I grew up in the little village where sugar was a scarce commodity. Mom always knew a quarter kilo should last us – a family of seven – two weeks. I loved sugar, and I licked it with abandon. And so, whenever I was sent to buy sugar, and came with a hole in the packaging –I used this to siphon some sugar as I went home – my mom would ensure I received a few canes befitting the crime of eating sugar. She practiced the spare the rod spoil the child rule as an art. But for me, this was a small price to pay compared to the sweetness of sugar. So our sugar fights were regular.
Until I was about 7 years old and by that time I was getting tired of sugar fights; and so one evening I asked mom why most of our fights always started with and ended with sugar! See, she had an explanation for it…
“Njeri, money does not grow on trees. When you eat sugar, you are increasing my budget, because we have to buy more sugar than I had planned for the week, but also, you cough a lot at night when you eat sugar, and I have to take you to hospital, this also costs me money”. And she added as an afterthought. “Do you like always being sick?”
Oh no, I did not like being sick, because in the village, there was this thing with doctors, that if you are not given 5 injections, you will not get better. So I had had my fair share of injections. And that, ladies and gentlemen, was the beginning of a very calm and sugar fight free household. Because now I knew how to avoid injections.
Moral of the story, you cannot beat what you don’t understand.
Without her knowledge, my mom had very easily made sure that I changed the behaviour that was not “desirable” in her house. Eating sugar for me meant injections, and I now knew the pain of an injection was not worth a few licks of sugar. The ending of our sugar fights was just a bonus.
For us to beat cancer, we need to make it as easy to understand as the sugar story to a seven year old. So let us talk about cancer, signs, symptoms and risk factors.
What we find however on the public domain is the assumption that cancer is one disease. Which is often viewed with fear, stigma, trepidation and a hopelessness that we can’t do much.
With over 100 different types of cancers, it is critical that we segment cancer into the various types, and look at a realistic way of dealing with the common ones, so that we can impact on the public health agenda of beating cancer through preventing what is preventable, curing what is curable and effectively managing what can be managed.
In Kenya, Cervical Cancer has overtaken breast cancer and now leads with over 4,800 women diagnosed annually, and over 2,500 dying yearly from the disease. In men, the leading type of cancer in Kenya is Prostate Cancer. Followed by Oesophageal cancer [https://kenyacancernetwork.wordpress.com/kenya-cancer-facts/ ]. For both Men and Women, incidence and mortality by Cancer of the Colon and Rectum, also known as Colorectal Cancer, is high. These five cancers [Cervical, Breast, Prostate, Oesophageal and Colorectal] are either preventable, or can be beaten if discovered early. So it is true to say that majority of our people are dying for lack of knowledge.
To bridge this gap, below are a few things you need to know about cancer, and a few things we can do to beat it.
Cancer develops when we have abnormal cell growth which causes lumps or tumours, but not all tumours are cancerous. There are known common cancer risk factors (attributes, characteristics or exposures of an individual) that increases the likelihood of developing the disease.
Some common risk factors are lifestyle choices such as tobacco and alcohol use, obesity, poor diet or bad eating habits and lack of physical activity. Other known risk factors include certain infections such as hepatitis B, hepatitis C and human papillomavirus (HPV), exposure to ionizing radiation and environmental pollutants.
All these risk factors act, at least partly, by changing the genetic composition of a cell. Often, many genetic changes are required before cancer develops, even though some cancers are due to inherited genetic defects from a person’s parents.
Advancing age is also an important risk factor for cancer probably because as we age, we are exposed to more cancer causing risk factors, and also the ability of the body to fight off some of the pollutants and genetic changes in our bodies is reduced.
Many cancers can be prevented through a modification of our lifestyles, by not smoking, maintaining a healthy weight, not drinking excessive alcohol, eating plenty of vegetables, fruits and whole grains, vaccination against certain infectious diseases, not eating too much processed and red meat, avoiding risky sexual behaviour and avoiding too much sunlight exposure.
Some common signs and symptoms for majority of cancers include the presence of a lump, abnormal bleeding, prolonged coughing, unexplained weight loss, frequent bloating and a change in bowel movements. While these symptoms may indicate cancer, they could also be causes for other diseases.
Way before we go screening for cancer in a health care setting, awareness of what is normal in your body is your first mechanism in beating cancer; because, if one notices any of the above common signs and symptoms, and takes action early, then we could easily have these signs and symptoms dealt with early, we can stop majority of the invasive cancers from developing through medical interventions.
There are proven tests and methods for screening for early detection which is useful in preventing cancers from becoming invasive or spreading to other body parts, if done in good time. For example, by giving access to screening for early detection using pap smears, and easy access to treatment for all their women past the age of 21 years, some European countries have reduced the incidence of cervical cancer to less than 5 per every 100,000 women. In east Africa, our age standardised rate is 41.5 per 100,000 women. The highest in the world.
The benefits of early detection are numerous, cost of treatment is reduced, chances of recovery are improved, and overall wellbeing is ascertained.
Majority of people in communities do not know that some cancers can be prevented, and often, a cancer diagnosis is taken with trepidation, because many people assume it will lead to death. Now that you know, talk about it to ease the pain caused by late diagnosis of cancer.
In our next week column, we will dig deeper into cancer screening for treatment, access to treatment and the various available therapies, and explore technology and modern day best practice in treating cancer. We will also highlight what is available in Kenya or aboard, to broaden our choices and options.
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Ms. Benda N. Kithaka is a Co-Founder and Board Chair of Women 4 Cancer Early Detection and Treatment. A Kenyan NGO helping Kenyans beat cancer sooner. Read more about is on www.women4cancer.org