By Dr. Andrew Odhiambo
Consultant Physician & Medical Oncologist
Did you know the word cancer comes from a “Greek” word meaning “crab” because of its finger-like projections resembling the shape of a crab? This already makes it sound spooky and it is no wonder that many people are not shy to say that “Cancer is a MONSTER” and here is why. Not only have I stated why but I have also suggested ways you may overcome and rise above cancer. Here we go…..
1. Cancer is NOT ONE a disease
Many people imagine that cancer is one disease when actually it is a group over 200 different types and subtypes of diseases. This explains why cancer is often complex to understand and may behave in many different ways. Take an example of breast cancer; there are at least 4 different subtypes which have different behaviour and prognosis. It is for this reason that there is no single test one can do for screening that excludes all cancer.
Now that you know this, it is paramount that you are aware and self-conscious about your body. Anytime something doesn’t feel right, and there is no explanation, please seek medical attention as soon as possible.
2. Cancer causes are not very well established
We often talk of risk factors and not direct causation. We know HIV causes AIDS but for the majority of the cancers, we don’t know what causes them. Tobacco use, heavy alcohol consumption and positive family history have been thought to be very important risk factors for many cancers. However, we still come across some cases of cancer that are strongly linked to these risk factors but lack the exposure. The best example is lung cancer. In many parts of Africa, we diagnose many cases of lung cancer in those who have never smoked cigarettes. Up to 66% of the time, we cannot identify any risk factor at all for the majority of cancers.
Now that you know this, you can still avoid all the known risk factors like tobacco and excessive alcohol use but at the same time, don't live carefree and imagine that you are immune from getting cancer simply because you have no risk factors. Go for periodic checkups whether you have been exposed to risk factors or not.
3. Cancer often mimics symptoms of common diseases & ailments
This is the most notorious characteristic of many cancers. They hide for so long undetected and when they begin to show symptoms, they resemble that of common diseases and ailments. Top in the list in Kenya is H. Pylori, Amoeba, Typhoid, Brucellosis and Tuberculosis. This is because they share many symptoms and it isn’t possible for primary healthcare doctors, nurses and clinicians to tell the difference. Stomach cancer will often mimic gastritis and H pylori. Lung cancer & lymphoma will often mimic Tuberculosis etc. These ailments are indeed more common than cancer anyway and are easily treatable. What’s more interesting is that some but not all patients would prefer to be diagnosed with H pylori and not stomach cancer. They are mostly content with being told they have H pylori over and over. The moment a doctor suggests tests to look for cancer, they are off to the next doctor in another hospital ready to take more H pylori medication. It’s human nature to be afraid of cancer.
Now that you know this, if you are treated for the same “common ailment” over and over a month on month please seek a referral to a specialist to rule out the possibility of cancer. The earlier it’s caught, the better your chance of cure.
4. Cancer instils a lot of fear
The “C” word is what some call it. So afraid to even say cancer. The fear of death is real. Cancer is one of the scariest diseases. The fact that we do not fully understand its causes make us more scared. Fear causes a lot of stigmas. Stigma, in turn, results in ignorance and poor knowledge which in turn breeds more stigma. It is natural to be afraid of cancer. Now that you know this you can help break this cycle by empowering yourself with basic knowledge about cancer, the types, common symptoms, and where to go for checkups.
5. Cancer treatment is not often straightforward
Unlike swallowing malaria tablets for 3 days and being cured, cancer treatment is often protracted, convoluted and multidimensional. Most solid tumours like breast, lung and colon will often require more than one modality of treatment. Most cancer patients will need to have biopsies taken to ascertain the diagnosis which requires the highly skilled pathologist to read the slides and describe the cancer. After which, one would require specialized body scans to know how far cancer has spread. This helps us to know the stage. After we stage cancer, we can then treat it. More often, cancer patients will need to see many different types of specialists’ throughout their journey. This may include the surgeon, oncologist, psychologist, therapist etc. Cancer surgery is often complicated. Chemotherapy and immunotherapy can also be long and very involving. After treatment, it's more scans and tests. It takes a toll on one’s family both emotionally and financially.
