30 September 2020
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Making strides in provision of cancer services

Written by  Memory Kutengule
SURVIVOR: Pheluwa recalls the agonising trauma of breast cancer she suffered - Pic by Memory Kutengule SURVIVOR: Pheluwa recalls the agonising trauma of breast cancer she suffered - Pic by Memory Kutengule

Blantyre, May 10, 2019: Her breast cancer diagnosis on March 11, nine years ago, remains the most unforgettable moment considering that the disease was already at an advanced stage. 

The agonising trauma Jean Pheluwa underwent still echoes in her mind to date.

At the age of 61, the Chilomoni Township resident still has memories of how her left breast was disfigured by what looked like an ordinary swelling.

“I went to Ndirande Health Centre where I was given an anti-inflammatory cream to apply regularly,” she says. But few weeks later, as Pheluwa narrates, the condition deteriorated from bad to worse.
“I started having bloody discharge from the nipple and the breast eventually lost shape.
“When I returned to the health centre, I was referred to Queen Elizabeth Central Hospital (QECH) where after being screened, I was diagnosed with advanced breast cancer,” Pheluwa explains, restraining tears from her eyes.

The story of Pheluwa is one case in point.

Close to 16, 000 new cases of cancer are recorded annually in Malawi with women within the age bracket of 15 and 59 and beyond like Pheluwa being the mostly hit.

Ministry of Health and Population spokesperson Joshua Malango says much as Malawi is having a steady fight against cancer, the ministry continues to register new cancer cases every year.

“Annually, an estimated 15, 349 new cases are diagnosed with cancer in Malawi. From that figure, 9, 383 cases are from women while the rest being for men.
“The common types of cancer are Kaposi Sarcoma, cervical cancer, esophageal cancer and urinary bladder cancer. But all the cancers are life-threatening,” Malango says.

Cancer is an uncontrolled growth and spread of cells that can affect almost any part of the body such as breasts, cervix, esophagus and skin.

The disease is the second killer globally in the view of World Health Organisation (WHO) such that the organisation reports that in 2018, an estimated 9.6 million people succumbed to cancer.

Out of the estimated figure, 70 percent occurred in low and middle-income countries including Malawi.

One third of cancer deaths, WHO indicates, result from five leading behavioural and dietary risks such as high body mass index, low fruit and vegetable intake, lack of physical exercises, tobacco and alcohol use.

Traumatised with how the disease remains the deadliest, Pheluwa, who is also a widow, recollects her life being at the verge of death as she had doubts of successful treatment.

“From what I know, once the person has been diagnosed with cancer in its late stages, chances are always high that the disease cannot be treated.
“Fortunately, one of the doctors at QECH recommended that I undergo surgery to remove the tumor before cancer cells spread to the rest of my body organs,” Pheluwa says.

Currently, Pheluwa is on chemotherapy.

“The doctor also prescribed some anti-cancer drugs for me. The dosage runs for five years,” she says.

Pheluwa with her frail body due to old age and chemotherapy cannot engage in any business to generate income to buy cancer drugs from private pharmacies, which she says are expensive.

“I rarely find the drug (cytamox) at QECH and, mostly, I buy it from private pharmacies at a very huge price.
“Each time when I don’t have money, I hit the streets and ask for alms to buy the medicine,” she says.

To this effect, Pheluwa wishes more resources were allocated to cancer services to enable her and other patients access required medication for free.

Pheluwa’s sentiments are echoed by one of the country’s cancer specialists at QECH Dr Leo Masamba who calls for concerted efforts among various partners to seriously invest in cancer services.

Dr Masamba says it is disheartening to note that currently cancer services do not receive funds from donors as it is the case with malaria, tuberculoses, diabetes, HIV and Aids.

“Cancer is not transmittable but a lot of people are suffering significantly. The amount of resources that cancer requires to treat is much more.
“Surprisingly, many people pour millions in other disciplines such as sports or fun but when it comes to cancer, the support is minimal,” the oncologist says.

He, therefore, said there is need for collective effort from government, organisations and individuals to invest in local capacity, equipment, medicine and more cancer facilities to provide adequate services to people suffering from the disease.

Some of the needed equipment, as Malango puts it, includes radiotherapy to treat cancer patients.

“Treatment of cancer is very effective during its early stages. Of course, right now, Malawi is doing surgery and provides chemotherapy.
“But we need radiotherapy to effectively treat many cancers within Malawi because, currently, 18 percent of referrals to hospitals outside the country are due to cancer,” Malango says.

Moved by the situation, President Arthur Peter Mutharika last year launched the construction of a cancer centre in Lilongwe. The centre is expected to be opened this year.

The facility will have radiotherapy machine to treat all cancer patients, thereby saving about K480 million spent on treatment of cancer abroad.

Cancer Association of Malawi (CAM) administrator Gonjetso Kalumbu commends government for its effort to have a cancer centre constructed in Malawi saying it will alleviate the suffering of cancer patients.

Kalumbu, therefore, says CAM will continue to carry out sensitisation campaign on the importance of early diagnosis of cancer to ensure timely access to treatment.

“Seriously, cancer patients especially the less privileged are struggling to access medication.
So, having a cancer centre with equipment of high quality standard and well trained specialists is the way to go for the country as far as provision of required cancer treatment is concerned,” Kalumbu says.


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