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In Kenya, we still have some people and communities in rural areas who continue to link cancer disease to witchcraft. This has negatively impacting on diagnosis and treatment of the disease. Many cancer patients are being lured to take concoctions, herbal drugs, and eating certain parts of rodent species or wild fruits for cure.  

The National Cancer Institute of Kenya through its awareness creation in community level cautions against the myths and misconceptions about cancer which comes at a time the disease has been on the rise among different ages and economic classes.

Cancer is not caused by witchcraft or any form of supernatural forces, it is a disease that can affect anyone, anywhere, in any country, at any time. Cancer is a complex group of diseases with many possible causes.

There are different risks to different people for different cancers. Some cancers are known to pass down families’ hereditary like breast, ovary, colorectal/intestinal and pancreatic cancer; therefore, those who have had a family member who has had such cancer would benefit from screening to assess risk and enable them to take necessary measures at an early stage to prevent cancer.

Other cancers are associated with age, viruses and lifestyle like smoking, stress, alcohol, bad sexual habits and diet for example, lung cancer, skin cancer, throat (nasopharyngeal), cervical cancer, and food pipe (oesophageal) cancer. Also, those with persistent infection with the Hepatitis B or Hepatitis C virus have an increased risk of developing cancer of the liver.

The age could be a contributing factor because the older you are, the more likely that you will develop a cancer. This is probably due to a buildup of damage to cells in the body over time.  The body’s defenses and resistance against abnormal cells may become weaker as one gets older.

Tobacco use can cause cancer almost anywhere in your body. Smoking of tobacco causes almost nine of every 10 cases of lung cancer, it can cause cancer almost anywhere in your body, including in the—

• Bladder.
• Blood (acute myeloid leukemia).
• Cervix.
• Colon and rectum.
• Esophagus.
• Kidney and renal pelvis.
• Liver.
• Lungs, bronchi, and trachea.
• Mouth and throat.
• Pancreas.
• Stomach.
• Voice box (larynx).

The most important things you can do to avoid health risks from cancer are—

• If you don’t use tobacco—don’t start!
• If you do use tobacco—quit!

Regardless of how long you have smoked, stopping can lower your risk of cancer and other chronic diseases. At least 70 chemicals can cause cancer in smoke from cigarettes, cigars, and pipes. When you breathe in that smoke, the chemicals enter your bloodstream, where they go to all regions of your body.

Many of these chemicals can harm your DNA, which controls how your body creates new cells and guides each type of cell to accomplish its job. Damaged DNA can cause cells to grow in ways that are not expected. These atypical cells have the potential to develop into cancer. People who smoke are not the only people who can get cancer from tobacco smoke. People around them—their kids, partners, friends, coworkers, and others—breathe in that smoke, too. Smokeless tobacco products such as dipping and chewing tobacco, can cause cancer, too, including cancers of the esophagus, mouth and throat, and pancreas.

Smoking harms nearly every bodily organ and organ system in the body and diminishes a person’s overall health. Smoking causes cancers of the lung, esophagus, larynx, mouth, throat, kidney, bladder, liver, pancreas, stomach, cervix, colon, and rectum, as well as acute myeloid leukemia. Quitting smoking reduces the risk of cancer and many other diseases, such as heart disease and COPD, caused by smoking.

The risk of premature death and the chances of developing and dying from a smoking-related cancer depend on many factors, including the number of years a person has smoked, the number of cigarettes smoked per day, and the age at which the person began smoking. Quitting smoking improves the prognosis of cancer patients. For patients with some cancers, quitting smoking at the time of diagnosis may reduce the risk of dying by 30% to 40%.

For those having surgery, chemotherapy, or other treatments, quitting smoking helps improve the body’s ability to heal and respond to therapy. In addition, quitting smoking may lower the risk that the cancer will recur, that a second cancer will develop, or that the person will die from the cancer or other causes

Pancreatic cancer is a type of cancer that begins as a growth of cells in the pancreas. The pancreas lies behind the lower part of the stomach. It makes enzymes that help digest food and hormones that help manage blood sugar.

