Fighting the Cancer menaceThe African,Oxford Initiative

The African and Oxford Initiative on Cancer (AFROX) was, over the weekend, inaugurated in Accra, to assist African countries in a Cancer Initiative, with Ghana being the hub for the programme.

According to one of the Chairmen of AFROX, Prof. David Kerr, by 2020, more than 70% of all cancer cases would be in Sub-Saharan Africa, causing a huge health problem.

However, he noted that the best thing to do was to try and prevent this, before it happens.

Prof. Kerr noted that cancer affects everyone – the young and old, the rich and poor, men, women and children – and represents a tremendous burden on patients, families and societies.

Cancer, he said, was one of the leading causes of death in the world, particularly in developing countries.

“Deaths occur in low and middle income countries, where resources available for prevention, diagnosis and treatment of cancer, are limited or nonexistent. Yet, many of these deaths can be avoided.”

Over 40% of all cancers, he underscored, could be prevented, but he was quick to inform that by 2020, there would be more deaths from cancer in the world.

AFROX, Prof. Kerr hinted was coming up with concrete programmes, to bring employment and financial aid to Ghana.

This notwithstanding, AFROX would work with various pharmaceutical agencies, to join in their effort to fight cancer in Africa.

Prof. Kerr noted that it was the hope of AFROX, to write a Cancer Code for Africa, and help the Health Ministry build a National Cancer plan for Ghana.

The main priority of the Initiative is to help cancer prevention, mainly Hepatitis B, to prevent liver cancer, and HPV vaccine, to prevent cervical cancer, which is common in women, and also an important health problem in Ghana.

In addition to this, a former Health Secretary of England, Alan Milburn, indicated that AFROX would be working with individual countries, and would try to put each of them on a National Cancer Plan.

He stated further, that the initiative would also work to bring into the country, human resources.

Also, they would be talking to the health industry in England, to assist in curbing the cancer in Africa.

“The rate of death in cancer from a developing country is as twice more than in a developed world. However people in Europe and America, often think of cancer as a disease of affluence, but 70% of the cases of cancer would be in developing countries, and not developed world,” he indicated.

It was his hope that cancer in Africa, would be managed, and services improved dramatically in the diagnosing of cancer in Ghana in general.

Based on projections, cancer deaths will continue to rise, with an estimated 9 million people dying from cancer in 2015, and 11.4 million in 2030.

WHAT IS CANCER?

Cancer is a generic term, for a group of more than 100 diseases, which can affect any part of the body. Other terms used are malignant tumours and neo-plasms.

Cancer is a leading cause of death worldwide. From a total of 58 million deaths worldwide in 2005, cancer accounted for 7.6 million (or 13%) of all deaths.

The main types of cancer, leading to overall cancer mortality are, lung (1.3 million deaths/year); Stomach (almost 1 million deaths/year); Liver (662,000 deaths/year); Colon (655,000 deaths/year) and Breast (502,000 deaths/year).

More than 70% of all cancer deaths in 2005 occurred in low and middle-income countries. Deaths from cancer in the world, are projected to continue rising, with an estimated 9 million people dying from cancer in 2015, and 11.4 million dying in 2030.

The most frequent cancer types worldwide are:

Among men (in order of number of global deaths) lung, stomach, liver, colorectal, oesophagus and prostate.
With women (in order of number of global deaths) they are breast, lung, stomach, colorectal and cervical.

WHAT CAUSES CANCER?

Cancer occurs because of changes of the genes responsible for cell growth and repair. These changes are the result of the interaction, between genetic host factors, and external agents, which can be categorized as:

Physical carcinogens such as ultraviolet (UV), and ionizing radiation chemical carcinogens such a asbestos, and tobacco smoke biological carcinogens such as infections by virus (Hepatitis B Virus and liver cancer, Human Papilloma Virus (HPV), and cervical cancer) and bacteria (Helicobater pylori and gastric cancer), and parasites (schistosomiasis and bladder cancer), contamination of food by mycotoxins such as aflatoxins, (products of Aspergillus fungi) causing liver cancer.

The incidence of cancer rises dramatically with age, most likely due to risk accumulation, over the life course, combined with the tendency for cellular repair mechanisms, to be less effective as a person grows older.

CANCER FACTS

40% of cancer cases can be prevented (by a healthy diet, physical activity and not using tobacco. Tobacco use is the single largest preventable cause of cancer in the world. Tobacco use causes cancer of the lung, throat, mouth, pancreas, bladder, stomach, liver, kidney, and other types. Environmental tobacco smoke (passive smoking) causes lung cancer.

One-fifth of cancers worldwide, are due to chronic infections, mainly from hepatitis B viruses, HBV (causing liver), human papilloma viruses, HPV (causing cervix), Helicobacter pylori (causing stomach), schistosomes (causing bladder), the liver fluke (bile duct), and human immunodeficiency virus HIV (Kaposi sarcoma and lymphomas).

HOW CAN CANCER BE REDUCED?
The existing body of knowledge, about the causes of cancer, and about interventions to prevent and manage cancer, is extensive. Cancer control is understood as public health actions, which are aimed at translating this knowledge into practice. It includes the systematic and equitable implementation of evidence-based strategies, for cancer prevention, early detection of cancer, and management of patients with cancer.

Up to one-third of the cancer burden could be reduced by implementing cancer preventing strategies, which are aimed at reducing the exposure to cancer risk, mainly by: changes in tobacco and alcohol use, and dietary and physical activity patterns, immunization against HPV infection, the control of occupational hazards, and reducing exposure to sunlight.

Another third of the cancer burden, could be cured, if detected early, and treated adequately.
Early detection of cancer is based on the observation, that treatment is more effective when cancer is detected early. The aim is to detect the cancer when it is localized. There are two components of early detection programmes for cancer:

(1) Education to promote early diagnosis, by recognizing early signs of cancer such as: lumps, sores, persistent indigestion, persistent coughing, bleeding from the body's orifices, and the importance of seeking prompt medical attention for these symptoms.

(2) Screening is the identification, by means of tests of people with early cancer, or pre-cancer, before signs are detectable. Screening tests are available for Breast cancer (Mammography), and Cervical cancer (Cytology tests).

Treatment of cancer is aimed at curing, prolonging life, and improving quality of life of patients with cancer. Some of the most common cancer types, such as breast cancer, cervical cancer and colorectal cancer, have a high cure rate, when detected early, and treated, according to best evidence. The principal methods of treatment are surgery, radiotherapy and chemotherapy.

Fundamental for adequate treatment, is an accurate diagnosis, by means of investigations, involving imaging technology (ultrasound, endoscopy, radiography), and laboratory (pathology).

Relief from pain and other problems can be achieved in over 90% of all cancer patients, by means of palliative care. Effective strategies exist for the provision of palliative care services for cancer patients, and their families, even in low resource settings.