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Cancer early detection, treatment saves lives

THE government announced recently that it plans to scale up cancer care and treatment units countrywide by strengthening service provision, which includes prevention and its early detection.

The plans aimed at reducing the number of cancer cases being diagnosed in their latest stages, when treatment may be less effective and in turn become hard to manage in advance stage.

In this scenario, health experts have been advocating to the public to develop a culture of checking their health statuses regularly, because the behaviour may lead to serving lives if a person diagnoses the disease like cancer in early stages and starts early treatment.

Early this month the Muhimbili National Hospital (MNH) introduced a new surgical treatment for early breast cancer without removing the entire breast.

This is a good news to breast cancer patients especially those in early stages who could be forced to undergo the removal of the entire breast through surgery—mastectomy—due to lack of advanced radiation treatment.

But with the availability of modern machines like linear accelerator (LINAC), at Ocean Road Cancer Institute (ORCI) breast cancer patients in early stages will now undergo breast conserving surgery that eliminates the deadly cells without removing the entire breast.

Health practitioners suggest the need for advocacy on health awareness among both community and healthcare workers and to encourage regular health checkup to improve the country's referral pattern, which would lead to early diagnosis and treatment of breast cancer.

According to statistics, approximately 80 per cent of women diagnosed with breast cancer in the country are examined at advanced stages of III and IV where treatment is less effective and outcomes become poor.

Deputy Executive Director of Muhimbili National Hospital- Mloganzila, Dr Julieth Magandi said recently that the referral pattern has been a big challenge towards improving breast cancer treatment in the country.

"Our referral pattern is a serious challenge to us if we really want to detect breast cancer at early stages...the only advantageous patients are those residing in Dar es Salaam, Mwanza and Kilimanjaro," said Dr Magandi who is also a General Surgeon.

She said the journey from primary health care to the national hospital is very long, leading to patient being diagnosed at critical stages.

Dr Magandi detailed that data from Bugando Referral Hospital, Muhimbili National Hospital and Ocean Road Cancer Institute indicate that most of cancer cases presented to the hospitals are at advanced stages.

In 2014, about 60 per cent of cancer cases reported at Bugando Hospital were in stages III and IV while in 2010, about 80 of all reported cancer cases at Ocean Road and Muhimbili were in stages III and IV, with only one per cent in stage one and 9.2 in stage II.

She noted that the one year data for between July 2012 and June 2013 from MNH department of surgery showed that out of 856 patients who were operated, 20 per cent were breast surgeries.

Dr Magandi clarified that of all breast surgeries, 15 per cent was breast cancer surgeries and most of them being mastectomy. "If at all we had breast conserving surgery, there would be one or two cases."

She further said that apart from improving referral pattern, there was also need to advocate health awareness among both community and healthcare workers.

"There should be effective training to health care providers at all levels and establish breast care unit in our faculties if we want to have quality healthcare for our breast cancer patients," she noted.

She added: "If we lack well trained people, we will not actually reach where we want to go in providing care for breast cancer patients," Dr Magandi said, adding that breast cancer was the most common cause of cancer deaths among women worldwide, representing 25 to 35 per cent of all female cancer cases.

Muhimbili National Hospital (MNH) Executive Director, Prof Lawrence Museru said that after cervical cancer, breast cancer was the second most common cancer and second leading cause of cancer mortality among women in the country.

He was speaking at the opening of the Breast Cancer Workshop held recently at MNH-Mloganzila to build capacity among local health experts in providing modern cancer treatment services.

Prof Museru said successful breast cancer control demands integrating early detection programmes with accurate diagnosis and timely, accessible and effective treatments in multidisciplinary approach.

"Addressing any of these components in isolation will not improve breast cancer outcome in the country," Prof Museru observed.

He added that efforts have been made to improve the quality of life of breast cancer patients worldwide by improving the type of surgery to patients who go to hospitals with small breast cancer tumour.

"These patients with small breast cancer tumour were offered with breast conserving surgery that is not routinely done in our Centres due to lack of facilities and knowledge gap," he said.

He said that radiation services have started to advance in the country with the use of modern machine like linear accelerator available at the ORCI by better incorporation of imaging modalities and more sophisticated irradiation techniques also allowing more targeted and less toxic treatment.

Prof Museru further detailed that the lifetime for developing breast cancer in Tanzania was approximately 1 in 20 and approximately half of all women diagnosed with breast cancer in Tanzania will die of the disease.

He noted that approximately 80 per cent of women diagnosed with breast cancer in the country were diagnosed at advanced stages III and IV when treatment was less effective and outcome becomes poor.

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Author: LYDIA SHEKIGHENDA

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