Let's stop the cancer march now

NAIROBI: October is officially known as the Cancer Awareness Month and around the world, activists, patients and policy makers are in deep reflection, determined to turn the tide on cancer, a scourge that terrifies kings and peasants alike.

It is gratifying that Kenyans are increasingly conscious about cancer, thanks to a convergence of factors including self-disclosure by celebrities, increased media attention and advocacy efforts by First Lady Margaret Kenyatta.

We have a well-articulated National Cancer Strategy, a strong political commitment and all is looking up for cancer control in Kenya. In 2010, deaths from non-communicable diseases including cancer accounted for two of every three deaths (34·5 million) worldwide. Eight million people died from cancer in 2010, a third more than two decades ago.

Here in Kenya, we are witnessing a groundswell of a cancer epidemic potentially driven by increased alcohol use, air pollution, low consumption of fruits and vegetables and unsafe sex.

Compared to HIV/Aids and childhood illnesses, cancer may not be a huge killer at the moment, but will certainly become the predominant public health pre-occupation in a few years to come. The time to nip it in the bud, therefore, is now! After all, cancer prevention is the most desirable public health goal.

However, we have to do it right. First, we need to 'democratise' cancer medicine.

We have 14 cancer specialists in the country and as laughable as might be, we should not be tempted to imagine that training hundreds of oncologists will solve the cancer question. We need to shift cancer diagnosis and management from the few PhD level specialists to general practitioners and nurses.

We did this with HIV, an equally complex disease and now close to a million Kenyans are on lifelong treatment. Nurses are true public health warriors and would be indispensable in the education of the public, detection of cancer, monitoring of cancer treatment and administration of palliative care in all the corners of our republic.

Second, cancer screening and diagnosis require an overhaul. At present, most countries including Kenya rely on CT scans and magnetic resonance imaging (MRI), which are capital and labour-intensive methods. It could cost upwards of Sh10 billion to equip all 47 counties with MRI machines, money that could potentially screen 10 million women for cervical cancer, provide one year's worth of life-saving medication for 1 million patients with HIV or drill 6,000 water boreholes. Cheaper but novel methods are required.

The successes achieved in malaria and HIV/Aids control resulted in part due to easy diagnosis based on a finger prick sample of blood. Although we have limited options for cancer diagnosis, the global community should invest in massive research for efficient technologies. Blood tests for prostate, ovarian and liver cancers are still controversial, but their application should be prioritized.

It is saddening though that research towards a cancer cure is not in tandem with explosion of innovations in information technology. Yet a cure is the noblest of human aspirations. We should not spare any penny in search for a cure.

The current excitement around the potential use of a malaria protein to kill cancer cells attests to the possibility of a cure if researchers are determined and are well funded. African governments should pull all diplomatic strings at the highest levels to ensure that we have a cure within a decade.

Cancer is not a single disease, but a collection of close to 150 different afflictions and that range from mild, curable conditions to aggressive tumours that are difficult to treat.
Cancer accounts for approximately 30,000 annual deaths in Kenya, half of which are preventable. The commonest cancers in Kenya affect the breast, cervix, food pipe, colon, lung and prostate. These could potentially be fueled by high body mass index, alcohol and tobacco use, unsafe sex, air pollution and low consumption of fruits and vegetables.
Scientists foresee a cure of certain cancers within the next decade. A cure would be one of the greatest triumphs for humanity in recent history.