Expanding radiotherapy centres to boost cancer treatment

Article: Salome Donkor
THE word ‘cancer’ evokes desperation that stirs grief and pain, a scourge that strains intellectual, social and emotional resources.
Statistics from the World Health Organisation (WHO) indicate that there are over 20 million people living with cancer in the world today, with the majority in the developing world.
According to medical experts, cancer, which is the term used for diseases in which abnormal cells divide without control and invade other tissues, is one of the killer diseases among both men and women.
Each cancer is thought to first start from one abnormal cell. What seems to happen is that certain vital genes which control how cells divide and multiply are damaged or altered. This makes the cell abnormal. If the abnormal cell survives, it may multiply “out of control” into a malignant tumour, which consists of cancer cells that have the ability to spread beyond the original area.
Dr Clegg Lamptey of the Surgical Department of the Korle-Bu Teaching Hospital in Accra says cancer affects various parts of the body, which results in various types of cancers, each with its own name and its treatment.
Some types of cancers that affect parts of the body are breast, lung, stomach, skin, cervical and prostate cancers. Doctors say cancers in children can affect any part of their bodies. Leukaemia is a type of cancer that starts in blood-forming tissues such as the bone marrow and causes the production of large numbers of abnormal blood cells which enter the blood.
Given the complex nature of the disease, early detection of cancer is crucial for effective treatment and such detection is almost impossible without the requisite equipment and trained personnel.
Doctors contend that irrespective of the type of cancer a patient develops, he or she may need one of the following processes — surgery, chemotherapy, radiotherapy and hormonal therapy — and that usually patients who have prostate and breast cancers go through hormonal therapy.
For this reason, the news that Ghana has secured $13.5 million loan from the OPEC Fund and the Arab Bank for Economic Development in Africa to upgrade and expand the radiotherapy centres at the Korle Bu and Komfo Anokye Teaching Hospital in Accra and Kumasi respectively could be described as a positive step to enhance the care and treatment of cancer cases in the country.
The story published in the Daily Graphic early April, quoted the Minister of Environment, Science and Technology, Ms Sherry Ayittey, as stating in an interview that another $9 million dollars was being sourced to establish a new radiotherapy centre at the Tamale Teaching Hospital to serve the northern part of the country and neighbouring West African countries not having radiotherapy facilities.
She said the projects were being undertaken in line with the government’s determination to ensure that cancer cases received prompt attention at the country’s two teaching hospitals.
Ms Ayittey said upgrading and expanding the two centres would enhance the care and treatment of cancer cases in the country and ensure that cases which were hitherto referred to hospitals outside the countries were treated locally.
Doctors say cancer could be cured when detected early, and that cancers needed multi-disciplinary treatment with various specialists. However, if left untreated, it may spread and destroy surrounding tissues.
Radiotherapy is an important means of treating cancers and most cancer patients go through this treatment. According to Wikipedia, the Free Encyclopedia, radiotherapy is used for the treatment of malignant cancer, and may be used as a primary or adjuvant modality. It is also common to combine radiotherapy with surgery, chemotherapy, hormone therapy or the mixture of the three. Most common cancer types can be treated with radiotherapy in some way. The precise treatment intent (curative, adjuvant, neoadjuvant, therapeutic, or palliative) will depend on the tumour type, location, and stage, as well as the general health of the patient.
Radiation therapy is commonly applied to the cancerous tumour. The radiation fields may also include the draining lymph nodes, if they are clinically or radiologically involved with tumour, or if it is thought there is the risk of subclinical malignant spread. It is necessary to include a margin of normal tissue around the tumour to allow for uncertainties in daily set-up and internal tumour motion. These uncertainties can be caused by internal movement (for example, respiration and bladder filling) and movement of external skin marks relative to the tumour position.
To spare normal tissues (such as skin or organs which radiation must pass through in order to treat the tumour), shaped radiation beams are aimed from several angles of exposure to intersect at the tumour, providing a much larger absorbed dose there than in the surrounding, healthy tissue.
Lack of knowledge of the disease and the cost of treatment makes it difficult for most cancer patients to bear the cost of surgery and treatment. For that reason, some patients seek support from herbalists and pastors, instead of visiting the health facility.
Mrs Gladys Boateng, Director, Reach for Recovery, a breast cancer support group, said because of the stigmatisation, myth and fear surrounding the disease, nobody wanted to be associated with it, stressing that that was affecting the fight against the disease.
There is therefore the need for a concerted effort and intensive education to highlight the world-wide growing cancer crisis and its effect on women in particular. There is the need for counselling and other support.
It is also necessary to demystify cancer to disabuse the minds of patients of the fear, misconception and myths surrounding the disease and encourage patients to go for regular, medical examination.
The survivors are encouraged to participate in stress-relieving trips and also take active roles in visiting one another.
According to Mrs Boateng, another important aspect of cancer treatment was the need to establish a hospice for terminally ill cancer patients for proper care and support and pointed out that support groups, such as Reach for Recovery, needed to be offered the maximum support to continue their good works.