Not all hope is lost

Being diagnosed of cancer sounds like the end of the world for most people, especially given the huge expenses associated with its treatment, yet the disease can be treated when detected early.

For 70-year-old Mr Paul Chimuti (not his real name) of Seke, lung cancer was the least of his worries as he never smoked all his life.

But fate dealt him a blow.

Towards the end of 2017, a few days after his 70th birthday, Mr Chimuti began experiencing shortness of breath.

Later, the symptoms graduated to a chronic cough and he would spit blood each time he coughed.

His general practitioner first thought it was tuberculosis. After several tests, it was established that Mr Chimuti was suffering from lung cancer.

“Overall, it was a horrible experience. The pathology lab reported my results showed some irregularities,” explained Mr Chimuti.

Several tests done by his doctor revealed stage three lung cancer.

“I always thought lung cancer was a concern of people who smoke, not someone like me,” said Mr Chimuti.

“Being told that I have lung cancer was like a death sentence for me.”

His doctor explained his treatment options — medication, surgery and some radiation approaches.

But since the initial shock, Mr Chimuti is determined to beat the cancer.

“My goal now is to live with cancer. I am entering the assembly line of lung cancer care that will last the rest of my life.” Oncocare clinic manager Mrs Portia Chuma said cancer has become a common problem, with many failing to access care and treatment due to the constant checks and reviews that make it costly.

“Cancer diagnosis is costly and as a result, the majority may fail to afford both the diagnostic and treatment costs,” she said.

Mrs Chuma lamented the lack of a guiding policy on the pricing of cancer drugs.

“Sadly, due to the non-existence of a guiding policy on drugs’ pricing, pharmacies charge drugs haphazardly, reaping off patients most of the time,” she said.

“It’s unfortunate that most people don’t have a health-seeking behaviour, hence most cancers are detected late.

“There are myths surrounding cancer, some attribute the condition to witchcraft. This, coupled with prohibitive costs, push some people to visit faith and traditional healers for help.”

Cancer cases continue to increase, with the reproductive organ cancers for both males and females accounting for high percentages of morbidity and mortality as compared to other cancers, according to the latest cancer report.

The high percentages have been attributed to lack of health-seeking behaviours and lack of readily available cancer facilities. At least 7 000 new cases of cancer are recorded every year in Zimbabwe and of these, 1 500 people die.

Cancer adversely affects the psychological well-being of the whole family, especially spouses who are mainly involved in care-giving.

Costs for diagnosis and treatment of cancers are determined by the type of cancer, position of the cancer, stage of the cancer and the type of treatment it requires.

According to a survey conducted by The Sunday Mail Society, radiotherapy for a whole session costs between $3 000 and $4 000, while chemotherapy costs between $100 and $41 000 per cycle, depending on the stage at which the cancer is.

Nonetheless, clinical oncologist, Dr Anna Nyakabau, said while the treatment of cancer is costly, it should be everyone’s responsibility.

“It’s a fact that cancer treatment is beyond the reach of many, hence it requires collaborative efforts, a multi-sectoral approach looking at prevention, diagnosis, treatment and palliative care,” explained Dr Nyakabau.

The other problem is that both the diagnostic and treatment services are highly centralised mainly in Harare and Bulawayo, thereby forcing people to travel long distances to access the cancer services.

This results in other hidden additional costs such as transport, food and accommodation.

Cancer Association of Zimbabwe monitoring and evaluation officer, Mr Lovemore Makurirofa bemoaned the deficiency of readily available cancer facilities.

“Cancer services aren’t readily available in the country and we still have a long way to go and there is no sustainable fundraising for cancers,” he explained.

Mr Makurirofa said poor health-seeking behaviours are fuelling cancer cases in the country.

“Many people become adamant when it comes to issues regarding their reproductive health and many-a-time they ignore the early signs of cancers and only visit the hospital when the cancers have progressed to advanced stages,” he said.

“For almost all cancers, it takes about 10 years from its progression to Stage One. About 81 percent of all cancers recorded in Zimbabwe are diagnosed at advanced stages.”

Cancer is a disease caused by a division of abnormal cells in a part of the body. When cancer starts in the cervix, it is called cervical cancer while prostate cancer is a cancer that occurs in a man’s prostate.

The most occurring cancers among Zimbabweans of all races are cervical cancer (18 percent), Kaposi sarcoma (10 percent), breast and prostate cancer (seven percent each), non-Hodgkin lymphoma and non melamona skin cancer (six percent each), oesophagus and colo-rectal cancers (four percent each), eye cancer (three percent) and other cancers accounting for 35 percent of registered cancers.

In 2012, Government allocated approximately $10 million for the revamping of the country’s only state-owned radiotherapy facilities located in Harare and Bulawayo.

However, linear accelerators at Parirenyatwa Group of Hospitals were not working as of last week.

While not all cancers are related to HIV/Aids, the advent of the pandemic has seen a marked increase in cancer cases in the country.

Moreover, 60 percent of cancers are associated with HIV.

Health experts say infection with HIV weakens the immune system and reduces the body’s ability to fight infections that may lead to cancer.

Some of the most common cancers diagnosed in people living with HIV include Kaposi sarcoma, Non-Hodgkin lymphoma and cervical cancer.

As a result, the National Aids Council (NAC) began procuring cancer detection equipment and drugs in 2012 as it seeks to diversify its measures to fight HIV and Aids.

NAC monitoring and evaluation director, Mr Amon Mpofu, however, said these will not be reserved for people living with HIV only.

“The procured cancer equipment and drugs will be distributed through the national pharmaceutical company and it’s meant to benefit everyone, even those not living with HIV,” he said.

Mr Mpofu also added that their procurement of cancer equipment and drugs is informed by the Ministry of Health and Child Care’s requests.

“We really can’t focus on HIV/Aids only without addressing the related diseases such as cancer. If we address cancers we would have addressed HIV,” added Mr Mpofu.

The introduction of a cancer levy has been debated on different fora, with policy makers invalidating the proposal for fear of burdening the tax-payer.

According to the Zimbabwe National Cancer Registry (2013), which was published in August 2015, the leading cause of deaths was cervical cancer at 13 percent and prostate cancer at nine percent.

Government recently rolled out the human papilloma virus (HPV) vaccine to tackle cervical cancer.

This comes as Government is being urged to invest in prevention of cancers.

“If Government invests in the prevention of cancers by holding awareness campaigns on living healthy and the signs and symptoms of cancers, we will be able to cut down on the cancer treatment burden,” Mr Makurirofa said.

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