Thursday, March 23, 2023

Prompt examination of breast cancer remains nightmare

Young and old women showing signs suggestive of breast cancer who visit government hospitals for medical attention are at high risk of having their breasts removed due to shortage of skilled personnel and the appropriate equipment for quicker diagnosis of malignant tumours in either of their twosomes at public facilities.

It would appear that the decision by government to divert cancer patients’ referrals which were initially made to South African hospitals to the much closer home, Gaborone Private Hospital (GPH) for Radiation therapy has not achieved the desired results, as prompt examination remains a nightmare.

This emerged at a multidisciplinary meeting of experts held at the GPH last Wednesday evening to discuss the different approaches recommended for treating a diverse range of cancers. The meeting was part of the subsidiary activities of the Tumour Board, a conference of cancer experts held under the auspices of the Botswana-Harvard Aids Institute Partnership focusing on a multidisciplinary approach to cancer treatment.

Dr. Memory Nsingo, Radiation Oncologist at GPH said, “While preservation of life takes precedence over conserving the patient’s breasts, it would appear that as for referred patients from the public sector hospitals it’s a given that the affected breast for the most part cannot escape resection as the only immediately practical and viable intervention to stop the cancer from spreading to other parts of the body.”

To corroborate her statement, Nsingo pointed out that in most cases patients referred to the GPH for brachytherapy, a form of radiation that is done by inserting radio- active material into the cancerous tumour to terminate the killer tissue, would already have reached an advanced stage by the time of presenting for medical attention.

“That makes it difficult to conserve their breast given that it doesn’t meet all the requirements of conserving the breast, namely that they present early, secondly that they need to have a mammogram and, lastly, that on the basis of the information derived from the mammogram a good interaction between the surgeon, the Oncologist (cancer care specialist) and a radiologist can obtain to determine the most appropriate treatment regime,” argued the GPH Cancer expert.

The GPH is believed to have begun receiving patients from government facilities who would previously have been referred to South Africa, starting February 2012 after the hospital managed to procure their own brachytherapy machine.

To compound matters, the costs of seeking help directly from the GPH is prohibitive enough to dictate that even upon discovery of any signs pointing to possible cancer they still have to present at government facilities despite clear knowledge that there is inadequate provision in terms of equipment, and the shortage of skilled personnel dealing with cancer issues also presents yet another.

As if that is not enough, Dr Michelle Gadd, a Surgeon and Cancer specialist from the Division of Surgical Oncology at the Harvard University affiliated Massachusetts General Hospital in the United states of America, said for patients who needed chemotherapy, which is the mandatory prescriptions for cancer, sometimes an alternative in lieu of radiation therapy, it was important to check the condition of the heart so as to determine the appropriate dose of the Adriamycin as it can hurt the heart.

But tragic enough, it emerged that the Echo cardiogram or Nuclear Medicine scan, as it is also called, is not available locally.

One doctor had earlier queried that a number of instances his patients later presented with heart problems after chemotherapy despite the fact that they did not complain of any heart issues before, thus prompting Gadd to explain the importance of taking precautionary measures.

Nsingo highlighted that it was imperative that people be encouraged to take the issue of cancer seriously enough so as to adopt a proactive and pre-emptive approach than allow unnecessary cost and avoidable loss of life.


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