Cancer: Africa’s Nameless Enemy

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To match Feature TANZANIA-CANCER/

In Emanuel Adu’s language, Twi, people call the skin cancer that is invading his cheek and nose sasabro. It means a disease that eats away at you.

The 73-year-old former cocoa farmer has come to the Korle Bu Teaching Hospital in Accra, miles from his home, to be treated with one of the two radiotherapy machines in Ghana.

“I had heavy bleeding and discharge from my nose. The doctor told it me was cancer, a cancer called melanoma, but I had not heard those words before,” he explains in the consulting room.

Most of Africa’s around 2 000 languages have no word for cancer. The common perception in both developing and developed countries is that it’s a disease of the wealthy world, where high-fat, processed-food diets, alcohol, smoking and sedentary lifestyles fuel tumour growth.

Yet Adu’s is one of an estimated one million new cancer cases sub-Saharan Africa will see this year — a number predicted to double to two million a year in the next decade.

How can a continent hope to diagnose and treat, let alone fight to prevent a disease that has no name?

Cancer kills the poor too

It’s a question David Kerr has been struggling with for several years. A cancer specialist based at Britain’s Oxford University and former president of the European Society of Medical Oncology, Kerr set up the charity AfrOx in 2007 to help African countries seek to prevent and control cancer.

“There have been some marvellously effective campaigns around AIDS, tuberculosis (TB) and malaria, and of course infectious diseases like those are terribly important,” he said in an interview. “But already there are more deaths in the world from cancer than from AIDS, TB and malaria combined.”

By 2030, according to predictions from the World Health Organisation (WHO), 70% of the world’s cancer burden will be in poor countries, a prediction Kerr says leaves most lay people, and even many doctors, “utterly astonished”.

“They think cancer is a disease of the wealthy. But the reality is that, in part because of success in tackling infectious diseases, Africans are living longer. It’s almost a booby prize that they’re now living long enough to get cancer.”

For many women in Africa, that means diseases like breast and cervical cancer have become common causes of death before their victims have begun to learn about them, let alone find words for them.

A study published in 2011 found that since 1980 new cervical cancer case numbers and deaths have dropped substantially in rich countries, but increased dramatically in Africa and other poor regions. Overall, 76% of new cervical cancer cases are in developing regions, and Sub-Saharan Africa already has 22% of all cervical cancer cases worldwide.

The same research found that some poorer countries saw a rise in breast cancer cases of more than 7.5% a year over the 30 year period studied — more than twice the global rate.

‘Explosion of cancer’

Such data come as no surprise to Verna Vanderpuye, a clinical oncologist and radiotherapy consultant at the Korle Bu hospital where Adu will come for his treatment every day for the next two weeks.

“There’s an explosion of cancer here,” she said in an interview in her overrun consulting room.

Unlike the diseases she is trained to treat, the oncologist is a rare thing in Ghana. She is one of only six trained cancer doctors who serve a country of 24-million people.

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