Health - An anonymous cancer patient in Brazzaville, Congo, once declared during a treatment session: “Given the fact that people know so little about cancer, we should be talking about this disease all the time, all year round, and not just in February.”
He was referring to the urgent need to continually raise awareness of cancer and how to prevent, detect or treat the disease, beyond the annual observance of the World Cancer Day on 4 Feb. every year.
Incidentally, the theme of this year's World Cancer Day this year - “Cancer – Did you know?” focusing on Target 5 of the World Cancer Declaration: “Dispel damaging myths and misconceptions about cancer,” provided a justification and an opportunity for all to undertake year-round cancer awareness-raising activities in the World Health Organisation (WHO) African Region.
According to the WHO, there is growing evidence that the African Region is facing a major public health challenge due to the rising burden of cancer. It is projected, for example, that by 2030, Africa will bear some 1.6 million new cancer cases, with 1.2 million deaths. The most common cancers in the Region are cancers of the cervix, breast, liver, prostate, Kaposi's sarcoma and non-Hodgkin's lymphoma.
To create the necessary awareness about the disease, it is necessary first to understand it. Cancer is a disease that occurs when abnormal cells within any part of the human body continuously grow out of control. The chances of developing most cancers are related to modifiable risk factors such as tobacco use, unhealthy diet, and harmful use of alcohol, physical inactivity, overweight and some chronic infections. It is therefore advisable to live a healthy lifestyle to prevent the onset of the disease.
Unfortunately, there are lots of myths and misconceptions about cancer and it is important for people to know the truth so they can better protect themselves. This is because myths, misconceptions and scientifically unsubstantiated claims about cancer and its risk factors in the African Region can lead to gross misinformation which can hurt rather than help efforts by individuals, families and communities to prevent, detect or effectively treat the disease.
Cancer is not caused by an injury, such as a bump or a bruise, either is it contagious. Although infections by certain viruses or bacteria increase the risk of some types of cancer, no one can get cancer from another person.
Many people in the Region do not know that they have cancer until it is at advanced stages due to the lack of awareness and the weakness of early diagnostic capacities in our countries. Evidence generated through research tells us that about 40% of all cancer deaths can be prevented if diagnosed early. Indeed a vast majority of patients survive the disease because of early diagnosis and available advanced treatment methods.
It is therefore important to provide people in the African Region with correct, evidence-based information to enable them make informed decisions which help to keep cancer at bay.
According to Dr Boureima H. Sambo, Head of the Non-Communicable Diseases Programme Area of the WHO Regional Office for Africa, tobacco use is responsible for 1.8 million cancer deaths per year (60% of these deaths occur in low- and middle-income countries); while being overweight, obese or physically inactive together are responsible for 274,000 cancer deaths per year).
Also, harmful alcohol use is responsible for 351,000 cancer deaths per year; chronic infections from hepatitis B, hepatitis C virus and some types of Human Papilloma Virus (responsible for 235,000 cancer deaths per year); exposure to occupational or environmental carcinogens or cancer-causing agents - responsible for at least 152,000 cancer deaths per year, and exposure to ultraviolet radiation.
By WHO’s current estimates, about 40% of cancer deaths are due to the above-listed five leading behavioural and dietary risks which can be summarised as tobacco use, harmful use of alcohol, low fruit and vegetable intake, lack of physical activity and high body mass index or being overweight or obese.
Referring to the most cost-effective and sustainable way of reducing Africa’s cancer burden, Dr. Jean-Marie Dangou, the Regional adviser for cancer control, stresses “Prevention, Prevention, Prevention!'
WHO recommends that cancers can be reduced and controlled by implementing evidence-based interventions and strategies for cancer prevention, early detection and management. Many cancers have a high chance of cure if detected early and treated adequately. Indeed, scientific knowledge, gathered over many decades, indicates that at least one-third of all cancer cases can be prevented. Likewise, reducing alcohol intake or abstaining from alcohol can decrease the risk of developing liver and digestive cancers.
Also recommended by WHO are healthy diets, particularly diets high in fruits and vegetables as these have a protective effect against many cancers. Conversely, excess consumption of red and preserved meat is associated with an increased risk of colorectal cancer. Regular physical activity combined with normal body weight is known to considerably reduce cancer risk, particularly for digestive, gynaecologic and breast cancers.
Other preventive measures including large scale vaccination against Hepatitis B virus, Human papilloma virus and adequate treatment for chronic infections also contribute to reducing the risk of cancer. In addition, appropriate individual and collective measures should be taken to avoid human contact with cancer-causing agents.
One scientifically substantiated fact that bears repeating is that deaths due to cancer can be reduced if cases are detected and treated through early diagnosis and screening. Early diagnosis consists in the awareness of early signs and symptoms in order to get them diagnosed and treated early before the disease becomes advanced.
Screening, on the other hand, is the systematic application of a test in a population that does not present symptoms of the disease. It aims to identify individuals with abnormalities suggestive of a specific cancer or pre-cancer condition and refer them promptly for diagnosis and treatment.
The 2013 World Cancer Day campaign is focusing its messaging on four myths: (1) Cancer is just a health issue:
Fact (1): Cancer is not just a health issue. It is a serious medical condition which has wide-reaching social, economic, development, and human rights implications. Cancer constitutes a major challenge to development, undermining social and economic advances in the African Region. Approximately 47% of cancer cases and 55% of cancer deaths occur in less developed regions of the world. The situation is predicted to get worse. By 2030, if current trends continue, cancer cases will increase by 81% in developing countries.
Myth (2): Cancer is a disease of the wealthy, elderly and developed countries
Fact (2): Wrong!. Cancer does not discriminate. It is a global epidemic, affecting all ages and socio-economic groups, with low- and middle-income countries bearing a disproportionate burden. In Africa as well as elsewhere in the developing world, cancer is threatening further improvements in women’s health and gender equality. Just two cancers, cervical and breast, together account for over 750,000 deaths each year, with the large majority of deaths occurring in developing countries which are now facing a growing double burden of infectious diseases and non-communicable diseases including cancer.
Myth (3): Cancer is a death sentence
Fact (3): Many cancers that were once considered a death sentence can now be cured and for many more people their cancer can now be treated effectively. With few exceptions, early stage cancers are less lethal and more treatable than late stage cancers. Cost-effective strategies for cancer control such as breast and cervical cancer screening as well as early detection exist for all resource settings and can be tailored to population-based needs.
Myth (4): Cancer is my fate
Fact (4): Again, wrong. With the right strategies, more than one in every three cancers can be prevented. Prevention is the most cost-effective and sustainable way of reducing the global cancer burden in the long-term. Global, regional and national policies and programmes that promote healthy lifestyles can substantially reduce cancers that are caused by risk factors such as alcohol, unhealthy diet and physical inactivity. Improving diet, physical activity and maintaining a healthy body weight could prevent around a third of the most common cancers.