. Most Zimbabweans are now consuming foods rich in animal fat and protein, energy dense snack food, carbonated sweetened beverages and alcoholic beverages which increase cancer risk.

Tobacco

Tobacco smoke contains approximately 4 000 chemical substances of which 438 can cause cancer. The use of tobacco increases the risk of many cancers including  the lung, oral cavity, larynx, oesophagus, pancreas, kidney and bladder.

Radiation

Exposure to E-rays, gamma rays and radon increase cancer risk. Ultraviolet radiation which comes from natural sunlight, sunlamps and other sources can lead to skin cancers.

Alcohol

Not everyone who drinks develops cancer but some cancers are more common in people who drink. Heavy consumption of alcohol increases the risk of the following cancers, oral cavity, larynx, pharynx, oesophagus, liver, colon, pancreas, stomach and breast cancer.

Occupational exposure

People who work in industries where they deal with asbestos, mecury, benzene, tar, agricultural chemicals, wood dust and other chemicals, are at risk of some types of cancers.

 

Genetics

Some cancers run in certain families but only a small portion about 5 to 10% are due to an inherited condition. The most common are breast, ovarian and colon. The remaining 90-95% of cancers are caused by mutations that happen during a person’s lifetime as a natural result of aging and exposure to environmental factors such as tobacco smoke and radiation. Other factors which influence risk are alcohol, viruses, oral contraceptives and diet.

There is need to implement more accurate preventive strategies to tackle this disease as many cases are preventable. Opportunities exist for vaccination programmes for cervical and liver cancer, genetic testing and use of new targeted therapies for breast and prostate cancer, and positive changes in lifestyle like limiting alcohol, quitting smoking, maintaining a healthy weight and eating a balanced diet. Ideally, people should practise healthy habits consistently from an early age, carry them into adulthood and inculcate them in their children.

Making a large proportion of a population aware of the risks of cancer is a more realistic goal.

However, there is still need to go beyond focusing on individual behaviour towards a wide range of socio-economic and environmental interventions to address the root causes which will probably go a long way in strengthening cancer preventive efforts. These include poverty, lack of education, unemployment, gender issues, limited access to clean water, healthcare and food.

I call upon policy-makers, the corporate world, health professionals and citizens to  work together in the fight against cancer. Let’s keep talking about cancer. Let us give it the priority it deserves, it cannot remain the untold story in Zimbabwe.

  •  Michelle C Madzudzo is a radiation therapist and Talk Cancer Zim founder and president

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