From farm to folk, food safety is important for everyone. You must eat healthy food. It is however more important that food is first, safe to eat. Food safety during cancer treatment is crucial. This is because cancer and its treatments – radiotherapy, chemotherapy, brachytherapy and stem cell transplants – compromise the immune system. This often exposes cancer patients to food-borne illness with the least food contamination. It is therefore critical that cancer patients keep to best personal and food hygienic practices.

Guidelines for Food Safety during Cancer Treatment

• Always wash your hands with soap under running water before and after preparing food, as well as before and after eating. There is the unfortunate habit in some African homes where hands are washed with just water before eating, but with soap and water after eating. It is a wrong cultural practice that all, especially cancer patients, must refrain from.
• Always eat cooked food as warm as tolerable. Allowing cooked food to cool for long before eating could allow germs to contaminate it and pose harm to you.
• Wash vegetables and fruits thoroughly using clean water before peeling or cutting.
• Scrub vegetables and fruits that have firm surface such as potatoes, carrots, oranges and melons before using.
• Cut away any damaged or bruised areas on farm produce.

  

• Wash the top lids of canned foods with soap and water before opening.
• Thaw food in the refrigerator, not in the open. You could also use the defrost setting of the microwave to safely defrost food.
• Put food in the refrigerator within two (2) hours after your finish serving. Do not allow cooked food to stay for too long before refrigerating.
• Do not put foods like milk and dairy products in the compartments of the fridge door. Regular opening of the door exposes them to temperature differences which could easily cause them to spoil. Rather, water and drinks are mostly meant to be kept in these fridge compartments.
• Foods containing eggs, cream or mayonnaise should be refrigerated after just one hour of cooking them.

  

• Always cook meats until well done, with no trace of blood in the centre. This is because meats are rich in nutrients and so attract a lot of germs.
• Use a different spoon to taste and a different one to stir your food while you are cooking.
• Always check the expiry date of packaged food products.
• Do not put raw poultry, meat, seafood and eggs in the same fridge chamber as ready-to-eat foods like cake, fruits, salads and dairy products.
• Always buy only pasteurized or refrigerated milk. Once you use milk or any dairy product, immediately keep what is left in the fridge.
• Use separate cutting board for vegetables and meats/fish. If you have one cutting board, then wash it very well after using it for raw foods before using it for cooked or ready-to-eat foods to limit the transfer or microorganisms from the raw uncooked to the ready-to-eat foods.

When in doubt about how to safely keep or eat any food, ask your Registered Dietitian. Always remember that, a healthy meal must first be safe.

Desmond Paa Kwesi Hackman (RD, LD, RO, MSc)

Dietician/Nutritionist Consultant, Sweden Ghana Medical Centre

Getting a cancer diagnosis can leave you feeling anxious and depressed. You may also worry how treatment may affect intimacy and your sexual performance. For men, the potential side effects of prostate cancer treatment can also be particularly concerning when they must decide which approach is right for them.

Treatment options for prostate cancer like surgery, radiation therapy, and hormone therapy can have varying side effects. These include erectile dysfunction, loss of libido, and reduced fertility. There is good news. Most of these side effects can be managed and many men have a good chance of returning to a full sex life after prostate cancer treatment. In effect, the goal is to give the patient the most appropriate cancer treatment method with the least side effects so that his quality of life will be preserved.

These days, there are a lot more options and open discussions about maintaining sexuality for men who need to go through prostate cancer treatment.

For dealing with erectile dysfunction, your healthcare professional can discuss alternatives to help you get and maintain an erection and to keep your sex life active. There is good advice available. Open communication with your partner also makes it easier to know what to expect when you are undergoing treatment and helps you to experiment with new ways of approaching sexuality. A counselling session can help you explore nonsexual intimacy to reduce anxiety over sexual performance during your treatment for prostate cancer.

If you are worried about reduced fertility, you can explore an option to store sperm in a sperm bank before starting prostate cancer treatment. Ghana already has a few certified fertility centres that offer these services. Remember, there are several options to deal with erectile dysfunction and related problems during prostate cancer treatment, which can be discussed with your healthcare professional at your cancer treatment center.

Two oncology nurses from Lakeshore Cancer Centre in Nigeria visited Sweden Ghana Medical Medical Centre (SGMC) for a week-long training in Chemotherapy protocols. Lakeshore Cancer Centre (LCC), located in Victoria islands-Lagos, is the first operational facility in Nigeria dedicated to cancer prevention and treatment. Our trainees were Mrs. Uchenna Chidinma, head oncology nurse and Miss Mary Osakwe, an oncology nurse.

A key objective of SGMC is to take away the burden of cancer from especially, the West African populace. This requires forming critical partnerships with other cancer management centres in the region. To that end, the SGMC-Lakeshore partnership allows cross-training of professionals to support continuum of care for our Nigerian patients. Learn more about how you can intern with us. Send an email to research@sgmcltd.com

Stomach (Gastric) Cancer – (GC)

In Africa, GC is ranked 12^th most common cancer however, in countries like Mali, it is the commonest cancer affecting men with about 92% presenting with late stage disease. It is no wonder therefore that the mortality rate of GC is an alarming 98%.

What is Stomach cancer?

Stomach cancer occurs when cells in the inner lining of the stomach become malignant (grow out of proportion). The portion of the stomach where the cancer begins determines the signs observed and the treatment options a patient can benefit from.

