In Kenya, cancer has become a huge menace claiming the lives of so many people.
The latest victim is Kibra MP, Ken Okoth (41), who passed on at The Nairobi Hospital on Friday, July 26.
Okoth was diagnosed with stage four colorectal cancer which he announced in February 2019.
After he went public about his illness, Okoth travelled to France, where he sought treatment, until two weeks ago, when he returned to the country.
Appearing in a past interview, Okoth told a local newspaper how he had been on treatment for ulcers and bacterial infections for about a year, not knowing he had cancer.
Doctors had also prescribed for him pills in order to manage stress and anxiety.
It was only when he sought a second opinion that he discovered that he had colorectal cancer.
Clearly, no one is spared when it comes to cancer as it affects everyone, both the rich and the poor alike.
So what causes colorectal cancer exactly and what are the warning signs? Read on to find out more.
What is cancer?
Cancer is defined as the growth of abnormal cells that multiply uncontrollably in the body.
Such cells infiltrate and harm the healthy body tissues and may spread to other parts of the body.
Cancer remains one of the deadliest diseases on earth today after claiming millions of lives globally.
Nevertheless, new developments in cancer screening and cancer treatment have augmented the survival rates for most types of cancer.
What is Colorectal cancer?
Colorectal cancer, also known as bowel cancer, colon cancer, or rectal cancer, is any cancer that affects the colon and the rectum.
It is the second leading cause of cancer death in women, and the third for men. However, due to advances in screening techniques and improvements in treatments, the death rate from colorectal cancer has been falling.
Colorectal cancer may be benign, or non-cancerous, or malignant. Malignant cancer can spread to other parts of the body and damage them.
It is not clear exactly why colorectal cancer develops in some people and not in others.
Symptoms of colorectal cancer include:
1. Changes in bowel habits
2. Diarrhoea or constipation
3. a feeling that the bowel does not empty properly after a bowel movement
4. Blood in faeces that makes stools look black
5. Bright red blood coming from the rectum
6. Pain and bloating in the abdomen
7. A feeling of fullness in the abdomen, even after not eating for a while.
8. Fatigue or tiredness
9. Unexplained weight loss
10. A lump in the abdomen or the back passage felt by your doctor
11. Unexplained iron deficiency in men, or in women after menopause
Note: Most of these symptoms may also indicate other possible conditions. It is important to see a doctor if symptoms persist for 4 weeks or more.
Possible risk factors include:
1. Older age
2. A diet that is high in animal protein, saturated fats, and calories
3. A diet that is low in fibre
4. High alcohol consumption
5. Having had breast, ovary, or uterine cancer
6. A family history of colorectal cancer
7. Having ulcerative colitis, Crohn's disease, or irritable bowel disease (IBD)
8. Overweight and obesity
10. A lack of physical activity
Screening can detect polyps before they become cancerous, as well as detecting colon cancer during its early stages when the chances of a cure are much higher.
The following are the most common screening and diagnostic procedures for colorectal cancer.
Faecal occult blood test (blood stool test)
This checks a sample of the patient's stool (faeces) for the presence of blood. This can be done at the doctor's office or with a kit at home. The sample is returned to the doctor's office, and it is sent to a laboratory.
A blood stool test is not 100-per cent accurate, because not all cancers cause a loss of blood, or they may not bleed all the time.
Therefore, this test can give a false-negative result. Blood may also be present because of other illnesses or conditions, such as haemorrhoids. Some foods may suggest blood in the colon, when in fact, none was present.
Stool DNA test
This test analyzes several DNA markers that colon cancers or precancerous polyps cells shed into the stool.
Patients may be given a kit with instructions on how to collect a stool sample at home. This has to be brought back to the doctor's office. It is then sent to a laboratory.
This test is more accurate for detecting colon cancer than polyps, but it cannot detect all DNA mutations that indicate that a tumour is present.
The doctor uses a sigmoidoscope, a flexible, slender and lighted tube, to examine the patient's rectum and sigmoid. The sigmoid colon is the last part of the colon, before the rectum.
The test takes a few minutes and is not painful, but it might be uncomfortable. There is a small risk of perforation of the colon wall.
If the doctor detects polyps or colon cancer, a colonoscopy can then be used to examine the entire colon and take out any polyps that are present. These will be examined under a microscope.
A sigmoidoscopy will only detect polyps or cancer in the end third of the colon and the rectum. It will not detect a problem in any other part of the digestive tract.
Barium enema X-ray
Barium is a contrast dye that is placed into the patient's bowel in an enema form, and it shows up on an X-ray. In a double-contrast barium enema, air is added as well.