Now that you know this, it is important to take part in the decision-making process of your treatment and be continuously involved. Ask for reading material concerning your type of cancer and don’t fear to question or challenge our decisions. Be empowered. We doctors are not gods to be worshipped.
6. Cancer can leave you mutilated
Cancer can be very destructive. Especially solid tumours. This is because surgery is a key modality in their treatment. Many breast cancer patients lose their breasts, sarcoma patients lose their limbs, and don’t get me started about colostomies and urostomies. These affect many patients’ quality of life and many will opt out of these procedures because of the emotional impact. I once had a patient refuse a colostomy because he knew his wife wouldn’t have sex with him ever if he got it. You can google what a colostomy is then you’ll understand. The physical disability is a permanent feature for many survivors’.
Now that you know this. It is possible that if your cancer is caught early, you will suffer less mutilation. But remember that sometimes it may be a sacrifice you have to make to remain alive. Should you be the one, remember you can apply for a disability card for tax and government benefits.
7. Cancer will bankrupt you and your family
Cancer treatment and care is very expensive. Don’t get me wrong. Not even the rich can afford comprehensive cancer care. I have seen rich families go broke and auction/sell everything. The more advanced cancer, the more expensive it gets. Remember earlier I said cancer treatment is multifaceted. Many specialists are involved. It can cost you millions. If you dare ask me how much immunotherapy costs you will faint.
Now that you know this, remember that early-stage cancer is cheaper to manage. Most times, a simple surgery will do. Once it starts spreading, then chemotherapy and radiotherapy are involved which raises the cost. Go for early screening and keep vigilant. Make sure your NHIF is up to date at the very least. If you can, add on private insurance. Don’t default on your NHIIF just because you are “healthy” lest you're are caught pants down.
8. Cancer affects families not individuals
“Cancer doesn’t have a face until it’s yours or somebody you know” – Anthony DelMonte. A popular phrase we use. But be careful when your kin gets cancer, you will be affected just as much as the patient. I have many relatives calling me from America and Europe worried about their sick parents in Kenya. The fear makes you have insomnia. Cancer patients do not attend clinic alone like patients with hypertension or arthritis. The whole family is there plus grand-kids and in-laws. That’s one of the main reasons I moved into a bigger office. To accommodate the big numbers. As a cancer doctor, you become a member of many families. You provide hope where there is none and walk with the family throughout their cancer journey and ensure a safe landing. Whether we win or lose, a safe landing is very important. Now that you know this, please be patient with your oncologist. Support her/him when they are low. Call them once in a while to check upon them. We go through a lot just to make sure you are well and well taken care of. We have families too and want to feel loved.
9. Cancer once treated may still come back
This is one fact that always breaks my heart. Once successfully treated, cancer may still come back. Usually with a vengeance. Even after going through all the best treatment, whether abroad or locally it may still crop up. Sometimes we still catch it early, but sometimes we don't.
Now that you know this, please pay attention to your follow up clinics. You may not tell on your own when something is wrong, but regular checkups may catch early recurrence.
10. Cancer affects children too
Lastly and very sadly, cancer affects children too. September which is around the corner is childhood cancer awareness month. Don’t imagine that young persons do not get cancer. They do, and it’s devastating when a life is lost. I always give props to my paediatric oncology colleagues. Big up!!! Because it’s not easy.
Now that you know this, remember to be extra vigilant when it comes to your child. Any unexplained tiredness, bleeding, body or abdominal swellings should demand thorough examination to exclude childhood cancer. Bathe your child frequently, don’t leave it all to the nanny, be vigilant and stay woke.
This was not meant to scare you but to make you empowered with knowledge because knowledge is power. Power is freedom. Freedom is life.
Disclaimer: My Views Are My Own and I Shall Bear No Responsibility for Any Actions That Are Influenced or Arise From My Blog
If you have any further questions you can message me (on my website www.drandrewodhiambo.com or facebook page) or tweet me @odhis1.
Dr. Andrew Odhiambo
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