African communities need sustained cancer awareness
Most of the newly diagnosed patients we work with receive the news with a shrug and tend to express relief that their illness is not HIV/Aids. Education and media campaigns have brought HIV/Aids to the mainstream with unintended adverse effects on healthcare planning and resource allocation. There is a tendency, among communities, healthcare professionals and government health officials, to rank diseases according to their perceived immediate threat to life.
Like their government health officials and public health policy-makers, African patients tend to react to symptoms when physical discomfort is at its extreme. The clinician and research communities speak of "late presentation for treatment" and the onus and blame for this neglect is put on the patient. The phenomenon should be called, as a wise cancer scientific lobbyist suggested, " [African governments'] failure to [educate] and treat". It is unfair to expect health illiterate and indigent individuals and communities to identify cancer early symptoms without arming them with the requisite disease information and urging them to seek timely medical interventions.
Governments, in consultation with other key stakeholders, especially grassroots cancer organisations, need to adopt and convey carefully crafted education campaign messages that are culturally appropriate and evidence-based. The HIV/Aids pandemic gripping Africa makes cancer education, care and control complex since the cancer treatment side-effects mimick late-stage HIV/Aids symptoms. Patients who have heard uninformed chemotherapy horror stories tend to shun treatment out of fear of stigma driven social exclusion and/or persecution. These are the patients, if they agree to commence treatment, that are most likely to default or be lost to follow up with dire consequences because of lack of reliable patient tracking systems as is the case in most African countries, South Africa included.
Sustained national cancer awareness programs and easily accessible primary healthcare screening service - with good referral to tertiary/oncology centers will assist in curbing the unnecessary social and economic burden of disease currently borne by Africa. Governments and the cancer community must ensure that we adopt comprehensive public cancer control and care policies that; educate, provide ease access to cost effective screening programs, diagnosis, evidence-based, affordable treatment and palliation services. Also, we need to always ensure that all our interventions are community and patient centred - taking into account poisitive culturall norms and beliefs to enhance buy-in and full compliance.