Hard questions no one is asking on cancer

Having watched two dear ones succumb to cancer in the last 60 days, this public health challenge just got very personal. Cancer stalks us with the aggressiveness of HIV/AIDS in the 90s. We must move beyond understanding to making deliberate health and lifestyles choices to survive.

Like all life-threatening diseases, our understanding of cancer is obscured by many myths. Is cancer contagious? Will my smart-phone or my moods place me at risk of getting cancer? Is cancer a death sentence? No is the answer. Yet, 48,000 people are diagnosed and 33,000 die of cancer annually. The disease is now the third highest killer of Kenyans, especially women.

Cancer occurs when normal cells in our bodies mutate into malignant cells and invade the body around them. While scientists are still searching how to stop cells from mutating in this way, there is no debate on what causes cancer.

Smoking, excessive alcohol drinking and poor diet cause cancer. So too, do biological drivers like obesity and exposure to environmental carcinogens like polluted air and certain viruses such as hepatitis and H-Pylori. If these are the causes, the drivers of death are poor public awareness, late detection and the high cost of treatment.

While rates are dramatically increasing in Kenya, the numbers of deaths in the US have dropped by 25 per cent since 1991. Two million lives have been saved as a result. Reducing smoking, early detection and advances in treatment have been central to keeping more Americans safe from cancer.

Detected early, most deaths caused by cancer are preventable. Whether it be breast cancer, cervical, throat or prostate, catching the tumor before it has time to overwhelm tissue and key organs is the only way to survive. The problem is, fearing high medical bills and unaware of the danger cancer poses, many Kenyans prefer to just take antacids. They only approach medical centres when fatigue, unexplained swellings and infections set in and their organs are failing.

Like elsewhere in the world, women, poorer and remote communities are most at risk. They are less likely to have health insurance, recreational facilities or time to go for regular checkups. First-line chemotherapy treatment can cost at least Sh500,000 per session. This treatment does not discriminate between good and bad cells. The body’s immunity is the first to go. For many, terrible side-effects soon follow.

Cancer poses a direct challenge to every-one of us. It also directly challenges Article 43 of the Constitution that states that every person has the right to the highest attainable standard of health.

All over the country, there are families struggling to pay the costs of expensive treatment and financial catastrophe. The question we all should be asking is how do we reduce the costs of treatment? How do we enforce anti-smoking laws and accelerate treatment for tobacco addiction? How do we bring detection testing closer to all Kenyans?

Can pap smears and other tests be available in all primary health centres? How do we improve the use of first line treatment and reduce the toxicity of chemotherapy? Is it time doctors recommended the combined use of homeopathic approaches and more controversially, the government legalised the medical use of cannabis oil?

Shujaa Jane Kiano joins a countless list of brave Kenyans who took on cancer. She died at 74. She didn’t get to realise her wish to live longer than her father who died at 78. We need to approach cancer, with this in mind. Unless we address the challenges it poses, many of us will not live as long as our parents did.

One day, with the right level of public health investment and behavioral change on the part of citizens, we will win. Cancer will stop being a death sentence. Until then, we need to protect ourselves with regular testing, health insurance and safer lifestyle habits.

- The writer is Amnesty International Executive Director. He writes in his personal capacity. Twitter: @irunguhoughton