Cancer is among the commonest non-communicable diseases afflicting our society today, and has robbed many of their dear ones. However, cancer experts say all hope is not lost because cancer can be treated and cured, especially if detected in its early stages.
John Muganda, an obstetrician and gynecologist at Polyclinique La Medicale, Kigali, says cancer is an abnormal proliferation and growth of cells of the body leading to abnormal body function.
He says the oncogenic human papilloma virus (which causes cervical cancer) arises from the mutation of a normal gene; mutated genes that cause cancer are called oncogenes.
Muganda explains that it is thought that several mutations need to occur to give rise to cancer cells. Cells that are old or not functioning properly normally self-destruct (apoptosis) and are replaced by new cells. However, cancerous cells do not self-destruct and continue to multiply rapidly producing millions of new cancerous cells.
According to Dr John Butonzi, a gynecologist at Butonzi Cancer Centre of Excellence, the exact cause of cancer is not known to date, though there are risk factors like smoking, genetic factors like obesity, some viruses, radiation and unhealthy lifestyles.
“Also heavy smokers and alcoholics can easily get cancer, but although young children can catch cancer, it is rampant in adults especially after the age of 55.
Dr Iba Mayele, a gynecologist at Clinic Galien, Kimironko, Kigali, says some of the common cancers especially in women such as cervical cancer, can affect any woman who is or has been sexually active. It also can occur in women who have had the human papilloma virus (HPV) which is spread during unprotected sex.
Mayele states that cervical cancer is also more likely in women who smoke, have HIV/AIDS, feed poorly, and those who do not get regular pap tests.
“Cervical cancer testing should start at 21years in women. Women between age 21 and 29 should have a pap test done every 3 years,” he says.
He urges women between the age of 30 and 65years to have a pap test plus an HPV test done every 5 years since it is the preferred approach. However, he says, it is also okay to have a pap test alone every 3 years.
According to Mayele, women over 65years who have regular cervical cancer tests and tested negative for the last 10 years need not worry, but a woman who has been vaccinated against HPV should still follow the screening recommendations for her age group.
Signs and symptoms
“For cervical cancer, the sign is uncontrolled proliferation of cells of the lower part of the uterus (cervix) leading to abnormal function, for example intermenstrual bleeding,” Muganda explains
He adds other than in cervical and endometrial cancer, where vaginal bleeding comes first, other cancers such as ovarian or uterine cancer are suspected when there is abdominal distension or discomfort, chronic pain in general at advanced stages of all those cancers.
“Ovarian cancer is more likely to occur as women get older, but for women who have never had children, and those who have unexplained infertility, or who had their first child after age 30, they are at increased risk for this cancer,” Mayele says.
Women with a personal or family history of hereditary non-polyposis colon cancer, ovarian cancer, or breast cancer are more likely to have the disease, he adds.
“Other signs of ovarian cancer are abdominal swelling, digestive problem loss of appetite and bloating, pelvic or abdominal pain, a sensation to urinate (pee) all time,” Mayele says.
Prevention and treatment
“To prevent cancer we need to avoid smoking, abusing alcohol, obesity, have a balanced diet, engage in physical activities, avoid air pollution and avoid sexually transmitted diseases,” Butonzi explains.
Muganda says cervical cancer at an early stage can be treated successfully by cryosurgery, where an early stage prostate is treated by freezing it, also known as laser ablation
Loop electrosurgical excision procedure (LEEP) can as well be used where a wire loop is heated by electric current in order to remove cells and tissues in a woman’s lower genital tract.
He also says cold knife conization (CKC) where a surgical procedure is used to remove a cone-shaped piece of cervical tissue which contains abnormal cells using a scalpel is another way of treatment.
“Radical hysterectomy, an operation that is done to treat some cancers of the cervix, by removing the uterus and tissue fibers that hold it in place. But for advanced stage of cervical cancer, chemotherapy where cancer drugs are used to treat it and radiotherapy can help,” Muganda says.
He says complete resection of the tumor can cure ovarian cancer if treated at an early stage.