Let’s not fight cancer with our eyes closed

 This disease, according to the National Cancer Control Strategy is the third killer disease in Kenya after infectious and cardiovascular diseases

Cancer is a menace that gnaws away one’s dignity in all facets of life — financially, socially and emotionally. Such a thief of humanity ought to be fought with all the ammunition available.

But how does one go to war without a plan or knowledge of the enemy’s statistics or strategies? How can one win a war based on assumptions and extrapolations? In fact is the state of cancer in Kenya as bad as reported by the media?

Cancer, according to the National Cancer Control Strategy (2011-2016), is the third killer disease in Kenya after infectious and cardiovascular diseases. In developed countries, it is second only to cardiovascular disease. Why Kenya has not won the war against infectious disease in 2016 is a story for another day, a story that could be related to the war against cancer through campaigns that have hit a new high. How come cancer is rampant now? Is this as a result of improved case registration rather than increased occurrences?

In my years of clinical work, seeing the fickleness of life in wards and clinics, one person with any form of cancer could be the 100th percent representation of that particular cancer. To individuals and their families, they are the entire ‘sample’. To the doctor and the facility, they are just a statistic of the many reported cases. But how many? And of what significance are these ‘statistics’? How do we, as clinicians for example, justify attending to prostate cancer patients in specialised clinics by multidisciplinary teams, rather than a simple surgical clinic? Why? It could be because prostate cancer is the commonest cancer amongst men in the country, but is it?

How do campaigners convince the country on the need for ‘x’ number of cancer care equipment if the country does not have proper data to justify this? This would be quite difficult to authoritatively state without adding caveats and disclaimers;  or gathering data from thin air. Lack of a cancer registry is our biggest hurdle.

Comparison of Kenya’s data in GLOBOCAN 2012 and that of other countries is unremarkable. Potential partners and donors have a difficult time coming to our aid in this era of evidence-based approach to health in which we are millennia behind.

We simply have no evidence to back our cause, except the facts that we know a neighbour, a relative or a friend’s uncle’s aunt’s grandfather who succumbed to a certain form of cancer. This unfortunately does not justify billions of shillings that we probably need to win this war.

Conferences have been held, many a people have donated funds towards cancer of all forms and screenings have been done, but to what ends? Proclamations have been made about establishing cancer treatment centres in every region in Kenya. So far, there are eleven or so, with radiotherapy units and other fancy, much-needed equipment. Noble as this initiative might be, how did we arrive at this figure? What are the statistics to support this and show that this will actually be of more value, and not a waster of meagre resources?

The National Cancer Control Strategy (2011-2016) clearly indicates that the country, in the 21st century, has no population-based data on cancer. What that simply means is that our cancer data are simply estimates. One of the goals of the strategy was to have cancer surveillance by 2016, but that goal is yet to be met. There is time, I hope. The document clearly outlines that a fully functional and dedicated cancer registry with appropriate expertise is key to cancer control and surveillance.

In my view, the cancer registry should be the first line of battle against cancer.

Dr Mercy Korir is a General Practitioner

[email protected]