The barium fills and coats the lining of the bowel, creating a clear image of the rectum, colon, and occasionally of a small part of the patient's small intestine.
A flexible sigmoidoscopy may be done to detect any small polyps the barium enema X-ray may miss. If the barium enema X-ray detects anything abnormal, the doctor may recommend a colonoscopy.
A colonoscope is longer than a sigmoidoscope. It is a long, flexible, slender tube, attached to a video camera and monitor.
The doctor can see the whole of the colon and rectum. Any polyps discovered during this exam can be removed during the procedure, and sometimes tissue samples, or biopsies, are taken instead.
A colonoscopy is painless, but some patients are given a mild sedative to calm them down. Before the exam, they may be given laxative fluid to clean out the colon.
An enema is rarely used. Bleeding and perforation of the colon wall are possible complications, but extremely rare.
A CT machine takes images of the colon, after clearing the colon. If anything abnormal is detected, a conventional colonoscopy may be necessary. This procedure may offer patients at increased risk of colorectal cancer an alternative to colonoscopy that is less-invasive, better-tolerated, and with good diagnostic accuracy.
Ultrasound or MRI scans can help show if the cancer has spread to another part of the body.
The Centers for Disease Control and Prevention (CDC) recommend regular screening for those aged 50 to 75 years. The frequency depends on the type of test.
Stages of cancer
The stage of a cancer defines how far it has spread. Determining the stage helps choose the most appropriate treatment.
A commonly used system gives the stages a number from 0 to 4. The stages of colon cancer are:
1. Stage 0: This is the earliest stage, when the cancer is still within the mucosa, or inner layer, of the colon or rectum. It is also called carcinoma in situ.
2. Stage 1: The cancer has grown through the inner layer of the colon or rectum but has not yet spread beyond the wall of the rectum or colon.
3. Stage 2: The cancer has grown through or into the wall of the colon or rectum, but it has not yet reached the nearby lymph nodes.
4. Stage 3: The cancer has invaded the nearby lymph nodes, but it has not yet affected other parts of the body.
5. Stage 4: The cancer has spread to other parts of the body, including other organs, such as the liver, the membrane lining the abdominal cavity, the lung, or the ovaries.
6. Recurrent: The cancer has returned after treatment. It may come back and affect the rectum, colon, or another part of the body.
In 40 per cent of cases, diagnosis occurs at an advanced stage, when surgery is likely the best option.
A number of lifestyle measures may reduce the risk of developing colorectal cancer:
1. Regular screenings: Those who have had colorectal cancer before, who are over 50 years of age, who have a family history of this type of cancer, or have Crohn's disease should have regular screenings.
2. Nutrition: Follow a diet with plenty of fibre, fruit, vegetables, and good quality carbohydrates and a minimum of red and processed meats. Switch from saturated fats to good quality fats, such as avocado, olive oil, fish oils, and nuts.
3. Exercise: Moderate, regular exercise has been shown to have a significant impact on lowering a person's risk of developing colorectal cancer.
4. Bodyweight: Being overweight or obese raises the risk of many cancers, including colorectal cancer.
A study published in the journal Cell has suggested that aspirin could be effective in boosting the immune system in patients suffering from breast, skin and bowel cancer.
A gene linked to bowel cancer recurrence and shortened survival could help predict outcomes for patients with the gene - and take scientists a step closer to the development of personalized treatments, reveals research in the journal Gut.
A study published in Science found that 300 oranges' worth of vitamin C impairs cancer cells, suggesting that the power of vitamin C could one day be harnessed to fight colorectal cancer
Researchers have found that drinking coffee every day - even decaffeinated coffee - may lower the risk of colorectal cancer.
Treatment will depend on several factors, including the size, location, and stage of the cancer, whether or not it is recurrent, and the current overall state of health of the patient.
Treatment options include chemotherapy, radiotherapy, and surgery.
The most affordable cancer treatment in Kenya reportedly costs Ksh 500,000 and this is not even cheap for the ordinary Kenyan. This figure can go as high as millions of Kenyan shillings when blood cancer is involved.
Cancer Hospitals in Kenya
Kenya still has fewer oncologists who are mostly found in a few health facilities in Nairobi.
Some of the best cancer hospitals in Kenya are situated in Nairobi county and they include;
1. Texas Cancer Centre
2. Cancer Care Kenya
3. Aga Khan University Hospital
4. Beacon Health Services Cancer Treatment Center
5. The Nairobi Hospital Cancer Treatment Centre
6. Kenyatta National Hospital
7. Moi Teaching and Referral Hospital found in AMPATH Oncology Center
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