The most common type of pancreatic cancer is pancreatic ductal adenocarcinoma. This type begins in the cells that line the ducts that carry digestive enzymes out of the pancreas.

Pancreatic cancer rarely is found at its early stages when the chance of curing it is greatest. This is because it often doesn’t cause symptoms until after it has spread to other organs.

Your health care team considers the extent of your pancreatic cancer when creating your treatment plan. Treatment options may include surgery, chemotherapy, radiation therapy or a mix of these.

Symptoms

Pancreatic cancer often doesn’t cause symptoms until the disease is advanced. When they happen, signs and symptoms of pancreatic cancer may include:

• Belly pain that spreads to the sides or back.
• Loss of appetite.
• Weight loss.
• Yellowing of the skin and the whites of the eyes, called jaundice.
• Light-colored or floating stools.
• Dark-colored urine.
• Itching.
• New diagnosis of diabetes or diabetes that’s getting harder to control.
• Pain and swelling in an arm or leg, which might be caused by a blood clot.

Causes

It’s not clear what causes pancreatic cancer. Doctors have found some factors that might raise the risk of this type of cancer. These include smoking and having a family history of pancreatic cancer.

Risk factors

Factors that might raise the risk of pancreatic cancer include:

• Smoking.
• Type 2 diabetes.
• Chronic inflammation of the pancreas, called pancreatitis.
• Family history of DNA changes that can increase cancer risk. These include changes in the BRCA2 gene, Lynch syndrome and familial atypical multiple mole melanoma (FAMMM) syndrome.
• Family history of pancreatic cancer.
• Obesity.
• Older age. Most people with pancreatic cancer are over 65.
• Drinking a lot of alcohol.

Prevention

Screening for people with a high risk of pancreatic cancer

Screening uses tests to look for signs of pancreatic cancer in people who don’t have symptoms. It might be an option if you have a very high risk of pancreatic cancer. Your risk might be high if you have a strong family history of pancreatic cancer or if you have an inherited DNA change that increases the risk of cancer.

Pancreatic cancer screening might involve imaging tests, such as MRI and ultrasound. These tests are generally repeated every year.

The goal of screening is to find pancreatic cancer when it’s small and most likely to be cured.

Genetic testing for cancer risk

If you have a family history of pancreatic cancer, discuss it with a health care professional. The health professional can review your family history and help you understand whether genetic testing might be right for you.

Genetic testing can find DNA changes that run in families and increase the risk of cancer. If you’re interested in genetic testing, you might be referred to a genetic counselor or other health care professional trained in genetics.

Ways to Lower Risk

You might reduce your risk of pancreatic cancer if you:

• Stop smoking. If you smoke, talk to a member of your health care team about ways to help you stop. These might include support groups, medicines and nicotine replacement therapy.
• Maintain a healthy weight. If you are at a healthy weight, work to maintain it. If you need to lose weight, aim for a slow, steady weight loss of 1 to 2 pounds (0.5 to 1 kilogram) a week. To help you lose weight, exercise most days of the week. Slowly increase the amount of exercise you get. Choose a diet rich in vegetables, fruit and whole grains with smaller portions.

Thyroid cancer is a growth of cells that starts in the thyroid. The thyroid is a butterfly-shaped gland located at the base of the neck, just below the Adam’s apple. The thyroid produces hormones that regulate heart rate, blood pressure, body temperature and weight.

Thyroid cancer might not cause any symptoms at first. But as it grows, it can cause signs and symptoms, such as swelling in your neck, voice changes and difficulty swallowing.

Several types of thyroid cancer exist. Most types grow slowly, though some types can be very aggressive. Most thyroid cancers can be cured with treatment.

Thyroid cancer rates seem to be increasing. The increase may be caused by improved imaging technology that allows health care providers to find small thyroid cancers on CT and MRI scans done for other conditions (incidental thyroid cancers). Thyroid cancers found in this way are usually small cancers that respond well to treatments.

