By ETHEL CHANDA –
Globally, cancer is not only one of the major public health concerns, but it is also the second leading cause of death after cardiovascular diseases.
According to the Union for International Cancer Control (UICC) 2022 February publication, 10 million people die from cancer yearly.
In addition, at least one third of common cancers are preventable while 70 per cent of cancer deaths occur in low to middle income countries.
The UICC further indicates that millions of lives could be saved each year by implementing resource appropriate strategies for prevention, early detection and treatment.
The UICC noted that the total annual economic cost of cancer is estimated at US$1.16 trillion.
Cancers can be caused by a number of different factors, and as with many other illnesses, most cancers are the result of exposure to a number of different factors.
It is important to remember that while some factors cannot be modified, around one third of cancer cases can be prevented by reducing behavioural and dietary risks.
In 2020, the diagnosis and treatment of cancer was adversely affected by the coronavirus disease 2019 (COVID-19) pandemic.
Additionally, reduced access to care owing to the proximity of healthcare settings and fear of COVID-19 exposure, resulted in delays in diagnosis and treatment that led to a short term drop in cancer incidence, followed by an uptick in advanced-stage disease and, ultimately, increased mortality.
Furthermore, in Zambia, 13,831 new cancer cases are recorded annually with an estimated 8,672 deaths, representing approximately 63 per cent of all new cancer cases.
Since the onset of the COVID-19 pandemic, the Ministry of Health has continued to record an increase in the burden of cancer.
Many individuals have not been able to access cancer screening services leading to presentations at advanced stages of the disease.
Similarly, cancer prevention services have stalled, including vaccinations against a virus that causes cancer of the cervix called Human Papilloma Virus (HPV).
This is according to the Ministry of Health.
Health Minister Sylvia Masebo said it is also important to note that the COVID-19 pandemic continues to pose great challenges among people living with or affected by cancer.
“Let me again emphasise that the COVID-19 pandemic presents a huge threat to the attainment of SDGs and Universal Health Care (UHC). Apart from increased mortality rates due to COVID-19 in Zambia, the pandemic has profoundly impacted cancer control services and overall healthcare delivery services,” the Health minister said.
She said the impact of the pandemic on cancer prevention has been on several levels, among them access to cancer screening programmes being reduced in the first wave in order to adhere to COVID-19 prevention guidelines.
Ms Masebo, who was speaking at a COVID-19 update in Lusaka recently, said other effects of the pandemic on cancer treatment are delays and logistical challenges to surgical and non-surgical treatment services like chemotherapy and radiotherapy.
However, the minister was quick to mention that Government has now put in place interventions to ensure continuity of routine services.
Ms Masebo fuetrher said over the four COVID-19 waves the country has experienced so far, the Cancer Diseases Hospital (CDH) has recorded 281 cases of patients with cancer who were also infected with COVID.
“Cancer patients are more susceptible to the severe form of COVID-19, leading to death of many patients,” she said.
Currently, one of the most pressing challenges the country is facing is poor access to cancer treatment, including surgery, radiotherapy and chemotherapy facilities.
“In order to mitigate the resulting prolonged disability and premature death, the New Dawn Government commits to improving access to cancer care by ensuring re-equipment of the CDH with new radiotherapy and theatre equipment,” Ms Masebo said.
She said the Government has also committed to procurement of cancer medicines and decentralisation of cancer services to the rest of the country.
Besides this, two new cancer treatment centres are planned for construction in Ndola on the Copperbelt and in Livingstone in Southern Province to have more cancer patients treated.
The Health minister said the two centres, once established, would significantly improve access to cancer care services in Zambia.
“Government is committed to expanding cancer prevention and control programmes countrywide while ensuring financial stability, sustainability and quality services for all our citizens,” she said.
CDH Executive Director Kennedy Lishimpi commended the Government for its plan to re-equip the health facility to save the lives of patients.
Dr Lishimpi said Zambia records on average about 13,800 new cancer cases annually, while the number that visits the CDH for treatment is 10,000.
He said this clearly shows that the majority of patients, though they have been diagnosed, are not accessing treatment.
“And if you look at the statistics again, we are losing about 8,000 of these cases annually, which is 63 per cent of the diagnosed patients dying. So these are quite high numbers that are very alarming,” he said.
Dr Lishimpi said from 2006 when the CDH was built, access has steadily increased and is sitting somewhere around 31 per cent of all the total number of cancer patients that are diagnosed in the country and accessing treatment for the disease.
CDH Head Clinical Care Susan Msadabwe said limited access to radiotherapy is the main challenge that the hospital is facing, leading to delays in many patients accessing treatment.
Dr Msadabwe said the hospital has a backlog of about 600 to 800 patients waiting to go on the machine.
“The problem is because of the machines, the radiotherapy equipment. You may understand that cancer treatment is not just a day’s treatment, so you receive radiotherapy for a period of two months. This means that when the patient goes onto the machine, they are on the machine for two months and that patient needs to finish before the other patient can be put onto the machine,” she said.
Dr Msadabwe said CDH needs at least two new linear accelerators, one to replace a cobhort unit that has been decommissioned, and the other linear accelerator needs replacement because it is at its end of life.
“So for us to be able to function normally, we need two brand new radiotherapy equipment that are called linear accelerators then we will be able to clear the backlog and make sure that we put patients on treatment timely,” she said.
Persons with under lying conditions, including Non-Communicable Diseases (NDCs), have an increased risk of developing severe COVID -19.
Individuals with cancer are among those with NDCs that have poor outcomes following COVID -19 infection.-ZANIS.