Prevention is better than cure

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Annie puts on a surgical mask which prevents her contracting Ebola through bodily fluids

Michelle C Madzudzo
WEAR a mask, sanitise your hands, practise social distancing is the message across the globe to prevent us from contracting COVID-19 infection, simply because prevention is better than cure.

February is national cancer prevention awareness month, and just being aware is not enough. We need to take action. Putting what we know about prevention into action may also have a positive effect on the cost of cancer care. Cancer prevention and early detection are now more important than ever.

A diagnosis of cancer is devastating for anyone, but in many high-income countries, people receiving such news can be reassured that they will be treated and hopefully  be cured. Good for them!

What about millions of people who live in developing countries where access to specialised treatment and medical care are limited and the health system is weak.

According to the International Atomic Energy Agency, for every 500 000 to 1 000 000 of the population there should be about one to two linear accelerators (radiotherapy treatment machines used to treat cancer patients) servicing the whole population.

In Zimbabwe, we need 14 to 28 linear accelerators but at the moment the country has six linear accelerators which may not all be functional at any given time. It only makes sense that in order to reduce the burden of cancer in a resource-constrained country like Zimbabwe there is need to strengthen preventive efforts through cancer awareness, awareness and awareness !

The practice of medicine is overwhelmingly reactive rather than proactive. People get cancer, seek medical help and how expensive that model is. Medical professionals are trained to treat diseases and not to prevent diseases.

I am confident I’m fully trained to deliver radiotherapy treatment to cancer patients, which is an important component of cancer control programmes in my country, but I also like thinking out of the box taking into cognisance the current situation in my country which has been stretched for decades now.

I believe in the old maxim: Prevention is better than cure, while most clinicians would rather wait for people to come to the hospital as patients. As a radiation therapist dealing with cancer patients, who show up late to get my services, it only makes sense for me to go outside the hospital walls and meet people before they become patients or when they are already patients but need some sensitisation so that they make informed decisions. In cases where prevention is not possible, awareness raising leads to early detection and treatment. This personal mission of raising awareness in the community was my motivation for setting up the Talk Cancer Zim Trust.

Of course, there have been many advances in treatment of cancer which have led to some wondrous cures, but advances alone will never be enough to stem the burden of cancer.  As every public health professional knows, at a population level, the only way to substantially reduce incidence and mortality for any disease is through prevention, and on a broad scale we have made far less progress in preventing cancer than preventing its predecessor scourges, we tamed infections with sanitation and vaccines, abetted by antibiotics.

Cancer is a different story, even today it continues to occupy our collective imagination as the king of terrors: The most dreaded disease, a bogeyman.

Cancer must be viewed not just as a curable disease but equally a preventable one. We will always need good treatment but we can’t treat our way out of this problem. In order to make a dent in a public health sense, we must prevent cancer.

The reasoning in cancer prevention through awareness is similar to why you change oil in your car rather than wait for the engine to have a knock. Cancer treatment is very costly  and resources are limited.

We must ask ourselves

Is it reasonable to buy fruits and vegetables as part of our daily diet rather than buy chemotherapy medication for colon cancer.

Is it better to treat lung cancer than to quit smoking?

Does it make sense to vaccinate young girls against human papilloma virus rather than treat cervical cancer later in life?

I guess you all agree with me, the answer is it better to prevent disease by any means possible rather than cure or treat it. In cases where prevention is not possible, early detection and treatment saves lives!

According to WHO, 30% of cancers are preventable. Although there is no sure way to prevent cancer, you can reduce risk by doing the following:

  • Stopping smoking
  • Reducing alcohol intake
  • Practising safe sexual habits
  • Avoiding overexposure to the sun
  • Limiting dairy foods, sugar and salt intake
  • Eating a high fibre diet rich in fruits and vegetables
  • Avoid additives such as nitrites, preservatives and colourant’s
  • Prevent irritants at work such as dust, tar, wood, agricultural chemicals
  • Having regular medical checks leads to early detection.

However, there are environmental, social and economic realities that make it difficult to adopt simpler ways that can help us to prevent cancer.

People can’t do this alone, government needs to put in place health promotion policies which support cancer prevention. If they are there already, then implementation is very crucial at this moment.

There is still need to go beyond focusing on individual behaviour towards a wide range of social, 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, health and food.

Let’s all work together in the fight against cancer. Each of us has a role to play in the fight against this dreaded disease,the government, policy-makers, corporate world, health professionals and the nation at large. There is need for us as a nation to work in sync with each others throughout the cancer care continuum from cancer awareness, diagnosis, early detection, treatment, palliative care and cancer surveillance. Together we can fight cancer, prevention is better than cure!