TEST ME FOR CANCER!!! This is a sentiment that we, as medical practitioners hear over and over again. The truth of the matter is that there is NO “ONE TEST” for cancer! History, examination and investigations of an individual can be targeted towards a SPECIFIC cancer if it is suspected. On the other hand, the practitioner can do a generalized medical examination geared towards screening for “common” cancers…
So, what are we on the lookout for when it comes to cancers in Kenya?
- Breast cancer – Any breast lump regardless of a person’s gender or age should be examined and investigated by a medical practitioner. In the yester years, breast cancer was found in mothers and grandmothers. But, currently in Kenya, breast cancer is being found in teenagers and thus the vigilance for breast lumps is vital at all ages. Breast cancer is rarer in men but this does not mean that men should slack off. If there is family history of breast cancer, all family members must do monthly self breast examinations as well as annual to bi-annual breast examination by medical personnel. Genetics is VERY important in breast cancer and thus families must be counseled, advised and followed up.
- Cervical cancer – Any unexplained vaginal bleeding in a sexually active female regardless of age should be actively investigated. This does not to mean that cervical cancer is the only cause of vaginal bleeding or that women who are not sexually active cannot get cancers. There are other causes of irregular vaginal bleeding like infections, trauma or hormonal imbalances. In addition, other cancers like endometrial cancer may also present with vaginal bleeding. If you know that you are H.I.V positive, please be more aggressive in having your vaginal bleeding investigated. And do not be offended if a medical practitioner asks you to take a H.I.V test if you have unexplained vaginal bleeding. Annual pap smears can help pick up early cancer!
- Colorectal cancer – Colorectal (colon/rectum) cancer is still more common in women especially those above 45 years of age in our set-up. This does not mean that men or younger women do not get colon cancers. Things to keep an eye out for are; change in bowel habits and rectal bleeding. Change in bowel habits means constipation or diarrheas that are persistent or recurrent without any obvious cause. Harmless things like hemorrhoids or fissures can be associated with all the above and this is the reason that we advice you see a medical personnel to investigate your symptoms.
- Prostate cancer – Prostrate cancer is more common in men above forty years of age in Kenya. The common nonspecific symptoms that men present with are difficulty in passing urine or blood in urine. This of course may also be the more common benign enlargement of the prostrate that is likely to affect any man as they advance in age. For all intents and purpose, prostate cancer should be caught early by annual screening for cancer in all men above forty years of age.
- Esophageal cancer – Any elderly man who complains of difficulty in swallowing should be screened for esophageal cancer. They will often complain of difficulty swallowing hard foods like meat and gradually softer and softer foods. Often, these symptoms are ignored as caretakers consider that the person is just being fussy on account of age. Any elderly person with difficulty swallowing should be investigated before age is considered the cause of symptoms.
- Stomach cancer – Any man 40 years and above with history of recurrent or persistent heartburn or acidity should be investigated for stomach cancer. Many people will attribute their symptoms to smoking, alcohol, foods or stress of life. As much as these lifestyle issues can aggravate hyperacidity symptoms like heartburn, stomach pains or persistent sore throats, stomach cancer must be ruled out. In addition, if one does have persistent acidity effects on the esophagus/stomach as well as long standing ulcers and chronic H. Pylori infection, they can later on develop cancer from the same. So, please avoid over the counter self medication and get yourself investigated for your symptoms.
- Liver cancer – Once again, men above forty years of age are at risk of developing liver cancer although other people can also develop liver cancer. In our set-up, the main risk factors include excessive alcohol consumption, hepatitis B infection and exposure to aflatoxin in our grains. The symptoms to look out for include yellowing of eyes, dark yellow urine, pale stool or abdominal pains. These of course are also symptoms of other harmless lesion and thus once again if you have concern please be investigated correctly by a medical practitioner.
- Lymphomas – Lymph nodes pay a vital role in helping our bodies to fight infection. They are found all over our bodies. Cancers of lymph tissue can present in the actual lymph nodes and present commonly with enlarged, painless lymph nodes regardless of gender or age. Others develop inside body cavities and present with symptoms for instance in the pelvis or abdomen presenting with abdominal pains and/or swellings. Lymphomas are common both in children and in adults in Kenya so all ages should be investigated as appropriate.
- Leukemia – Leukemia essentially means that cancer is affecting blood cells and affecting the function of the bone marrow. This means that functions of three main areas of the bone marrow are compromised and this reflects the symptoms that one presents with. When the white cells are affected, the body cannot fight infections and one may present with recurrent infections and/or fevers. When the red cells are affected, one presents with anemia and its usual symptoms like headache, fatigue and dizziness. When platelets are affected, one presents with bleeding with or without obvious trauma.
- Skin cancer – Though Kenyans are not known to be sit in the sun to tan, there are those who spend long hours working in the open under direct sun without protective gear. In addition, H.I.V. due its immunosuppressive nature, allows for the commoner squamous cell skin cancer to develop. Skin cancer presents as an ulcer or a poorly healing wound. Thus, any unexplained ulcerations on their skin should be investigated. In addition, any wound that is not healing as expected should be investigated for any cause of immunosuppression as well as to rule out skin cancer. Less commonly we encounter a skin cancer called malignant melanoma. This develop from pre-existing moles (beauty spot/black spot) – If any mole on your body starts to grow bigger, itch or become painful, please have it investigated immediately…
Final important take home message is that cancer is a TISSUE DIAGNOSIS!!! Early cancers usually present in the exact same way as many of the usual HARMLESS lesions in the body. No one can diagnose cancer by looking at you…… A practitioner may suspect cancer based on your presentation… However, a specimen MUST be taken from the area in question and the sample sent to the laboratory for CONFIRMATION of ANY CANCER.