Symptoms

Most thyroid cancers don’t cause any signs or symptoms early in the disease. As thyroid cancer grows, it may cause:

• A lump (nodule) that can be felt through the skin on your neck
• A feeling that close-fitting shirt collars are becoming too tight
• Changes to your voice, including increasing hoarseness
• Difficulty swallowing
• Swollen lymph nodes in your neck
• Pain in your neck and throat

When to see a doctor

If you experience any signs or symptoms that worry you, make an appointment with your health care provider.

This being a Breastfeeding week, let’s learn something on the relationship between Cancer and Breastfeeding. Did you know that women who breastfeed have a lower risk of breast cancer especially before menopause, than women who don’t breastfeed?

Many women are not aware that breastfeeding their babies can help lower their own risk of developing breast cancer; despite the fact that most parents are aware that breastfeeding is the best way to nurture babies and offers them vital health benefits.

Breastfeeding may be more strongly linked to a lower risk of estrogen receptor-negative (Some breast cancer cells require progesterone and/or oestrogen. Hormone receptors are unique proteins found inside these cancer cells. When hormones attach to hormone receptors, the cancer cells with these receptors grow.

Hormone receptor-negative tumors are estrogen receptor-negative (ER-negative) and progesterone receptor-negative (PR- negative). Hormone receptors are not expressed in these tumors. Because of this, they either have few or no hormone receptors.

Approximately 75% to 85% of newly diagnosed breast cancers are hormone receptor-positive, these hormones cane be treated with hormone therapies; hormone theraphy drugs include aromatase inhibitors, tamoxifen, anastrozole, exemestane and letrozole. Hormone receptor-negative breast cancers are not treated with hormone therapies because they don’t have hormone receptors.

Research suggests that breastfeeding women are less likely to develop pre and post-menopausal breast cancer symptoms. And breastfeeding longer than six months can have additional benefits. Most women ignore their breast health, which results in breast cancer, due to which the number of increased breast cancer cases worldwide.

Breastfeeding protects children from cancer, it reduces not only the mother’s chances of cancer but also the child’s. It is therefore beneficial to both mother and child. Studies show that breastfeeding prevents the child from being overweight, that later reduces the risk of many cancers such as pancreatic, post-menopausal breast, endometrial, oesophagal, rectal, and kidney cancers. 

A mother’s hormones are altered by breastfeeding, which may delay the onset of her menstrual cycle and minimize her lifetime exposure to oestrogen and other hormones that may increase her risk of breast cancer. Breastfeeding may also aid in preventing breast cancer-causing mutations in cells.

Breast cancer can be detected during breastfeeding; when a woman feels a lump in the breast during breastfeeding, it could be a sign of breast cancer, and the lumps can disappear after some time but can translate to cancer as a result of mastitis, which is an infection of the breast tissue by a bacteria which blocks milk ducts. Symptoms are swelling and pain in the breast, skin warmth and redness, fever. Fibro adenomas, which are lumps that feel like marble when touched and always move beneath the skin can also be the symptoms.

HPV is a double stranded DNA virus that has long been known to be the causative agent for genital warts and has recently been determined to be responsible for cervical cancers. Cervical Cancer: This is cancer of the uterine cervix with 90% of the cancers being squamous cell in origin. Persistent infection of the cervix with HPV is the primary cause of cervical cancer.

Risk Factors of Cervical Cancer

HPV infection is contracted mainly through sexual behavior which includes multiple sexual partners, new partners, partner sex history and age of onset of sexual intercourse. There are over 100 types of HPV with types 16 and 18 accounting for 70% of cervical cancers and the remaining being caused by types 31 and 33.

Prevention:

• Responsible sexual behavior, including abstinence and use of condoms

• Vaccination

• Cervical cancer screening as per current screening guidelines

Vaccination against Human Papilloma Virus disease should be done before the onset of sexual activity for optimal protection but can be used in sexually active groups to prevent multiple or persistent infections.

Three prophylactic HPV vaccines, directed against high-risk HPV types, are currently available: the quadrivalent vaccine, the bivalent vaccine and the nonavalent vaccine.

