Chronic illnesses have been on the rise in the world, with the most fatal ones being cancer, diabetes and various heart diseases. It is expected that the annual cancer cases will rise from 14 million in 2012 to 22 million in the world thin the next two decades.
According to a World Health Organization (WHO) report, more than 60 per cent of the world’s total new annual cases of chronic illnesses occur in Africa, Asia and Central and South America. These regions account for 70 per cent of the world’s cancer deaths.
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body; however not all tumors are cancerous since benign tumors do not spread to other parts of the body.
Possible signs and symptoms include a lump, abnormal bleeding, prolonged cough, unexplained weight loss and a change in bowel movements.
Kenya like many other African Countries has not been spared the challenges of these chronic diseases with cancer being the third highest cause of mortality in Kenya, accounting for approximately seven per cent of deaths per year, after infectious diseases and cardiovascular diseases.
According to a report on the Ministry of Health website on cancer, there are approximately 39,000 new cases of cancer in Kenya each year with more than 27,000 deaths being reported each year. About 60 per cent of the Kenyans affected by cancer are less than 70 years old.
In Kenya between 2010 and 2015, the rate of people dying from cancer increased from about 31 deaths per 100,000 people to 33 deaths per 100,000 people and daily cancer deaths have been increasing steadily since 2012.
Cancer deaths also increased steadily over the five years from 11,995 in 2010 to 14 175 in 2015, representing an increase of 18 per cent in five years.
An Oncologist Dr. Samuel Charo based at Narok referral Hospital Cancer Unit says perhaps the current data which show increase in cancer cases is due to better diagnostic equipment and facilities available in our hospitals today, leading to more cases being diagnosed.
Leading cancers in Kenya for women include lung, colorectal, breast and cervical cancer which the last two being the most common, affecting 34,000 and 25,000 women, respectively. Men on the other hand are mainly victims of lung, stomach, colorectal, prostate and esophageal cancers that affect 17,000 and 9,000 men respectively.
The Demographic Health Survey (KDHS 2008-15) indicated that Childhood cancer accounted for 15 per of cancer admissions at Kenyatta National Referral Hospital between 2008 and 2015.
One in 10 children survives cancer in Kenya compared to seven in 10 in the developed countries. If skin cancer other than melanoma were included in the total new cancer cases each year would account for 40 per cent cases.
The leading type of cancer, Hodgkin Lymphom, however is not common in Africa. In 2012, about 165,000 children under 15 years of age were diagnosed with cancer in Kenya.
Medics say cancer can be caused by tobacco which contributes to 22 per cent of cancer deaths, while 10 per cent can be caused by obesity, poor diet and lack of physical activity and drinking of alcohol. Exposure to ionizing radiation and environmental pollutants has also been found to cause cancer to some extent. But some cancers such as acute lymphoblastic leukemia can be genetic.
Cancer patients face numerous challenges which include lack of treatment and cancer facilities, lack of awareness, inadequate diagnostic facilities, high cost of treatments which and mostly high poverty index.
Meet 20-year-old Peter Koikai, an orphan who hails from Majengo slums in Narok town. Peter was diagnosed with liver cancer in 2014 when he was preparing for his Kenya Certificate of Secondary Education (KCSE).
Betty Koikai, his aunt and guardian says they mobilised well-wishers who managed to raise Sh.2.7Million for his treatment in India. This helped to improve his health to improve to the extent that he was able to do his exams, albeit with difficulty in preparations and obtained an aggregate of B-(Minus).
His desire is to get well and study medicine and help save cancer patients in future. But Peter is not out of the woods yet as he is required to go back to India for a bone-marrow transplant which is expected to cost a whooping Sh.3.2million and this is minus the cost of drugs and transport expenses among others.
The family is now calling on well-wishers to come out and assist him raise this amount in order to save his life. Betty says currently, Peter requires over Sh.100, 000 every month for his drugs and chemotherapy treatment.
Peter and his aunt are now calling upon the government to invest more in cancer treatment by coming up with a properly equipped cancer hospital, saying this will help cancer patient access better, faster and cheaper treatment instead of travelling abroad.
“In India, Peter was attended to faster and at a cheaper cost and cancer machines and equipment there are a state of the art thus helps in detecting even the slightest cancer sign in the body and patients are able to start treatment early which saves lives,” Betty says.
Oncologist Dr. Charo concurs saying there are only two cancer treatment centres in Kenya at Kenyatta National Hospital and Moi Referral Hospital in Eldoret and these are ill-equipped and are not adequate to handle all cancer patients in the country.
“You will find that a patient is booked for treatment so many months after diagnosis and this is what is killing cancer patients because the longer a patient stays without treatment, the more the disease spreads and becomes difficult to manage,” he says.
Dr. Charo says the number of oncologists in the country is also very low compared to the number of patients they are supposed to attend to and most of them are concentrated in Nairobi and Eldoret, hence the need to train more doctors.
According to Dr. Charo the risks of cancer increases significantly with age and many cancers occur more commonly in developed countries. Rates are increasing as more people live to an old age and risks of cancer increase as lifestyle changes occur in the developing world.
“It seems to me that breast cancer in Kenya and the rest of Africa is not getting the recognition it deserves, the level of breast cancer awareness in Kenya is low,” says Dr. Charo.
He adds that according to the Kenya cancer survey, four in five cases of cancer are diagnosed in the late stages of the disease. Review of the health data shows that the rate of death from cancer in Kenya is far outpacing population growth and may double in the next 11 years.
“The data also shows that cancer is now the third leading cause of death in Kenya and is threatening to move further up the list of top killers in the coming decade. Cancer, like diabetes and heart diseases is a non-communicable disease, which means it cannot be spread from one person to another,” adds Dr. Charo.
Cancer can be prevented by not smoking, maintaining a healthy weight, not drinking too much alcohol, eating plenty of vegetables, fruit and whole grains, vaccination against certain infectious diseases such as human papillomavirus (HPV) which causes cervical cancer, not eating too much processed food and red meat and actually avoiding too much sunlight exposure.
Early detection through screening is useful for cervical and colorectal cancer; the benefits of screening breast cancer are controversial. Cancer is often treated with some combination of radiation therapy; surgery, chemotherapy and targeted therapy, pain and symptom management are an important part of care.
Even with late stage of cancer, the suffering of patients can be relieved with good palliative care. There are several hospices in the country that have been helping to give this palliative care to the patients who are in last stages of cancer.
However, it’s not all gloom as the country is set to construct the first ever state of the art cancer treatment centre after President Uhuru Kenyatta recently signed an agreement with the Indian government for the same. This is a very welcome move as it will go a long way in early treatment and diagnosis of cancer thus saving lives.