The Herald (Harare)

16 January 2013

Zimbabwe: Free Cancer Treatment Most Welcome

opinion

Plans to offer free cancer treatment are necessary; cancer is the last of the chronic illnesses where income really matters and it is a chronic illness where early detection is so critical, detection that is often not made since so many put off visits to doctors and hospitals until the cancer has developed and spread. Other major chronic illnesses we have defeated or are controlling.

Diabetes is not routinely discovered and routinely treated.

While some lower income people do move into this condition, it is notoriously an illness that hits the more-expensively fed, so support for those who cannot afford the treatment is no great drain on a health budget.

High blood pressure is again routinely treated, is again more common among those who can afford more expensive processed foods and is again managed for all.

HIV was the serious illness that could not, as the pandemic exploded across Southern Africa, be treated.

Now it can and the availability of generic drugs has seen hundreds of thousands able to afford the treatment, daily pills, and hundreds of thousands more helped through the Aids levy on income tax and generous international help.

Malaria is being fought and the battle is winnable, in the sense that if no one has it then mosquitoes cannot pass it on.

Swathes of mosquito country have been cleared and in any case the treatment can be bought in the smallest village stores and is very cheap.

Clinics can handle the illness and in malaria areas do so routinely.

So cancer is now moving back towards the top of the list of killer diseases.

The trouble with cancer is that it has very few symptoms when the mutated growth is small.

Screening and testing are needed to discover it, which is why there is more and more screening for the most common cancers among the whole population in some countries.

It will not catch them all but screening catches a lot.

Treatment at this stage is fairly easy.

If surgery is required then the cancer is a single clump of cells.

And it might well be possible to use non-surgical methods to wipe out that clump.

We presume this is what the proposed cancer centres in Harare and Bulawayo will largely be doing, making people with the early symptoms well rather than uselessly fighting cancer once it has spread.

The most critical factor is cancer awareness.

If people know they can be hit by cancer, and are aware of simple home tests and take action promptly, such as seeing a clinic or a doctor when there is a strange lump, then they have a good chance of survival.

With the new centres the clinic system now finally will have a place where people whose suspicions have weight can be sent, for final tests and that critical early treatment.

But the battle requires greater awareness as well as more facilities to test and fight the cancers.

The new centres are only half the answer.

We would hope that routine screening for some cancers can be extended to the whole at-risk population, not just those with money or on medical aid.

The cost is small in comparison to the benefits, and we are not just talking about the need to save lives.

There is a huge economic cost to the nation when younger working people die, as we learned to our cost when Aids was felling tens of thousands a year.

Someone had to pick up the tab to look after orphans; skilled workers, educated and trained at others' expense, were dead before they had made their contribution to society through work and taxes.

So it is not "just" alleviating human suffering, important as that is.

It is cheaper for the Government to find and destroy as many early cancers as possible rather than sort out the mess that the death of otherwise healthy people leaves behind.

We note, from Prime Minister Morgan Tsvangirai's remarks that these two cancer units are still being planned.

We hope that the plans turn rapidly into properly equipped and staffed wards and that the necessary training in awareness programmes and early diagnosis, at least to the extent of referring a patient for a proper test, are spread rapidly through the whole primary health system.

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