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Wednesday, 12 December 2018

The hidden scare: Colorectal cancer in Egypt

Colorectal cancer affects around 4,000 people in Egypt annually

Ingy Deif, Thursday 22 Feb 2018
Reuters
Colon cancer cells (Reuters)
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"Colon cancer is not a death sentence! But how much do we know about it? The answer is probably not enough!" A smile flashes across Iman Hashem's face as she tells Ahram online her story.

Iman, a 42-year-old pharamcist and mother of two, recounts the trauma that turned her life upside down almost six years ago.

"For one whole year, I never gave much thought to the pain I had in my stomach, until it got much worse and it became accompanied by crippling lethargy. I was so exhausted that I barely could function as a mother and my work came to a halt.

"After a checkup I was advised to proceed with a colonoscopy, and days later I got the news: colon cancer stage four, and a few months to live. I was 36 then.

"I decided that I wasn’t going to give up, I was a mother of two, and they needed me, so I went into eight hectic rounds of intense chemotherapy until the tumor shrank, and then I was ready for surgery.

Now that I am cancer-free, I know and tell people to run checkups if any symptoms occur, and to do it regularly starting the age of 50. Diagnosis is not a death sentence. Hope is always there," she concludes.

Iman is one of almost 4,000 new cases diagnosed in Egypt with colorectal cancer each year, according to statistics from the National Cancer Institute, with the number of mortalities ranging between 1,200 and 1,500.

She was in her thirties when diagnosed, which is at least a decade younger than the benchmark of 50, the age indicated by many health recommendations in regards to kick-starting regular colonoscopies.

The WHO defines colorectal cancer as the development of a tumor from precancerous growths (called polyps) in parts the rectum or the colon. It is the third most common type of cancer globally, ad affects slightly more men than women.

Dr Yasser Abdel Qader, the head of oncology at Qasr El-Aini hospital, part of Cairo University, says there has been a surge in younger cases in Egypt in the past few years.

"In Egypt we have the same rates of cases worldwide, but it had been noted that the number of cases detected within young ages had been on the rise. The reasons behind the increase in youth cases remain a mystery," he said.

Cancer strikes most when it is discovered in later stages, and when lack of symptoms prevents early detection. Nothing applies more on colorectal cancer

Signs include lethargy, weight loss and changes in bowel movement.

Abdel Qader says that the main reasons behind the development of colorectal cancer are related to lifestyle.

"Although inflammatory bowel diseases like Crohn's disease and genes are a culprit in some of these types of cancers, it is known that most causes are heavily associated with lifestyle. Excessive consumption of meat and low intake of fibre is a main culprit. Add to that, overweight, smoking, alcohol consumption and lack of exercise, and the colon becomes a ticking bomb," he tells Ahram Online.

Abdel Qader says that in the case of diagnosis, methods of treatment vary according to the stage of tumour development and spread.

"Surgery is effective when the cancer is confined to the intestines and detected in an early stage. Sometimes chemotherapy is a opted for before surgery to minimise the size of the tumour.”

In later stages a combination of surgery, chemo, radiotherapy, targeted therapy and post-treatment care is tailored to each case.

Abdel Qader stresses that there have been recent breakthroughs, for example by using the treatment regorafinib for treatment of advanced cases, which for the first time can be taken orally, sparing patients the agony of intravenous drugs.

But he emphasises that a speedy diagnosis makes a good outcome much more likely.

“Before talking about treatment, we should emphasise prevention. If diagnosed at an advanced stage, due to neglecting colonoscopies as a result of not being aware of their existence, a reluctance to discuss the issue with a physician or an unjustified fear of the procedure, chances of recovery from colorectal cancer are minimal, however early detection drives cure rates up to nearly 95 percent,” he says.

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