CELEBRATING WORLD CANCER DAY – I AM AND I WILL

Today is one of the most important days in a cancer warrior’s calendar. We commemorate World Cancer Day. A few weeks ago I introduced this year’s theme of I AM and I WILL. The cancer society worldwide is asking ‘who are you?’ and ‘what are you doing to fight cancer?’

My answer is I am a radiation oncologist I will beat cancer in Zambia with you. So many inspiring conversations have been rolling on to my social media platform, with a lot of people declaring to engage in this fight on an individual level. That is exactly the type of attitude we need moving forward. The over arching policies at a national or global level really begin with you. Without your participation the policies do not translate into action. You have the power to kick cancer more than you actually realise. 

I remember how the epiphany of how my participation as an individual contributes to a bigger picture came to me. It was during my first appraisal as a young doctor and I was given a form to complete. Accompanying it was the departmental action plan, hospital action plan, ministerial action plan as well as the national development plan. The national development goals referenced the millennium development goals (MDGs) at that time and as I got to United Nations document I was illuminated and it dawned on me that no matter how much the Secretary General at the UN wanted to talk about things if I didn’t play my part on a daily basis on the wards, in my clinics on my research desk and indeed in my home, all those things remain talk. And so my advocacy journey began. I must thank my supervisor who took that approach as I find many people do not understand what their place is in the bigger picture.

Two very inspiring articles came my way this week on how cancer affects everything. Metaphorically the two articles articulated the infiltrating characteristic of cancer. The ripples of the negative effects of advanced or neglected cancer can be seen miles away from the source. 

The first article tackled something few people link – maternal death from cancer and subsequent child mortality. The article authored by Vega et al summarised a scientific study that found this link. The mathematical models they used found that women’s death from cervical and breast cancer across all societies poor or rich leads to increased death of children in significant proportions.

I found this information unforgiving. Many a time when we sit as experts around a table dividing funds and we may find it hard to decide who the money should go to. Well, science is telling us we can’t ignore cancer prevention in women and expect our indicators for child mortality to improve. The article also points out that for women aged between 15 – 49 (childbearing years) the word neoplasm accounted for the most common cause of death worldwide between 1990 to 2016.

My mother died from cancer when I was 27 years old and yet I still feel so lost as a daughter. And this is in spite of me having a super dad who I am very close to. I therefore can’t imagine the little ones who have to live through an advanced stage cancer of their mothers and deal with the aftermath.

A few weeks ago I had a patient who had been diagnosed with cervical cancer during her pregnancy. We actually had our consultation meeting a day before her caesarean section. Fortunately for her, the antenatal team that took care of her do pap smears as part of routine care and discovered this misfortune. She did not have any symptoms at all. As the cervix is the neck of the womb and actively dilates during labour, a caesarean section was planned for safe delivery.  We have planned to start treatment 6 weeks after her delivery to enable the womb to shrink back to proportions that will make treatment possible. The baby will not be able to breast feed as the mother will be on chemotherapy but we are investing in the future to keep this mother alive and decrease the risk of this child dying.

The second article that caught my attention was authored by Rodin et al reporting results of a study they undertook to measure the cost of cervical cancer to society should the level of radiotherapy penetration remain the same. In simple terms? It is a well-recognised fact that radiotherapy services which is a central part in curing cervical cancer, is lacking in most parts of the world. These scientists reported on 3 scenarios: 1) if we left things as status quo; 2) if it took 20 years to reach desirable maximum or 3) if miraculously we reached were we wanted to be today. They found that leaving things status quo is going to cost the world $271.3billion over 20 years whilst if we invest actively in radiotherapy treatment solutions over the same period a total economic gain of $53.2 billion and a social gain of $137.5 billion will be seen. 

These numbers and the way they are derived are astronomical and I don’t blame you if they have rested as a cloud over your head. Initially it may also make you feel detached and actually confirm you have nothing to do with the talks that go on in Geneva and New York where policy documents are drafted. However, I want you to take a minute and stop. If you are a woman all you have to do is to get screened for cervical cancer. If you are a man your responsibility lies in encouraging the females in your life to get screened.

Dear country men and women, faithful readers of this column, by participating in cancer screening you are actively declaring your part in ‘the bigger picture’, achieving sustainable millennium goals (SDGs) 3, 4 and 5 which are promoting well being and ensuring healthy lives for all at all ages, reduce child mortality and improve maternal health respectively. Wishing you a happy World Cancer Day.

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