Dr Joseph Kamugisha The availability of modern cancer screening methodologies and advanced epidemiological studies have been at the forefront of public health in recent years. It’s well known that the highest cases of cancer incidences are linked to genetic predisposition. But there are quite a sizeable number of cancer cases caused by other risk factors. Viral infections and toxins are factors that have been widely studied and found to inflict mutations that cause cancer. Of course, the body’s self-defense or immunity is the primary consideration for the fight against occurrence of diseases. Diet is one of the major factors known to boost the immune system. This is the reason why dietary or other lifestyle adjustments are some of the ways to minimise the risk of cancer occurrence. Modern cancer therapies are very expensive and the cost to carry out an invasive procedure is also very high. Such factors should always elicit our mind or alert us on stringent control and prevention measures. Pembrolizumab and nivolumab are second generation immunotherapy drugs. Pembrolizumab is a widely used immunotherapy medication in the treatment of advanced or recurred or metastatic cancer conditions. The drug has been largely used in the treatment of metastatic lung cancer diseases, skin cancer (melanoma) and gastric cancer, among other various cancer conditions. Pemba is one of very expensive medications on market. The standard cost for every single injection is valued at $10,000 (about Rwf7.6 million) taken once every month, but in some cancer types might require a single dose or injection every two-weeks. We should also put into account the toxicity of medicine itself. Chemotherapy is a chemo-toxic medicine with diverse side effects. The body system usually struggles to eliminate these toxins and end up accumulating in the circulation system that gives rise to occurrence of symptoms. Nutrition or diet for patients under chemotherapy treatment is always an important factor to consider and it’s mandatory to all cancer patients. It is also advisable to engage in lifestyle activities that boost our body defense mechanism or help eliminate as much toxins from the body as possible. Collaborative cancer centers work hard on a regular basis to trace the best solution or treatment of the disease. They discuss about the outcome of various treatment modalities and also assess new possible studies that will improve treatment protocols. Many scientists and cancer experts around the globe have studied how cancer develops and spreads. Most of the chemotherapy medications damage or inhibit cancer cell DNA or information system for replication. Most of biological cancer treatments available aim to keep the cancer cell inactive or stay in dormant stage for a long time. Some natural products have proved to be more efficient than chemotherapy medications, but majority of studies on herbal or natural plant extracts are not conclusive. In medical oncology, we usually ensure that cancer cells do not break away from the original cancerous tumor to travel through the bloodstream or through lymph vessels to other parts of the body. Lymph nodes or lymphatic vessels work like the blood vessels only that they carry the lymph fluid from other parts of the body back to the heart. Some cancers can spread through systemic channels where as others can spread through lymph nodes. Some cancers can spread through both ways and once we have received a cancer victim, we always strive to block the cancer on either channel. Some patients who are declared cancer free might develop lesions at the previous site or different site of the body. This is what is referred to as recurrence and is usually a setback in terms of disease progression control. Distant recurrence or metastasis of the disease means some cancer cells became resistant to the medications or chemotherapy during treatment and broke-off from the primary tumor to survive the initial treatment reaction. Such cancer cells travel through lymph nodes or blood vessels to start growing in a different part of the body. Different cancers have different spread or metastasis channels; they tend to spread to different parts of the body. Common sites of metastatic spread or distant recurrence include the lungs, bones and brain.