Middle class face bigger cancer threat due to sedentary lifestyle

A child performs during a cancer awareness session.  [PHOTO: FILE]

The Bucket List is an acclaimed movie released in 2007 featuring Morgan Freeman and Jack Nicholson who play the role of two patients who have just been diagnosed with lung cancer.

With one rich and the other poor, the two strangers share a ward and their common fate and divergent views of life fast breed a strong friendship.

With doctors giving them only one-year to live, the two decide to make a wish list and set off on a globe-trotting adventure, crossing off items on the list one by one.

While the movie is a work of fiction, to many of the more than 12 million people diagnosed with cancer each year, The Bucket List is a movie they can identify with.

Cancer is a condition where cells undergo mutation and sometimes spread to other parts of the body.

In the past, cancer was considered to be a rich man’s disease and more prevalent in developed countries. Opulent lifestyles were considered the predisposing factors.

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However, in the last decade, the developing world has seen an increase in cancer infections. By the year 2020, seven out of 10 new cancer cases recorded will be found in developing countries.

Drinking and smoking

Risky lifestyles like drinking and smoking, together with poor nutrition and physical inactivity, have all been blamed for increased instances of cancer in Africa.

Data from the International Agency for Research on Cancer (IARC) states that in 2008, about 715,000 new cancer cases and 542,000 cancer deaths occurred in Africa.

In Kenya, cancer is now a silent killer disease whose scale and devastation appears to have caught medical policy makers and the government off-guard. Recent data on trends and incidence reports point to a disease that is slowly but surely snowballing into a pandemic.

Up until the turn of the millennium, cancer morbidity cases in public health centres in the country were not even included in health statistics.

Even today, data on cancer incidence, trends and prevalence in Kenya is far to come by and scattered while opinion on distribution patterns of the disease among experts equally differentiated.

In an attempt to take stock of Kenya’s cancer burden, the government’s department of research conducted a study. The research found out that up to 50 Kenyans die each day due to cancer, with around 28,000 to 30,000 new cases reported annually.   

The International Centre for Cancer Research, an institute of the World Health Organisation, lists four main types of cancer that are common in Kenya.

They include breast, cervix, prostrate and oesophageal cancers. Combined, the four cancers amount to over 35 per cent of Kenya’s cancer burden and in 2012 claimed 8,160 lives.

Behind the statistics, however, lies an even worrying trend. The demographic for patients diagnosed with cancer in the country today is shifting, debunking old myths and mis-conceptions. Now, 25 year-olds barely out of college are getting diagnosed with cancers that was once considered a problem of the rich and/or aged.

Dr David Makumi, the vice-chair of the Kenya Cancer Association, states that emerging trends point to a disease that is fast spreading among the youths and middle class.

“The demographics in terms of age for cancers in sub-Saharan Africa are coming at a much younger age today than what is recorded in the West,” he explains.

While there are several risk factors in cancer that cannot be controlled like age and family history, the increasing numbers of cases in young cancer victims has been blamed on sedentary lifestyles and avoidable behavioural patterns.

“The level of alcohol intake and smoking in most of our young people today is also on the rise and causing a spike in some of the cases of cancer that we are seeing in younger patients,” explains Dr Makumi.

The rise in cases of cervical cancer in young women in Kenya has been blamed on the fact that many women in Kenya today are said to start sexual activity quite early in life, exposing themselves to the human papillomavirus (HPV) that causes cervical cancer.

“Girls in Kenya today have been known to start sexual activity as young as 13-years-old,” explains Dr Makumi. “The fact that cervical cancer develops slowly and can lay dormant for 10-12 years often means that by the time it is diagnosed, it may have spread or become worse.”

Cervical cancer, which has traditionally been the second most common type of cancer to affect women in the country, is becoming an even bigger menace for younger Kenyan women.

Data from IARC states that in 2012, cervical cancer overtook breast cancer to be the leading cause of death in Kenyan women with 2, 451 women succumbing to the disease, compared to 1, 969 victims of breast cancer. 

Kenya’s increased industrialisation has also been said to have come at a steep price with many casual workers in Nairobi’s Industrial Area said to have developed cancer due to exposure to harmful industrial chemicals and solvents.

“Some workers operate in industries that deal with harmful solvents on a daily basis and these have been proven to contain chemical compounds that are carcinogenic in nature,” says Dr Makumi.

Many of these workers, however, operate without proper protective clothing or radiation counters that monitor their level of exposure for those working with heavy metals like lead.

“Data on cancer is difficult to consolidate because, as a country, we do not have a central cancer registry which indicates the cancer cases that have been recoded and from which regions,” says Dr Opiyo Anselmy, the head of the Cancer Treatment Centre at the Kenyatta National Hospital (KNH), which is the sole government cancer centre in the country capable of offering full cancer treatment.

Without this registry, it has become difficult to devise region-specific policies and campaigns to fight the disease or create awareness.

Several studies

From the analysis of cancer incidence data sourced from several studies and interviews with cancer specialists, The Standard has been able to develop a rudimentary map of some cancer cases and where they are most prevalent.

Burckitts Lymphoma is a type of lymphoma that is prevalent in infants and young adults and has traditionally been found to be common in the coastal region. This has been attributed by several studies to the malaria burden in this region, which is one of the most common pre-disposing factors of infection.

A study conducted on the prevalence of oesophageal cancer, the second and third most common type of cancer in men and women respectively found out that this type of cancer is prevalent in the North Rift region of Kenya.

Incidences of liver cancer were further found to be common in Eastern Province owing to poor eating habits and consumption of aflotoxin cereals which is a common predisposing factor.

Other experts have stated that the heavy chewing of tobacco in parts of Central Province has seen a high prevalence of oral cancers in this region although other predisposing factors still exist.

Most of these distribution patterns, however, come from studying patients at referral hospitals and doctors are quick to caution that a deeper analysis needs to be done to generate more specific data.

“This is a good observational representation of what is on the ground,” explains Dr Alice Musibi, an oncologist at the department of medicine at AgaKhan University Hospital.

“However it is not statistical for we do not yet have a population-based cancer register that would map out the trends and prevalence of cancer cases in relation to the different populations.”

Dr Musibi further argues that the increased cases of cancer could be owing to better reporting of cancer incidences and more awareness and much less attributable to a rise in infections. 

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Bucket List Kenya Cancer Association sub-Saharan Africa