Accra Medical Centre (AMC), a leading healthcare provider located at Ringway Estates, Osu, Accra has waged war against rising cancer disease and its associated mortalities in Ghana and the West African sub-region.
With its state-of-the-art facility, the hospital is assisting in ongoing efforts to improve access to healthcare within Ghana by providing services geared at preventive medicine and screening services for cardiovascular risk factors and diseases such as hypertension, diabetes, and hyperlipidaemia.
It also aims to screen for precancerous and early-stage malignancies using available and approved screening tools, according to the management of AMC.
Accra Medical Centre Partners Apollo Group
In its quest to provide bespoke world-class cancer management services to its patients, the AMC is partnering with Apollo Hospitals, India’s first corporate hospital to offer some care to their patients in Ghana.
For instance, just recently doctors of the Apollo Hospitals conducted a medical consultation for all cancers at the Accra Medical Centre.
They also organised a medical seminar for healthcare workers at the same place.
Why AMC is waging war against cancer
In 2019, Ghana with a total population of 30,417,858 had 22,823 total cancer cases in 2018. Out of this number, a total of 15,089 died of the cancer disease, according to the World Health Organization (WHO).
The most common cancer cases recorded in 2018 that also contributed to the high incidence of deaths according to the WHO data were-Breast, Cervix, uteri, Colorectum, Corpus uteri, Leukaemia, Liver, Non-Hodgkin lymphoma, Ovary Prostate and Stomach cancers.
Current estimates indicate that over 24,000 new cases of cancer are recorded each year in Ghana.[1] In 2020, 15,802 Ghanaians died from cancer.[2]
The Global Burden of Adolescent and Young Adult Cancer in 2019: A Systematic Analysis for the Global Burden of Disease Study 2019 noted that 60% of the world’s death is due to four disease groups including cancer which is a present burden with future implications.
It added that 3.9 million cancer deaths occur annually in Africa, with a significant burden on the paediatric population.
Socio-economic impacts of cancer
Besides the cancer disease burden, there also exist huge socio-economic impacts of the disease on the nation, patients, families, and communities.
The disease is very complex to deal with as additional costs relating to the purchase of medicines in pharmacies, the purchase of orthopaedic equipment, home help or a patient accompaniment service, and additional costs arising from travelling to the hospital for treatment.
It is reported that for the average leukaemia treatment, families are asked to pay ranging from 45-55,000 Ghanaian cedi, equivalent to over $3,800-5,900. One surgery can cost over 15,000 Ghana cedi, or $2,621. For many, such huge amounts could be the end of the road.
“That money is a lot for many Ghanaians,” Kwame Yeboah, a free cancer treatment advocate. “Even a teacher with a monthly salary of some few thousand cedis cannot afford such colossal cancer treatment”.
Ghana with a current population of 32 million people whilst more than 11 per cent live below the international poverty line – defined as living on $1.90 a day or less.
Doctors at both public and private health facilities do not turn children away if their families cannot afford treatments.
They rather ask parents to contribute what they can, and the hospital appeals to philanthropists through the media for them to pay the remaining balance.
Furthermore, some businesspeople also donate thousands of cedis on their birthdays, and other special occasions, while churches and mosques send regular payments too to support cancer patients.
Most common cancers in Ghana
According to health experts, cancer is a group of diseases that affect different parts of the body including the lungs, breasts, skin, and liver.
They said there are over 200 different types of cancers that attack the human body and almost all of them are fatal. Each of them has a unique variety of signs and symptoms and a diagnostic process.
Breast Cancer – Maybe the most talked about or most popular cancer worldwide.
Most of the women affected with breast cancer are below the age of 50 in Ghana (58.2%). Breast cancer happens when cells in your breast grow and divide in an uncontrolled way, creating a mass of tissue called a tumour.
Signs of breast cancer can include feeling a lump in your breast, experiencing a change in the size of your breast, and seeing changes to the skin on your breasts.
Mammograms, self-checks, and regular checks by health professionals can help with early detection. Early detection helps breast cancer patients to live long fulfilling lives while late-stage detection can be fatal.
Lung Cancer – According to the WHO data published in 2020 Lung Cancers Deaths in Ghana reached 237 or 0.14% of total deaths. This is alarming considering the major cause of lung cancer is smoking cigarettes.
Lung cancer also can be caused by using other types of tobacco (such as pipes or cigars), breathing secondhand smoke, being exposed to substances such as asbestos or radon at home or work, and having a family history of lung cancer.
The best way to prevent lung cancer is to avoid smoking of any form whether primary or secondary.
Lung cancer is treated in several ways, depending on the type of lung cancer and how far it has spread.
People with non-small cell lung cancer can be treated with surgery, chemotherapy, radiation therapy, targeted therapy, or a combination of these treatments. People with small cell lung cancer are usually treated with radiation therapy and chemotherapy.
Prostate Cancer – Prostate cancer is cancer that occurs in the prostate. The prostate is a small walnut-shaped gland in males that produces the seminal fluid that nourishes and transports sperm.
