Men ‘overlooked’ in cancer care

Monday February 6 2017

 Ocean Road Cancer Institute (ORCI)

 Ocean Road Cancer Institute (ORCI) 

By Syriacus Buguzi @TheCitizenTz

Dar es Salaam. It was midday on Thursday at the Ocean Road Cancer Institute (ORCI)—just two days ahead of World Cancer Day which was marked on Saturday—and the issue of gender and cancer came up.

It emerged following a visit at the ORCI cancer ward. Just after stepping into the white building constructed over 100 years ago, one catches a glimpse of how cancer leaves patients in pain—beds occupied by people who look thoroughly wasted, with balding heads—a sign of the side effects of chemotherapy, commonly referred to in short as “chemo”.

However, what stands out more is the impression of a gender difference that is noticed as one criss-crosses the wards and long corridors. And, immediately a question comes up: why are there more women than men at the facility? Or does this mean cancer affects more women than men in Tanzania?

The first floor of the ward is occupied by men who are afflicted by various forms of cancer. Moving higher up, both the second and third floors are all filled with women who are mainly afflicted by either cancer of the cervix or that of the breast—few affected by other types, a doctor in the ward confirmed.

Data obtained from the institute further reveals that cancers affecting females more are of two types of the top four at ORCI—cervix cancer and breast cancer. The rest—Kaposi’s sarcoma and cancer of the esophagus affect both sexes but they are in the top four category.

Kaposi’s sarcoma (KS) is a cancer that affects the skin and mouth. The lungs, liver, stomach, bowel and lymph nodes can also be affected. Kaposi’s sarcoma is a type of cancer that people with Aids often get.

Cancer of the Oesophagus affects the oesophagus (gullet, that is the food passage from the throat to the intestines).

Last year alone 1, 896 women were diagnosed with cervical cancer while 567 other cases were for breast cancer. Men carry only 1 per cent of the breast cancer burden.

Yet still, women share the burden of the other cancers with men—the Kaposi’s sarcoma cases who were 789 and esophageal cancer cases that were 473.

Just a quick look at the data, 15 per cent of those with Kaposi’s Sarcoma was for women while men were 24 per cent. And, 5 per cent of esophageal cancer was women while men were 16 per cent.

It’s not only about the data differences. There is a growing gender gap in cancer interventions in Tanzania that calls for attention as local and global health statistics on the disease continue to pose a grim picture.

The global figures are disturbing. Cancer is now responsible for almost one in every six deaths globally. More than 14 million people develop cancer every year, and this figure is projected to rise to over 21 million by 2030, says the World Health Organisation (WHO).

Cancer campaigners say women empowerment groups have raised the profile of cancer in women, forcing the government and other stakeholders to focus their attention on female cancers, leaving the affected men behind.

In his appeal to the public about the cancer scourge, titled: “Men must rise up against cancer, just as women are doing”, Dr Winluck Shayo, a Tanzanian physician based in the United Kingdom once said, “There is a greater degree of awareness concerning cancer of the breast, uterus and cervix in most communities—now even men are more aware of these (female) cancers.”

“This is not the case when it comes to cancers that affect men. There is a general lack of awareness,” noted Dr Shayo in his effort to raise prostate cancer awreness in Tanzania.

Yet, according to the Founder of Tanzanian Cancer Society (Tacaso), Mr Franklin Mtei, female cancers have a high incidence and they grow rapidly compared to cancers affecting men. This, he said, makes it evident for the government and other organisations to focus more on females.

Taking the example of breast and cervical cancers, Mr Mtei who is also a radiotherapist, told The Citizen yesterday that breast and cervix screening programmes being carried out across the country have helped in detecting the cancers early—this is not the same for men, he said.

A physician at the ORCI, Dr Chacha Josiah, told The Citizen that there are more studies going on cancer in women that in men. “This has made it easy for those intervening to think of women.

We still need to see more studies on men’s cancers and this can probably give us a different picture about the magnitude of cancer in the country,’’ he said. Dr Chacha suggests that new interventions should also focus on the health seeking behaviour of people in Tanzania because men could have been left behind because of traditional, social or cultural norms.

“We have been told by psychologists on a number of occasions that with cancer and other health problems, women tend to turn up for screening and treatment compared with men. This also makes our databases to paint a picture than women are more affected than men,” he said.