By Dr Duku Fred | I have severally seen families battle with heavy costs treating cancer and not to talk about the immense stress that goes with it when the word advanced cancer comes from the messenger of doom-the health worker. This usually means obvious death starring at the victim and future burial costs to the attendants after spending millions on a never changing situation.
Cervical cancer is the most widely spreading and most available adulthood cancer affecting only women of course directly but also affects their male spouses or relatives financially/socially. This is caused by the Human papilloma virus (HPV) that inhabits the female and male genital organs hence spread sexually. In low doses, this virus has no effect or may cause genital warts. This gives us an insight into the prevention measures. Though cancer is non communicable (can’t be spread from person to person), this one seems to like though indirectly since the causative agent can be transmitted sexually. For those that utilise their mouth in sexual ecstasy, the same viruses may contribute to your chances of developing laryngeal cancer. Not to forget, the papilloma virus in males causes Cancer of the penis whose surgical treatment in advanced stages may be amputation. Imagine a man with no tools!
Even with these virus transmissions, not everyone gets these cancers because it may have a genetic linkage sometimes BUT NOT ALL THE TIME. These viruses alter DNA in our cells (mutation) leading to cancer. Some people’s cells are more chanced/more susceptible to these alterations. Even if this chance is linked to family history, how many of us know our chances or likelihood of getting mutations leading to cancer if exposed to these viruses. None I suppose. Chances also increase with increased doses or number of virus strains harvested during the multiple sexual exposures with the multiple sexual partners, male or female. Whoever and wherever you are, this is what you can do to avert the cancer incidence rise and survive catastrophic expenditures on a dying patient:
- Avoid multiple unprotected sex ventures.
- Vaccination against HPV for the strains most implicated is now done for girls in P4 or those 10yrs old in schools not because its them that will get these cancers but because they are close to the age when they are likely to get sexually active. Resources have also limited to that selection. There is also an assumption that the adult male or female has already been exposed hence immunized with those low doses which do not cause cancer. Head teachers and parents should be on the demanding side since I have provided all information they need here.
- Do regular cervical cancer screening tests at least once annually. It does not hurt and this is done in many facilities especially hospitals and even some sub-hospitals (Health Centre IVs). Even private facilities do these at a cheap cost. It is unfortunate even our own female health workers or spouses or relatives of health workers rarely screen. Remember early cancer is usually without symptoms. Patients only appear in hospital with signs of advanced disease like smelly vaginal discharge managed poorly for a long time ignorantly on several antibiotics and vaginal bleeding managed poorly yet could be cancer.
- Seek treatment early if any symptoms or signs arise. Better safe than sorry. Interventions are cheaper when seen early. Cryotherapy (treatment with extreme cold gases) for the very early stages is accessible and cheap. After that level, surgery to remove the cervix and uterus is preferred which unfortunately is feared sometimes leading to delays, as if dying with a uterus benefits anyone. In the late stages, death is as good as obvious and patients get desperate for any option including surgery that may not help but only worsen disease to an earlier death. I sometimes get patients at this stage. Other than symptom management and prayers, I can’t offer much to save them. It is a time of regret as many are those that could have been counseled for surgery months back but could not make it due to fear. At this stage with desperation in the room, it is unfortunate that many of our health workers take advantage of the situation. Although some may be ignorant on management, some are actually selfish. Instead of offering palliative care, they milk the remaining resources out of these victims in the name of offering surgery and this quickens death.
All said above, we all have a role to play!
*The author is a medical doctor working in Kamuli District, Eastern Uganda