World Cancer Day

When Government Employees Medical Scheme (GEMS) member, Thuli Vilakazi,* was diagnosed with breast cancer, she believed she had been handed a death sentence. Confronted with the prospect of having to pay huge amounts for cancer treatment and highly specialised medical care, she began to grow despondent and lost
all remaining hope of survival.

She imagined her three children growing up without a mother and her husband wiling away his days as a lonely widower. In Thuli's community, when someone was diagnosed with cancer, they were always spoken about in hushed tones as if cancer was indeed the grim reaper in disguise ready to carry them off into death's waiting arms. In their eyes, cancer was a rich man's disease with ordinary people often believing that they would simply die without access to adequate cancer care. 

Little did Thuli know that being diagnosed with cancer is not a death sentence and that access to proven and effective cancer care and treatments is a matter of social justice to which all people have a right. Being a GEMS member she furthermore had access to a really good disease management programme while the Scheme was there to hold her hand every step of the way.

Targeting the myths and stigma that surround cancer is the main target of this year's World Cancer Day, which falls on 4 February. According to the World Health Organization (WHO), more people die from cancer than from Aids, malaria, and tuberculosis combined. The WHO projects that the global number of deaths from cancer will increase by nearly 80% by 2030 if immediate action is not taken. Most of these deaths are expected to occur in low to middle income countries like South Africa where myths, stigma and lack of knowledge are often the greatest barriers in the fight against cancer. 

Other myths targeted by the World Cancer Day campaign include dismantling the belief that cancer is a subject that doesn't need to spoken about. In truth, while cancer can be a difficult subject to address, particularly in certain cultures or communities, dealing with the disease openly can improve outcomes at an individual, community and policy level. Myths and stigma about cancer can often hinder public discussion and perpetuate a negative cycle of fear and misconceptions. Talking about the disease can also help alleviate feelings of shock, fear, anger, sadness and loneliness that come with being diagnosed with cancer. Raising awareness, challenging the things we are fearful to talk about and questioning misinformation is a vital part of the World Cancer Day agenda.

Another myth targeted by the campaign is the idea that there are no signs or symptoms of cancer. This may be true for some cancers but there are certain warning signs and symptoms to watch out for with cancers such as breast, cervical, skin, oral and colorectal cancers and some childhood cancers. Equipping primary healthcare workers with the relevant knowledge and skills to recognise the warning signs and symptoms of cancer is essential for the early detection of the disease, particularly in low-resource settings such as South Africa.

What are the different types of cancer?
There are over 100 types of cancer, although some are more common than others. The most recent figures from the South African Medical Research Council indicates that the cancers causing the highest number of deaths rank as follows:

What are the symptoms of cancer?
Different cancers have different symptoms. However, there are certain general symptoms that may signal cancer, such as:

• Severe tiredness
• Unexplained weight loss or weight gain
• Developing a lump or growth
• Persistent cough or hoarseness
• Noticeable changes in bowel movements or bladder activity
• Difficulty swallowing
• Continual indigestion
• Changes to the appearance of the skin and to existing moles or wounds that do not heal
• Constant unexplained pain in a particular area of the body

If you are experiencing any of these symptoms visit your doctor as quickly as possible. Cancer can spread very quickly and the sooner it is diagnosed the greater the chances are of treating it successfully.

Preventing cancer
In addition to the common misconceptions, there is also a widespread belief there is nothing you can do to prevent yourself from getting cancer. In truth there is a lot that can be done to prevent cancer. According to the Union for International Cancer Control (UICC) which founded World Cancer Day, "with the right strategies, a third of the most common cancers can be prevented." By living a healthy lifestyle and engaging in healthy activities such as eating a nutritious diet, exercising and not smoking or consuming alcohol, you can decrease your chances of getting cancer drastically.

For example, tobacco use is the most common risk factor for cancer and is linked to 71% of lung cancer deaths and 22% of all cancer deaths. Based on current trends, tobacco use is estimated to kill approximately one billion people by the end of the 21st century. Alcohol is also a known risk factor for cancer. The consumption of alcohol is strongly linked to cancers of the mouth, pharynx, larynx, oesophagus, bowel and breast as well as liver cancer and bowel cancer in women. 

In addition, overweight and obesity is increasing globally at an alarming rate. Obesity is a high predictor of certain types of cancers such as bowel, breast, uterine, pancreatic, oesophagus, kidney and gallbladder cancer. A key message in this year's World Cancer Day campaign is that prevention is the most cost-effective and sustainable way of reducing the global cancer burden in the long term.  Challenging the myth that cancer is an inevitable disease, by actively promoting behavioural change and positive lifestyle choices, is vital to the success of the campaign.

The last myth the UICC is attempting to dispel on World Cancer Day this year relates to people's misconceptions about their right to cancer care. Like Thuli, many people believe that they do not have the right to access cancer care due to financial circumstances, socio-economic status or ignorance. According to section 2 of the South African Constitution, all citizens have the right to cancer care as enshrined in the Bill Rights and GEMS is committed to providing the best possible care for all its members. For Thuli, combatting the myths and stigma surrounding cancer will not only improve her quality of life but may also help prevent her close friends and family from developing the disease as well.

Show your support for World Cancer Day by actively taking a stand against the myths and stigma surrounding cancer as well as joining in the activities organised for World Cancer Day by the Cancer Association of South Africa (CANSA).

For any GEMS member queries please phone the GEMS call centre on 0860 00 4367 or visit our website at www.gems.gov.za. GEMS will assist you in every way possible to ensure your family's health and wellbeing.

References
World Cancer Day Website: http://www.worldcancerday.org
Cancer Association of South Africa:  http://www.cansa.org.za
World Health Organization:  http://www.who.int/en/

* Name has been changed to protect the privacy of the individual.