THE CANCER MENACE IN THE 20s-30s AGE-GROUP

  It's Monday the 19th January 2015 at 5.30p.m and I'm lazing on my couch trying to review something. My mum calls me and tells me that she has not seen my blog-post for the week. I told her that I didn't feel like writing because my last two posts did not get much reads. She reminded me that that's the life of a writer, there are high and low seasons. I got motivated, dropped the book I was reading and started writing. I had so much to share, I could feel it boiling up in me. 

  Last week was a very tiring week for me. The magnitude of the diseases I saw was too heavy for me to bear. This is because it mostly involved my age-mates. Let me brand the week's experiences 'cancers affecting my agemates' We diagnosed two breast cancers in    girls old enough to be my age-mates if not younger . One of the girls allowed me to share her story. The little girl in her early 20s came in with complaints of a breast lump.  On the first half of the history, I automatically presumed it's the harmless Fibroadenoma mostly encountered in late teens and early twenties.  I thought so because of her age.  Examination of the breast and further analysis of her previous medical notes made me conclude the worst. It was breast cancer !!! Yes, at that young age. We went ahead and recommended a mastectomy which was done later in the week . I was almost in tears. Here was girl, younger than me and having to bear such sad news. Infact, she is the age of my younger sister. I couldn't imagine my sister going through that, she is too young; she is a baby. Despite being a medic and having the knowledge , I have always intentionally  presumed that breast-cancer is a disease of the 40s and above . But here was a girl, barely past her teenage-hood and diagnosed with it. I don't remember the last time I did a self breast examination, are we too ignorant and presumptive? We diagnosed her cancer at stage 3. Is there a chance that it would have been diagnosed much earlier? How often do women from age 13 examine themselves or report any minor anomaly? A Breast cancer relapse in a patient in her 30s who had fast become a friend topped up my sorrows for the week. We had successfully done her mastectomy two months back but she couldn't access chemotherapy/radiotherapy because of the inadequacy of such facilities to the poor patients in the country. Sometimes, you cannot avoid taking patient issues too personally. This reminds me of cases of three women, all at age 30 who came to the hospital at different times with  complaints of heavy persistent menstrual periods. We all thought it was Dysfunctional Uterine Bleeding(D.U.B), fibroids or the side effect of contraceptives. Ultrasounds confirmed the worst. They all had 'cauliflower' masses arising from the cervix. On vaginal examination, they had fungating,friable and bleeding cervical masses. (We should have done the examination before the ultra-sounds but African women are hesitant to have vaginal examinations during menstrual periods). They had Cancer of the Cervix. They were shell shocked. They had come for simple medication to stop the 'periods,' only for them to learn that it was not periods.  We did a biopsy and histopathology confirmed all the three cases. They had come to pick the results last week. I had to endure the heavy task of breaking the news and giving advise on what to do next. One of the lady stared at me in shock and asked me to slowly repeat what I had been saying because she had switched off completely in panic and fear. To her, it was like a death sentence. All three are exactly 2 years older than me, with dreams and ambitions, but cancer had come to interfere with their good life. I could feel their pain. None of them had the history of cancer in their families, they had started the history!  When did you last have a pap-smear done? It could happen to anyone. It knows no age group and it doesn't matter that you don't have a family history. 


 There was pancreatic cancer diagnosed on a 29 year old. We all presumed it was distal stomach cancer after a series of investigations and had him set for a partial gastrectomy (removal of half the stomach). In theatre we sadly learned that it was  pancreatic cancer. An inoperable cancer. It's what claimed Steve Jobs' life ; the founder of Apple Inc. It was very sad! Wasn't cancer a disease of the west?? I have learned to be careful. I have stopped taking things for granted. I have stopped presuming that cancer is a disease of the old timers. Each time I'm tempted to skip eating fruits and vegetables, I remember my two advanced colon cancer patients who died at age 35 and 38 respectively here in Chaaria. Each time any of my family member presents with acid regurgitation I treat them promptly to avoid barrett metaplasia and consequently cancer of the esophagus. Each time a patient comes in with a persistent lymph-node enlargement I quickly advise on a lymph-node biopsy because hey, I have already seen more than 5 lymphomas this year. Each time I hear anyone complain of bloody urine, I quickly dash to do an ultrasound; haven't we diagnosed bladder cancer on girls in their twenties? I associated almost everything with cancer last week. It got to my head so much, I could have easily misdiagnosed simple TB for Lung-cancer. I didn't want to presume anything. It's good for all of us to be on the look-out. A small ailment could end up being a horrific experience if not followed up early. Most cancers are also preventable by making simple lifestyle modifications.    

 There you have it. I hope that we will all be on the alert and stop taking things for granted.  I pray that all cancer patients receive the care they deserve and get on with their lives . I hope that a time is coming when cancers will be detected timely and completely cured. I mostly pray a time is coming when all cancers will be preventable.  P.S: Cottolengo Mission Hospital should be made a cancer diagnostic centre. We diagnose at least 15-20 cancer patients every week. The top on the list are the many esophageal and stomach cancers, the many liver cancers mostly from Tseikuru, prostate cancers , colon cancer once in a while, nasopharyngeal tumors, occasional brain tumors, the many lymphomas,cancers of the head of pancreas has become the first differential diagnosis in patients with obstructive jaundice. The list is endless.