Date drafted: 11, September, 2012
Commonly known as colon or bowel cancer, colorectal
carcinoma (CRC) is a cancer that develops in the colon or rectum. Most CRC
cases arise in the colon. Only about twenty eight percent of the cases arise
from the rectum. CRC mostly appears due to lifestyle, increasing age and in
some cases due to genetic disorders. CRC is the third most diagnosed cancer in
the world, though it is common in developed countries. As a result of increased
incidences of CRC, Moi Teaching and Referral Hospital (MTRH) in Eldoret have
started a colostomy clinic to address CRC cases.
Although some major risk factors have been identified,
studies done worldwide have yet to establish the causative agents of CRC. Major
risk factors identified include having had an inflammatory bowel disease, high alcohol
consumption, cigarette smoking, high consumption of red meat, and consumption
of fat, exposure to radiation, lack of physical exercises and diabetes.
Approximately ten percent of the cases are linked to insufficient activity.
Diabetes is said to contribute thirty percent.
Those with a family history in two or more blood
relatives are also at a great risk of the disease. Furthermore, a number of
genetic syndromes such as Gardner syndrome have been linked to CRC.
Symptoms can include blood in stool, abdominal pains,
anemia, stool leakage, hard stool and weight loss. Treatment of CRC depends on
how advanced it is. Surgery is the primary treatment although this may only be
curative if CRC is detected early. Radiation is also conducted on the patients
to try and reduce the tumors.
CRC can easily go unnoticed. It has taken some
patients and physicians over two years to discover it. A report on CRC in
western Kenya showed that it took some patients up to five years to discover
they had CRC.
As an attempt to create awareness of CRC and to
establish its effects on patients, Mr. Peter Kamau, the head of screening at
MTRH cancer center, took part in an assessment of CRC patients in western Kenya.
The assessment took a period of almost nine months.
In the assessment, thirty five CRC patients were
followed up from January to September 2012. They were invited in September with
an objective of forming a psycho social support group in order to create
awareness and also to boost the morale of the patients. Only twelve patients
showed up. Nine out of the thirty five were confirmed dead and twelve others
could not be reached via phone.
“Those who could not be reached are probably dead,”
Mr. Kamau reckoned. Six of the confirmed dead had stoma – an artificial opening
made in order to serve as an alternative passage of stool when the rectum of
the patient is blocked by a tumor.
The assessment report, titled “Living
with Colorectal Carcinoma in Western Kenya; Lessons from the follow up of 35
patients for nine months in MTRH cancer centre and qualitative interview of 12
patients,” highlighted
a number of issues about the lives of CRC patients.
Out of the twelve patients interviewed, one was
between the ages of 20 – 30 years; four were between the ages of 30 – 40 years,
one was between the ages of 40 – 50 years, two were between the ages of 50 – 60
years and four were between the ages of 60 and 70 years.
Patients with stoma have to incur additional costs,
particularly for the management of their condition.
 |
| Mr. Kamau holding colostomy bags. The
one on the right costs 45 shillings. The one on the left costs 1000 shillings. |
First, patients had to buy colostomy bags in which they
store their stool in temporarily. Colostomy bags have to be replaced after some
time – may be after two to three days of use. Some of the bags are too
expensive for the patients to afford, forcing them to go for days, even months
without one. One of the patients assessed spent twelve months without a
colostomy bag. Apparently one bag costs as much as one thousand Kenyan
shillings. Although there are cheaper alternatives which cost around forty five
Kenyan shillings; they are not suitable in the outdoors since they are
transparent.
Some of the patients assessed used alternatives such
as towels and polythene bags. Some preferred to stay home with buckets rather
than buy colostomy bags. Recycling of bags was also noted among some patients.
Monthly costs of drugs for the patients with stoma were
as follows. Five of the twelve patients used between $119 and $178, two
patients used between $297 and $416, two other patients used between $476 and
$595 and finally three patients used between $714 and $833. Clearly it is
expensive to manage CRC.
Five of the patients with stoma said their condition
lowered their sexual desires. Only one of the patients did not respond to the
question at hand.
Having stoma also negatively impacted how the patients
worked. Out of the six patients with stoma, four claimed their condition made
them to stop working completely. One said that his work output had been reduced
by fifty percent and the other said that he worked normally.
The faith of patients living with stoma was also
affected though from the data gathered at MTRH, five of the patients stated that
their faith in God was still strong. One of the patients stated that his
relationship with God was unenthusiastic.
Concerned about the fate of those who may not know
they are suffering from CRC, Mr. Kamau urged people to go for screening. “I am
coming out to create awareness that CRC is with us here and people should rise
up and come for screening,” Mr. Kamau stated.
Note:
This is an unabridged news story done during the
author’s internship spell at the Kenya News Agency (KNA). A modified version of
the story may have been published under KNA or an associated media firm(s), and
if so, the reader is urged to treat this story’s ownership as that of the media
firm under which it is published. Thank you.
