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New cancers on the rise and detection is not always easy

Saturday February 9 2019

Kibra MP Ken Okoth, CANCER

Kibra MP Ken Okoth recently revealed he is battling cancer. Just like many patients, his diagnosis with colorectal cancer came in late. PHOTO | FILE | NATION MEDIA GROUP 

ELIZABETH MERAB
By ELIZABETH MERAB
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During her last days, she had become very weak due to lack of appetite. Her blood level was also on the decline and transfusion couldn't help much.

For patients to undergo chemotherapy, they need to not only be strong but to also have enough blood in the veins

For these two reasons, Elizabeth Wamaitha’s chemotherapy sessions had to be postponed. The 24-year-old succumbed to stage four colon cancer on July 14, 2018, almost five months after her story first appeared in the Nation.

TREATMENT

When Ms Wamaitha’s story was published, she was the youngest patient to have been diagnosed with colon cancer. Most of the patients found with the disease are often above the age of 40.

“She was my only sister and the last-born in our family of four children and we buried her the following Friday on July 20, 2018,” recounted her brother Edmond Mwaura.

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Mwaura says he learnt about two years ago that his sister was ailing from a disease he later found out was cancer.

“It was really hard for me to accept it, but I kept my hopes up and firmly believed she would be healed,” he told the Saturday Nation.

Even as cancer treatment improves and survival rates go up, so, too, does the number of people afflicted with the deadly disease.

New global cancer data suggests the global cancer burden has risen to 18.1 million cases. The cases are predicted to grow to 29.5 million by 2040.

Last year, the World Health Organization’s International Agency for Research on Cancer (IARC) recorded 9.6 million cancer deaths.

According to WHO’s latest global cancer data, one in five men and one in six women worldwide develop cancer during their lifetime, and one in eight men and one in 11 women die from the disease.

The burden of cancer is only increasing and according to WHO the factors behind it are population growth, ageing, late detection and screening.

COLORECTAL

Whereas the international agency notes that globally lung and female breast cancers are the leading types of cancer worldwide, cancer experts in Kenya predict a shift in pattern as cancers of the food pipe and stomach are increasingly ravaging young people in the country and quickly becoming top killers.

In its Globocan report that analyses new cases and deaths among men and women, the IARC notes oesophagus cancer kills 4,354 Kenyans every year, overtaking cervix, breast, stomach and prostate cancers.

Most of the patients are diagnosed when the disease is already at advanced stages.

Before she was diagnosed with colon cancer, Ms Wamaitha always felt bloated. Doctors at her school kept putting her on anti-bloating medication, which never really relieved her discomfort, despite taking the medication for six months without any signs of improvement. Her family sought a second opinion.

While doctors were able to slightly improve her outcome, Ms Wamaitha succumbed to stomach cancer, which was diagnosed much later into her treatment.

But her predicament with late diagnosis is not unique. Recently, at the age of 41, Kibra MP Ken Okoth revealed he is battling cancer. Just like many patients, his diagnosis with colorectal cancer came in late.

“I was diagnosed with stage four colorectal cancer with metastases to the liver,” he told a local daily.

For over a year, he said, he presented symptoms of ulcers, at times bacterial infections and that is what he was being treated for. At some point, he was even prescribed medication to manage stress.

By the time his doctor ordered some advanced scans, the cancer had already advanced to stage four.

SECOND OPINION

According to Dr Andrew Odhiambo, an oncologist at Kenyatta National Hospital and Nairobi Radiotherapy and Cancer Centre, cancers of the food pipe are rapidly increasing in the country and so are the delays in diagnosing them.

“If you are being treated for a condition repeatedly, be it amoeba or typhoid, make sure you get a second opinion because as it is, some cancers will often present like normal ailments.

“Some, like stomach cancer, will present like acidity or heartburn and the doctor seeing you will not tell the difference between the two. It is the repeated nature of going to hospital over the same issue that will ring a bell for further tests,” he explained.

While the disease is known to affect mostly older patients, especially men, Dr Odhiambo said there is a new trend of younger patients being diagnosed with it.

“This is not a surprise. We are seeing more patients with oesophagus and stomach cancers than before and most come after many months or years of misdiagnosis, when the disease has advanced.

“Unlike the demographics in Europe and the West, here in Africa we are having younger patients coming to the clinic with the disease,” he said.

Some of the trigger factors for cancers of the gastric system include links of food pipe cancer to volcanic soils, alcohol and tobacco chewing or smoking.

“Most of the gastric cancers we are seeing are already in stage four, which is often too late. Something that is very weird is that when patients have an explanation for what could be ailing them, they become at ease.

SYMPTOMS

For instance, if you are told you have H.pylori, you will be at ease not knowing whether something else more dangerous could be lurking underneath that H.pylori,” he added.

For patients aged over 50, experiencing weight loss and anaemia, and who have been taking acidity drugs for over a month, Dr Odhiambo advised immediate screening as there could be something wrong.

“People with a family history of cancer should also go for screening, which includes stool tests and colonoscopy, as they are at a higher risk of developing the cancer.”

Colorectal cancer symptoms depend on the size and location of the cancer. Some commonly experienced symptoms are changes in bowel habits, changes in stool consistency, blood in the stool and abdominal discomfort.

“These symptoms, however, differ depending on whether the cancer is detected in the patient’s right or left side of the colon.”

For instance, he says, if the cancer is on the left side of the colon, patients are likely to spot blood in their stool.

This is because the left side of the colon is closer to the rectum compared with the right colon.

“Patients who have the cancer on the right side will often present with fatigue, weight loss and anaemia. This is because they are silently loosing blood which is not spotted it in their stool as the right side of the colon is far from the rectum,” Dr Odhiambo said.

As a result, many patients often have their diagnosis when the cancer is in an advanced stage.