Why most cancer patients in Tanzania have less chance for survival

By Dr Heri Tungaraza

Cancer diagnosis is scary news--people take it as a death sentence with no appeal. This was how it was like when HIV cases started emerging in the 1980s.

But there are great strides made in HIV treatment today. People with HIV live longer than before. This is not seen in cancer though the disease has been around since the times of Hippocrates, around 400 BC.

The contrast is not only obvious between HIV and cancer but also between cancers and cardiovascular disease where deaths have substantially gone down due new medications and state of the art technological diagnostics.

Yes, there has not been any amount of success in cancer care over the past 100 years. Over the years, we have witnessed the invention of new drugs like imatinib that have changed Chronic Myeloid Leukemia to a manageable disease. With the advent of new diagnostic tools, cancer is diagnosed much earlier than before, increasing the opportunity for treatment and in some cases cure. Advanced tests have given the health care providers a possibility of preventing around 1/3 of all cancers.

However, the little progress made all over the world in the fight against cancer is not shared by those in developing countries like Tanzania. Sadly, many patients come to the hospital at a very late stage. Studies carried in the country show that many patients with breast cancer for instance, seek medical help while they are already with stage III or IV.

This could be caused by the long distances to health care facilities, lack of awareness, and poverty among others. The government and its stake holders must take calculated steps to mitigate this trend to save thousands of lives.

The other major setback contributing to poor survival for cancer patients in the country is the poor accessibility to treatment. Cancer treatment is very expensive and it requires multi-disciplinary approach which does not come cheaply.

It can be treated by surgery, chemotherapy, radiation, hormonal and immunotherapy. The public hospitals that have the capacity to treat cancer usually run out of these drugs due to under budgeting, leaving the patient at cross roads. For radiotherapy the challenge is equally huge because so far there us only one radiotherapy machine.

However there are plans by the government to get two more machines that would be stationed in Dar and Mwanza. To compliment these efforts, the private sector is called upon to invest in this area to improve care for oncology patients.

I must admit that our cancer patients have poor chances of survival due to the fact we are still treating cancer like a single disease. Due to poor resources, we are failing to benefit from the advantages of precision medicine where every treatment is customized for every other patient.

Till today, we have not been able to use the information from genetics. Tailored treatment plans improve patient outcome. It's also evident that we understand less about the cancer in our communities due to lack of research forcing us to always turn to the west for guidance. Research will get us more information about the cancer that our people succumb to and hence have a better chance to tackle this scourge.