TREATMENT: Study highlights urgent need to improve healthcare infrastructure and drug availability in sub-Saharan Africa to increase survival for patients with colon cancer or other forms of cancer

By WSAM Correspondent

ATLANTA – Fewer than one in 20 patients diagnosed with potentially curable colon cancer received standard of care in Sub-Saharan Africa, a worldwide study has revealed.

The study was conducted by researchers at the American Cancer Society (ACS), Martin-Luther University in Germany, and many other institutes worldwide. Its findings were published in the Journal of the National Comprehensive Cancer Network on Wednesday.

The new findings showed that 55 percent of curable colorectal cancer (CRC) patients in sub-Saharan Africa survived two years after a diagnosis of their disease, compared to 84 percent of patients in the United States.

Meanwhile, the risk of dying from CRC (also known as curable colon cancer) was 67 percent higher in patients diagnosed in low-income countries than those in middle-income countries.

“The burden of colorectal cancer is increasing in sub-Saharan Africa, however, little was known about treatment and survival in the region,” said Dr Ahmedin Jemal, senior vice president, surveillance & health equity science at the American Cancer Society and senior author of the paper.

“These findings underline the urgent need to improve healthcare infrastructure, including the oncology and surgical workforce, and drug availability in the region to increase survival for CRC and other cancer patients.”

For the study, researchers examined a random sample of 653 patients with CRC diagnosed from 2011 to 2015 obtained from 11 regional population-based cancer registries in the sub-Saharan region.

The registries included Abidjan (Ivory Coast), Addis Ababa (Ethiopia), Bamako (Mali), Brazzaville (Congo), Bulawayo (Zimbabwe), Cotonou (Benin), Eldoret (Kenya), Kampala (Uganda), Maputo (Mozambique), Nairobi (Kenya), and Namibia.

Information on clinical characteristics, treatment, and/or vital status was obtained from medical records in treating hospitals for 356 (54%) of the patients (“traced cohort”).

The authors assessed whether receipt of treatment for this type of cancer in the region met the National Comprehensive Cancer Network® (NCCN®) Harmonized Guidelines™ for the region, and whether overall survival after a diagnosis differed between low-income and middle-income countries in SSA.

Of the 356 patients with CRC, for whom medical charts were obtained, 51.7 percent were male, 52.8 percent were from low-income countries, 55.6 percent had colon cancer, and 73.6 percent were diagnosed with nonmetastatic disease.

Among the patients with non-metastatic disease, however, only 3.1 percent received guideline-concordant or standard-of-care treatment, 20.6 percent received treatment with minor deviations, 31.7 percent received treatment with major deviations, and 35.1 percent received no treatment.

GETTING INTO GRIPS WITH PECULIAR OVARIAN SYNDROME

INCIDENCE: Polycystic ovary syndrome, a hormonal disorder that afflicts women of reproductive age, is estimated to affect between eight and 13 percent of women, with up to 70 percent cases undiagnosed unfortunately…

By Thuli Zungu

September is International Polycystic Ovary Syndrome (PCOS) Awareness Month, a time dedicated to increasing awareness among the general public about the condition. Even though PCOS is a common disease, it can have severe effects on those who suffer from it.

Dr Bradley Wagemaker, a medical director at Lamelle Pharmaceuticals, says many women realise they might be dealing with a fertility issue related to PCOS only when they try to get pregnant and struggle. Fortunately, there are medical solutions and nutritional supplements designed to help manage and even reverse the condition.

“That overwhelming frustration and anger that feels like it comes out of nowhere, but could probably be related to the inexplicable seven kilograms of weight you’ve just picked up this past year; a menstrual cycle with a mind of its own… also, what is up with these nipple hairs?” Wagemaker says. He says if this sounds like a page out of your diary, it’s likely that you’re one of the eight to 13 percent of women who suffer from the common, but under-diagnosed, condition.

Yet, as common as PCOS might be, and severe its symptoms, PCOS typically goes undiagnosed for months and – in most cases – years, says Dr Wagemaker.

Many women, and sometimes even their healthcare providers, shrug off the symptoms associated with PCOS as a natural part of being a woman. Sadly, this all too often leads to delayed diagnoses, says Dr Wagemaker.

“While strides are being made in the medical industry and through PCOS Awareness Month in September, to improve the number of women being correctly diagnosed and treated at an early stage, women need to educate themselves on the signs to look out for,” he says.

Dr Wagemaker says PCOS is an endocrine (hormonal) condition that affects both girls and women, but often diagnosable only in women of reproductive age. Symptoms include heavy, irregular or even absent periods, excess facial and body hair, oily skin and acne, and small cysts on the ovaries. The affected may also be more susceptible to insulin resistance, weight gain, psychosocial disorders, endometrial cancer, and other serious and life-threatening conditions.

Also, PCOS often leads to infertility in women. With hormonal imbalance brought about by PCOS, the ovaries are unable to grow and release eggs, stunting the ovulation stage in a women’s cycle – that all-important time for baby-making, he says.

“It’s sadly very common for women to suffer in silence, thinking that the uncomfortable, inconvenient and even traumatic symptoms of PCOS are nothing more than a normal part of being a woman,” says Dr Wagemaker. “Instead, the message we should be sending to all women is that PCOS is manageable, and that you may not have to forgo your weight loss goals or your dream of starting a family.”

Maintaining a healthy diet with limited sugar and carbohydrates is a good starting point, as is regular exercise. There are also supplements available to help alleviate the symptoms of PCOS. Ovaria, for instance, is a nutritional supplement that helps regulate insulin activity in the body, he says.

Dr Wagemaker says in this process, the cells in a woman’s body are better able to use the glucose stores available, helping to regulate blood insulin levels, the ripple effect of which is normalised androgen levels and improved PCOS symptoms (bye-bye to weight gain, so long, nipple hairs). This also improves fertility for women who are trying to fall pregnant.

While there’s still a long way to go in ensuring more women can get the PCOS diagnosis and effective treatment they deserve, women who are armed with the right information have more control over their own PCOS journeys – and that’s half the battle, won, he says.