The bivalent vaccine contains non-infectious protein antigens for HPV 16 and 18, the quadrivalent against non-infectious protein antigens for HPV 6, 11, 16, and 18 and the nonavalent, non-infectious protein antigens for HPV 6, 11, 16, 18, 31, 33, 45, 52 and 58.

The quadrivalent and nonavalent vaccines offer comparable immunogenicity, efficacy and effectiveness for the prevention of cervical cancer, which is mainly caused by HPV types 16 and 18. Target population: The recommended primary target population for HPV vaccination is girls aged 9–14 years, prior to becoming sexually active.

85% of people will get an HPV infection in their lifetime.  Almost every unvaccinated person who is sexually active will get HPV at some time in their life. Most women, including teens, become infected with HPV each year. Most HPV infections will go away on their own. But infections that don’t go away can cause certain types of cancer, this is why HPV vaccination is important.

HPV vaccination works.

HPV infections, genital warts, and cervical pre-cancers (abnormal cells on the cervix that can lead to cancer) can be prevented by HPV vaccination. Among vaccinated women, the percentage of cervical pre-cancers caused by the HPV types most often linked to cervical cancer have drops by 40 percent.

HPV vaccination is cancer prevention.

HPV is estimated to cause nearly 6700 cervical cancer cases in women every year in Kenya. HPV vaccination can prevent 5000 of these cancers by preventing the infections that cause them.

Preventing cancer is better than treating it.

HPV can cause several kinds of cancer. Only cervical cancer can be detected early with a screening test. The other cancers caused by HPV may not be detected until they are more serious. HPV vaccination prevents infections that cause these cancers.

Early protection works best.

Most children only need two doses of HPV vaccine when vaccinated before age 15 years. As a parent, take the advantage of the freely available HPV vaccination in all public health facilities in the country for girl child.

HPV vaccination provides safe, effective, and long-lasting protection.

HPV vaccine has a reassuring safety record that’s backed by over 15 years of monitoring and research.

Ultraviolet (UV) radiation is a form of electromagnetic radiation that comes from the sun and man-made sources like tanning beds and welding torches.

There are different types of radiations, ranging from very high radiation like gamma and X-rays to very low-energy radiation like radio waves. UV rays have more energy than visible light, but not as much as x-rays and in the middle of this spectrum.

Higher-energy UV rays are a form of ionizing radiation. This means they have enough energy to remove (ionize) an electron from an atom or molecule. Ionizing radiation can damage the DNA (genes) in cells, which in turn may lead to cancer. The highest-energy UV rays though don’t have enough energy to penetrate deeply into the body, so they mainly effect the skin.

UV radiation is divided into 3 main groups:

• UVA rays have the least energy among UV rays. These rays can cause skin cells to age and can cause some indirect damage to cells’ DNA. UVA rays are mainly linked to long-term skin damage such as wrinkles, but they are also thought to play a role in some skin cancers.
• UVB rays have slightly more energy than UVA rays, and can damage directly the DNA in skin cells. They are the main rays that causes sunburns. And also most skin cancers.
• UVC rays have more energy than the other types of UV rays. Fortunately, because of this, they react with ozone layer in the atmosphere and don’t reach the ground, so they are not normally a risk factor for skin cancer. Some man-made sources, such as arc welding torches, mercury lamps, and UV sanitizing bulbs used to kill bacteria and other germs also produce UVC rays.

Exposure to UV Radiation

Sunlight

Sunlight is the main source of UV radiation, even though UV rays make up only a small portion of the sun’s rays. Different types of UV rays reach the ground in different amounts. About 95% of the UV rays from the sun that reach the ground are UVA rays, with the remaining 5% being UVB rays.

