We share the
sentiments in this important paper about the massive burden of cancer of all
types in SubSaharan Africa (SSA), and that something needs to be done. We agree
that trials need to be adopted on various treatment modalities that originate
from resource rich Global North countries. But perhaps the investment should go
along with elimination of ignorance and superstition that todate informs SSA
communities that 'cancer is caused by withcraft / witches, is a curse for sin,
is inflicted atimes by remote control by the victims enemies and / or elderly
relations especially mother-in-law. The result is that victims harbour the
condition for years and eventually report first to native doctors or religious
houses for exorcism or divine intervention. When all these fail the victim
presents to orthodox medicine practitioners to perform ' miracle' on advanced
metastasized cancer .
The order
challenge is that whereas in resource rich countries comprehensive approaches
are adopted to manage cancer from health promotion, to prevention, before
treatment, in LMICs such comprehensive approach is lacking. In LMICs it is the
exception to find screening for early detection of cancer and even when there is
one the follow up steps for positive screening report is lacking: take breast
cancer as one example, mammograms are springing up but virtually no treatment
service for the positive mammogram cases. No intervention radiologists, very
few breast surgeons, lack of intra-operative frozen section service, lack of
pathologists, lack of supportive and rehabilitative care service. lack of
follow up. Rather than just setting up a mammogram centre, LMICs need whole
breast cancer service to cover the whole cycle. The same applies to other
common SSA cancers, prostate, cervix, etc. Prevention is always cheaper and
better than cure!. Treatment outcomes are invariably better if cancer is
detected early.
It is okay
to conduct trials on treatment but effort should also be directed at cancer
awareness / health promotion and prevention. Whole cancer care services are
needed all over SSA.
Joseph
Ana.
Africa Center for Clin Gov Research &
Patient Safety
@ HRI West Africa
Group - HRI WA
Consultants in
Clinical Governance Implementation
Publisher: Health and
Medical Journals
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Estate, Calabar
Cross River State, Nigeria
Cross River State, Nigeria
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