The Aden Cancer Center [Archives:2002/04/Health]
In Yemen, cancer is considered one of the most common causes of death. Its a pity that like any other developing country the number of deaths will continue to rise and require attention. With modernization, lifestyle linked with physical inactivity, smoking and new eating habits led to the emergence of about 361 000 new cases in 1985 which forms 4.7% of the total cancer patients of the world. In Yemen there is no reliable data due to lack of a national control register. It is estimated that there are 16 000 cases annually where only 5-10% will be known to the health services.
It is relieving though to know that effective program of cancer control has been accumulated in the world and Yemen needs to implement this knowledge. In Aden, the first Cancer Center has been established as a base of all future activities of a cancer control program based on the extensive knowledge and experience available. The Center was established at the University of Aden and is a non profit making center. The centers activities include prevention, education, diagnosis, treatment, palliation and rehabilitation. All the cancer patients will be registered so that they may be effectively followed up and also in order to outline the causes and pattern of cancer in Aden and its adjacent governorates.
The main objectives of the Center include:
– Prevention of cancer
– Early diagnosis
– Relief of pain and use of measures to improve the quality of life of the victims
– Select strategies for control activities
In February 1998, International Association of Cancer Registries (IARC) France, gave associate Membership to Aden Cancer Registry. A Population Based Cancer Registry started functioning at the same time which proved efficient through applying the experience acquired from a training course.
The main source of information to the Center is the Cancer Registry which does the documentation of basic data about the patients and entry in a computerized register. This is an initial and essential step in the beginning of the establishment of the epidemiology of cancer and at the same time attempting to ensure continuity of care of the patients. As a start the Center registers Aden Governorate and the adjacent governorates of Lahj, Dhalee and Abyan. The data is from hospitals, main pathology and hematology laboratories, private clinics and abroad registry at the Ministry of Health (Aden). The data analysis is done by a computer system Canreg-3 package received from the IARC-Lyon which records the information in an orderly manner and automatically deletes one of any similar cases recorded.
As one of the objectives of the Center is education and prevention the Center has outlined important subjects which call for public awareness:
1) Tobacco It has been recognized internationally that restriction of its use will reduce incidences of lung cancer.
2) Diet Some types of food like fats have been associated as inducers of cancer while some like vegetables and fruits are protective.
3) Hepatitis In the incidence of high rates of viral hepatitis B in Yemen, it has been suspected of potential consequence of hepatocellular carcinoma. In this case among other efforts, the Center will conduct surveys to determine the HBV carrier rate, mode of transmission and also establish a vaccination strategy.
4) Life style Aspects of lifestyle including Alcoholism, Sex indulgence predisposing to AIDS (HIV), prolonged exposure to sunlight, which are well recognized factors in other countries but not so relevant to Yemen though awareness is mandatory.
5) Women safety Some cases of cancer have shown relation to reproductive factors like breast cancer prevalent to women who are nulliparous (have not delivered); Sex indulgence at a young age predispose to cervical cancer; Oestrogen therapy in menopausal women risks endometrial breast cancer. Therefore the Cancer Center will encourage instruction on these elements starting in schools.
As far as diagnosis is concerned the earlier it is done the more the chances of effective treatment. This has been inappropriate so far due to lack of infrastructure and resources. The Cancer Center will promote efforts to ensure the supply of adequate services. Also public education on early recognition of early signs and symptoms like lumps, sores, bleeding, persistent cough, weight loss and significance of prompt medical consultation.
In management and treatment, the Center will refer the patients to specialists with known expertise with specific cancers and begin to promote protocols in treatment. The Center will discourage invasive medical procedures that will have no achievement, involve the family in the support of the patient at home, also relieve the symptoms as much as possible may it be physically, psychologically, socially or spiritually.
As from 10th of January 2002 a delegation from Canada is expected in Yemen for the purpose of establishing an international cancer program. They will be in Aden between the period of 18th to 21st of January. For enquiries kindly contact [email protected].
For all the activities to be implemented surely joint efforts are required from the Faculty of Medicine, the Ministry of Health, hospitals, doctors and the community at large. Cancer is regarded not only as the burden of the affected individual but the problem of the whole society. It would only be inhuman to watch a fellow person die in agony. God knows it could be anyone next, since the only certain way to avoid cancer is not to be born!