Cancer: Govt urged to scale up interventions

Government of Rwanda needs to urgently revise its national strategy against cancer to ensure more timely detection and treatment, experts and activists have said.
Women during a cancer sensitisation match in 2012. File.
Women during a cancer sensitisation match in 2012. File.

Government of Rwanda needs to urgently revise its national strategy against cancer to ensure more timely detection and treatment, experts and activists have said.

The call comes just days after the latest World Health Organisation’s report indicated that developing countries are expected to bear the brunt of a significant increase in new cancer cases over the next two decades.

According to WHO 2014 World Cancer Report, developing countries in Africa, Asia, as well as Central and South America account for more than 60 per cent of the world’s new cancer cases and around 70 per cent of the world’s cancer deaths.

The report adds that 14 million new cancer cases were reported across the world in 2012, with that figure expected to rise to 22 million cases by 2032. Cancer deaths are also projected to go up from 8.2 million a year to 13 million a year.

The reasons given for this ailment hitting developing countries harder range from aging populations, to higher rates of infection-related cancers, and cancers associated with industrialised lifestyles.

And it’s only going to get worse if these regions do not invest more in screening and prevention. Cancer rates in developing countries are “made worse by the lack of early detection and access to treatment,” the report reads in part.

Dr Tharcisse Mpunga the Medical Director of Butaro Cancer Centre of Excellence, Northern Province, called for more commitment on the side of the government to check the spread of the disease.

“There is need to revise the national strategic plan against cancer to cater for new cases,” Mpunga said.

“We receive an average of about 60 patients per day. This is an indication that cancer is actually a big concern,” he added.

 He cited breast cancer in women and lymphoma in men as the commonest cancers in the country.

A study conducted between 2007 and 2013 by RBC indicates that 4,615 people were diagnosed with different cancers in the country, the most common being breast cancer, with 15.8 per cent.

Cervical cancer came close, with 15.6 per cent, while stomach cancer and uterine cancer were at nine and 5.5 per cent, respectively.

Mpunga also decried the shortage of cancer treatment facilities which makes control of the disease difficult.

“If only we could acquire at least one radiotherapy machine for the whole country, it would be a milestone,” he said.

Mpunga noted that since cancer treatment is not covered by Mituelle de Sante ( a community based health insurance scheme), it is increasingly difficult for the poor to access care.

Prioritise cancer

Anne Rugege, the Executive Director of Breast Cancer Initiative, East Africa, an NGO involved the fight breast cancer, said they were pushing for a new national policy on non-communicable diseases which will see cancer also given priority in as far as funding and sensitisation is concerned.

“There should, for example, be a one-stop centre for cancer ailments, so that no one travels abroad for treatment,” she said.

Rugege pointed out that one of the biggest challenges is that of patients getting depressed on being diagnosed with cancer and declining to report back for treatment.

“There is need to convince people that being diagnosed with cancer is not a death sentence,” she said

But Government officials involved with cancer intervention programmes say the country is on the right course against the disease.

Dr. Marie-Aimee Muhimpundu, the head of Non Communicable Diseases (NCD’s) at Rwanda Biomedical Centre (RBC), said there is an ongoing refresher course targeting at least one medical doctor per district in the country, with an aim of equipping them with cancer detection skills.

“The objective of this is to ensure early detection of these ailments,” she said.

Muhimpundu noted that about five hospitals offer cancer care services, with only three fully trained oncologists countrywide.

“So far we only handle mild cases, and we usually refer complicated ones abroad, especially to India,” she said, adding that there is need to carry out mass sensitisation on cancer.

 Muhimpundu noted that the biggest challenge is that of late diagnosis, since most victims show up when their cases are in advanced stages.

She added that plans are under way to start free breast cancer screening later this year.

Rugege also remarked that her organisation carries out bi-monthly seminars especially around Kigali, to increase breast cancer awareness.

“Last year alone about 800 members of the public benefited from this drive,” she said.

Rugege also challenged members of the public to control their lifestyles by watching their diets, exercising more, and abstaining from alcohol and tobacco.

Oda Nsabimana, a breast cancer survivor, who lives in Gatenga Sector, Kicuciro District, echoed a similar message, saying there is need to establish a one-stop centre for cancer patients.

“I lived with cancer for about 10 years. If it wasn’t for a government bail-out, I would not have raised the $7,500 (about Rwf5 million) that Nairobi hospital demanded for surgery.”