Prostate cancer affects about 60% of black men. The Ghana Cancer Control Strategy plan document revealed that 200 out of every 100,000 men in Ghana are suffering from this cancer.
While some types of prostate cancer grow slowly and may need minimal or even no treatment, other types are aggressive and can spread quickly. Prostate cancer that’s detected early, when it’s still confined to the prostate gland has the best chance for successful treatment.
Usually, there are no signs or symptoms in its early stages. However, more advanced cases can cause signs and symptoms such as trouble urinating, decreased force in the stream of urine, blood in the urine, blood in the semen, bone pain, losing weight without trying, and erectile dysfunction.
Many health professionals advise men to reduce their risks of prostate cancer by choosing a healthy diet full of fruits and vegetables, regular exercise, maintaining a healthy weight, and frequent medical checks to know their status.
Cervical Cancer – Cervical cancer is a type of cancer that occurs in the cells of the cervix; the lower part of the uterus that connects to the vagina. Various strains of the human papillomavirus (HPV), a sexually transmitted infection, play a role in causing most cervical cancer.
Early-stage cervical cancer generally produces no signs or symptoms. However, signs and symptoms of more-advanced cervical cancer include vaginal bleeding after intercourse, between periods or after menopause, watery, bloody vaginal discharge that may be heavy and have a foul odour, and pelvic pain or pain during intercourse.
There are many risk factors that we should consider. Risk factors for cervical cancer include having many sexual partners, early sexual activity, having sex at an early age, having other sexually transmitted infections (STIs), a weakened immune system, smoking, and exposure to miscarriage prevention drugs.
To help prevent or reduce these risks, women are advised to get the HPV vaccine and have routine Pap tests. practice safe sex and avoid smoking.
Colon/rectum Cancer – Maybe the least prevalent of the cancers mentioned so far. Common causes of colorectal cancer are lack of regular physical activity, having diets low in fruit and vegetables, a low-fibre and high-fat diet, or a diet high in processed meats, being overweight, and obesity. alcohol consumption and tobacco use.
Many doctors and health professionals suggest that people may reduce their risk of developing colorectal cancer by increasing physical activity, keeping a healthy weight, limiting alcohol consumption, and avoiding tobacco.
The reality
The top non-communicable disease accounting for mortality in young people is lifestyle-related. More than 70% of cancer global mortality will be in Africa by 2030, according to a report titled- ‘Non-communicable diseases pandemic and precision medicine: Is Africa reality?’.
The survival rate is increasing, and Ghana has the largest percentage of older people in the subregion, Oncology will become the next top killer as our capacity to care gets better, the report noted.
Challenges in Fighting Cancer
Scientists at the Radiological and Medical Sciences Research Institute (RAMSRI) of the Ghana Atomic Energy Commission (GAEC) revealed that the death toll associated with Cancers in Ghana is on the rise due to inadequate information and improper management of these cancers.
Scientist at the RAMSRI Dr Francis Hasford at a public lecture observed that the rate of cancer incidence in Europe and other parts of the Western World is higher compared to Ghana, but usually records low deaths due to adequate information and effective management of the disease.
Touching on Ghana’s situation concerning cancer treatment, he disclosed that over 4 million people compete for one Radiotherapy machine nationwide, which he described as unfortunate.
He added that the situation has mostly led to a frequent breakdown of the treatment facilities due to intense pressure.
“So far Ghana has only three Radiotherapy facilities for cancer treatment. One is situated at Korle Bu Teaching Hospital and another at Komfo Anokye Teaching Hospital with one being a private facility”.
The situation could also be blamed on inadequate public education. Most cancer patients resort to herbalists who may not know their actual ailments for treatment before they later report to the hospitals when their conditions deteriorate.
Additionally, doctors at the Accra Medical Centre indicated that the healthcare expenditure pattern has not changed in the last 50 years.
More money is spent on salaries than on innovation and research. The transition of disease from communicable to non-communicable is missed.
What can be done to arrest cancer?
Despite efforts by the WHO to prioritise tackling cancer inequity, hurdles remain due to the limited evidence to inform cost-effective decision-making and the high expense of cancer control.
In Ghana, cancer treatment is focused on large referral centres in major cities, with disparity in resources and health worker expertise in rural areas and limited coverage of the National Health Insurance Scheme (NHIS), according to studies.
Policy efforts to expand cancer services are further hindered as patients prioritise traditional alternatives over orthodox cancer services.
Multiple social-cultural, economic and health system factors can influence how patients access, navigate and choose suitable cancer care in Ghana.
Experts are calling for an equal measure of awareness-creation for cancer as it is with HIV and Malaria.
The way forward
With the advance of telemedicine and virtual learning, it is possible that the deadly cancer disease can be reduced and even eradicated if proper attention is paid to it.
Governmental strategy to emphasise the disease transition must be relooked at. Training programme modification to fit with current needs is also advocated by the experts.