UV rays reaching the ground depends on a number of factors, such as:

• Time of the day: UV rays are strongest between 10 am and 4 pm.
• Time of the year: UV rays are stronger during spring and summer months. This is less of a factor near the equator.
• Expanse from the equator (latitude): UV exposure goes down as you get farther from the equator.
• Height above sea level: More UV rays reach the ground at higher elevations.
• Clouds:  UV rays can get through to the ground, even on a cloudy day.
• Reflection off surfaces: UV rays can bounce off surfaces like water, sand, snow, pavement, or even grass, leading to an increase in UV exposure.
• Contents of the air: Ozone in the upper atmosphere, for example, filters out some UV radiation.

The amount of UV exposure a person gets depends on the strength of the rays, the length of time the skin is exposed, and whether the skin is protected with clothing or sunscreen.

Man-made sources of UV rays

Man-made sources can also be expose people to of UV rays. They include:

• Sunbeds and sunlamps (tanning beds and booths): The amount and type of UV radiation someone is exposed to from a tanning bed (or booth) depends on the specific lamps used in the bed, how long a person stays in the bed, and how many times the person uses it. Most modern UV tanning beds emit mostly UVA rays, with the rest being UVB.
• Phototherapy (UV therapy): Some skin problems (such as psoriasis) are helped by treatment with UV light. For a treatment known as PUVA, a drug called a psoralen is given first. The drug collects in the skin and makes it more sensitive to UV. Then the patient is treated with UVA radiation. Another treatment option is the use of UVB alone (without a drug).
• Black-light lamps: These lamps use bulbs that give off UV rays (mostly UVA). The bulb also gives off some visible light, but it has a filter that blocks most of that out while letting the UV rays through. These bulbs have a purple glow and are used to view fluorescent material. Bug-zapping insect traps also use “black light” that gives off some UV rays, but the bulbs use a different filter that causes them to glow blue.
• Mercury-vapor lamps: Mercury-vapor lamps can be used to light large public areas such as streets or gyms. They do not expose people to UV rays if they are working properly. They are actually made up of 2 bulbs: an inner bulb that emits light and UV rays, and an outer bulb that filters out the UV. UV exposure can only occur if the outer bulb is broken. Some mercury-vapor lamps are designed to turn themselves off when the outer bulb breaks. The ones that don’t have this feature are only supposed to be installed behind a protective layer or in areas where people wouldn’t be exposed if part of the bulb breaks.
• High-pressure xenon and xenon-mercury arc lamps, plasma torches, and welding arcs: Xenon and xenon-mercury arc lamps are used as sources of light and UV rays for many things, such as UV “curing” (of inks, coatings, etc.), disinfection, to simulate sunlight (to test solar panels, for example), and even in some car headlights. Most of these, along with plasma torches and welding arcs, are mainly of concern in terms of workplace UV exposure.

UV causes cancer

Most skin cancers are a result of exposure to the UV rays in sunlight. The risk of melanoma, a more serious but less common type of skin cancer, is also related to sun exposure, although perhaps not as strongly. Skin cancer has also been linked to exposure to some man-made sources of UV rays as discussed above.

Many studies have found that basal and squamous cell skin cancers are linked to certain behaviors that put people in the sun, as well as a number of markers of sun exposure, such as:

• Spending time in the sun for recreation
• Spending a lot of time in the sun in a swimsuit
• Living in an area that gets a lot of sunlight
• Having had serious sunburns in the past (with more sunburns linked to a higher risk)
• Having signs of sun damage to the skin, such as liver spots, actinic keratoses (rough skin patches that can be precancerous), and solar elastosis (thickened, dry, wrinkled skin caused by sun exposure) on the neck

Studies have also found links between certain behaviors and markers of sun exposure and melanoma of the skin, including:

• Activities that lead to “intermittent sun exposure,” like sunbathing, water sports, and taking vacations in sunny places
• Previous sunburns
• Signs of sun damage to the skin, such as liver spots, actinic keratoses, and solar elastosis

Because UV rays don’t penetrate deeply into the body, they wouldn’t be expected to cause cancer in internal organs, and most research has not found such links. However, some studies have shown possible links to some other cancers, including Merkel cell carcinoma, which is a less common type of skin cancer and melanoma of the eye.

Studies have found that people who use tanning beds (or booths) have a higher risk of skin cancer, including melanoma and squamous and basal cell skin cancers. The risk of melanoma is higher if the person started indoor tanning before age 30 or 35, and the risk of basal and squamous cell skin cancer is higher if indoor tanning started before age 25.

The International Agency for Research on Cancer (IARC) is part of the World Health Organization (WHO). One of its major goals is to identify causes of cancer. Based on the available data, IARC has made the following determinations:

• Solar radiation is carcinogenic to humans.
• Use of UV-emitting tanning devices is carcinogenic to humans.
• UV radiation (including UVA, UVB, and UVC) is carcinogenic to humans.

The FDA has also proposed a new rule to ban the use of indoor tanning devices by anyone under age 18, to require tanning facilities to inform adult users about the health risks of indoor tanning, and to require a signed risk acknowledgment from all users.  Some US states have already banned indoor tanning by all people younger than 18, while others have banned use by younger teens and children.

UV rays and vitamin D

Your skin makes vitamin D naturally when it is exposed to UV rays from the sun. The amount of vitamin D the skin makes depends on many things, including the age, how dark the skin is, and how strong the sunlight is.

Vitamin D has many health benefits. It might even help lower the risk of some cancers. At this time, doctors aren’t sure what the optimal level of vitamin D is, but a lot of research is being done in this area.

Ways to Help Reduce Exposure to UV Radiation

Some of the ways to help ensure you’re not getting too much sun:

• If you’re going to be outside, simply staying in the shade, especially during midday hours, is one of the best ways to limit your UV exposure from sunlight.
• Protect your skin with clothing that covers your arms and legs.
• Wear a hat to protect your head, face, and neck.
• Wear sunglasses that block UV rays to protect your eyes and the skin around them.
• Use sunscreen to help protect skin that isn’t covered with clothing.

Chances of getting cancer can highly be reduced by lifestyle choices, at individual level, each one has the ability to help reduce the risks of getting cancer through their ways of living. Cancer screening, vaccination and most importantly the right health choices helps in lowering the risks for many common cancer types.

Better Healthy Choices

Cancer risks can be reduced by practicing healthy choices like avoiding tobacco, maintaining the right weight, protecting your skin from the harmful rays of sun and limiting the amount of alcohol.

Lung cancers, mouth, voice box, throat, pancreas, kidney, cervix and bladder cancers have been linked to the use of tobacco. Avoid being around secondhand smoking (SHS) also called environmental tobacco smoke (ETS) as this has also led to many cases of cancer. Chewing of tobacco has also been linked with the cancers of mouth, throat and pancreas. It is therefore important to quit tobacco smoking to help prevent cancer.

• Eating a healthy diet can also help reduce the risks of cancer. Eating plenty of vegetables, fruits and other foods from plant sources like legumes and whole grains; limiting fat from animal sources and refined sugars and eating lighter and lean food
• Limit processed meats. Eating processed meat often can slightly increase the risk of certain types of cancer. This news comes from a report from the International Agency for Research on Cancer, the cancer agency of the World Health Organization.

People who eat a Mediterranean diet that includes extra-virgin olive oil and mixed nuts might have a reduced risk of breast cancer. The Mediterranean diet focuses mostly on plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts.

Screening

Getting screening tests regularly may find breast, cervical, and colorectal (colon) cancers early, when treatment is likely to work best. Lung cancer screening is recommended for some people who are at high risk.  Screening raises the chances of finding cancer early. That’s when treatment is most likely to succeed.

Vaccination

Vaccines (shots) also help lower cancer risk. The human papillomavirus (HPV) vaccine helps prevent most cervical cancers and several other kinds of cancer, Human papillomavirus (HPV) is a sexually transmitted virus that can lead to cervical cancer and other genital cancers as well as squamous cell cancers of the head and neck. The HPV vaccine is recommended for girls and boys ages 11 and 12. Hepatitis B can increase the risk of developing liver cancer. Adults at high risk of getting hepatitis B are people who have sex with more than one partner, people who have one sexual partner who has sex with others, and people with sexually transmitted infections.