What are the risks for Stomach Cancer?

Anything that increases your chances of getting a disease is known as risk. Research has demonstrated that the factors that affects an individual’s chance of GC is both genetic (unpreventable) and environmental (preventable). These include:

• Having first degree relatives who have been diagnosed with GC.
• Age – the older one gets, the higher one’s risk of GC
• Sex – men are more likely to be diagnosed with GC
• Current/past infection with Helicobacter pylori
• Epstein-Barr Virus (EBV) infection
• Smoking
• Obesity

What are the signs and Symptoms of Stomach Cancer

These and other signs can be indications of stomach cancer or of other conditions. You should check with your doctor if symptoms persist.

• Bloating and nausea particularly after a meal.
• Pronounced heartburn, indigestion and stomach discomfort
• Persistent stomach pain
• Difficulty swallowing
• Loss of appetite
• Blood in stool and/or vomiting blood
• Unexplained weight loss.

Diagnosis of Stomach Cancer

Stomach cancer can be diagnosed in one or several of these ways:

Clinical examination: At an advanced stage, a medical doctor will look out for the following on physical examination: fluid retention in abdomen, abdominal mass, enlarged liver and lymph nodes and bowel obstruction

Endoscopy: This is when a doctor passes a thin tube with a camera down your throat to observe the lining of your stomach for suspicious cells. If tumour cells are found, they are biopsied (taken to the lab for further test) to determine tumour characteristics, lymph node involvement and spread to other tissues.

Imaging: using equipment such as X-rays, computerized tomography (CT) scans, ultrasound and positron emission tomography (PET) scans, pictures from your stomach can be created and visualized.

Treatment of Stomach Cancer

At Sweden Ghana Medical Centre, a multi-disciplinary team of Medical Oncologists, Radiotherapists, Medical physicists and Pharmacists will be involved in providing premium care to manage your stomach cancer. Other professionals who will be involved in your care include:

• Nutritionist
• Case managers
• Nurses
• Counsellors

The range of treatment an individual can benefit from at SGMC are:

chemotherapy: Use of anti-cancer drugs to shrink tumour before surgery, to mop out remaining cancer cells post-surgery or to slow the growth of cancer cells in the case of advanced disease. This can take up to 6 months.

Radiation therapy: This is the use of high energy rays to kill cancer cells. It can also be used in combination with chemotherapy drugs, known as chemoradiation, to slow the growth or prevent the recurrence of stomach cancer. In advances cases, radiation therapy can help reduce some symptoms of disease such as pain.

Targeted therapy: When standard chemo drugs don’t work, your oncologist may suggest using specific drugs that target specific genes or proteins that makes your cancer grow. Targeted therapy can slow the growth or the extent of spread of your cancer.

Other treatment include surgery to remove tumours, portions or whole stomach and immunotherapy, an approach that boosts immune cells to fight cancer.

Preventing Stomach Cancer

• Eat a diet rich in fruits and vegetables and reduce intake of salted, smoked and cured foods
• If you are diagnosed with pylori infection, ensure you complete the prescribed antibiotic course for complete eradication.
• Avoid the use of tobacco
• Engage in physical activity to lower your risk of stomach cancer
• Use of NSAIDs such as Aspirin seems to reduce one’s risk of stomach cancer.

By Abigail Amoah

With Africans becoming wealthier, non-communicable diseases like cancer are on a steady rise. The International Agency for Research on Cancer (IARC) reports that nearly 71% of people diagnosed with cancer in Africa die. This statistic is alarming considering Africa reports lower cancer cases than most parts of the world. Perhaps you have heard about the case of Ugandan Carol Aturhiwe who died in June last year, from lung and throat cancer due to underequipped cancer facilities in the country and on the continent. Has much changed in the past year?

In response to cancer being considered a public health threat, there have been contributions through partnerships to make cancer treatment more accessible to patients. One example of these partnerships – championed by leading pharmaceutical brands – benefits up to 6 countries on the continent (1 from West Africa) and has as part of its objectives, building capacity of underequipped oncology centers and expanding access to medicine for some common cancers in sub-Saharan Africa.

Another drawback of cancer care in Africa is the issue of late presentation of disease largely due to limited cancer knowledge. To that end, there are various initiatives targeting cancer education and advocacy in the region. The set-up of population-based cancer registries in many countries across the continent indicates future growth in the area of African centered cancer research which will inform government intervention and policies around cancer management. Also remarkable is the spike in investment into cancer care. Hospitals and cancer centers are opening new facilities, purchasing more state-of-the-art equipment and training oncology staff to meet the growing cancer treatment demands in Africa. In addition, organizations are opening cancer funds to provide financial support to their members and their dependants when they receive a cancer diagnosis.

Sweden Ghana Medical Centre has in the past year been involved in a number of these developmental projects to support cancer management in Ghana. For instance, through its maiden medical research symposium, a multi-disciplinary team of health experts gathered to discuss and implement action items towards supporting African-Centered research in this era of precision medicine. From this symposium research networks were borne and various medical projects carried out. Secondly, we have expanded training of professionals in oncology from Ghana and other African countries. In 2017/2018, We trained up to 12 Oncologists and medical physicists from Eastern and Western Africa as well as student interns from across Ghana, the US and the UK. In equipping these individuals, we aid in capacity building for cancer care. SGMC has also invested in new machines for cancer treatment such as our new Brachytherapy machine launched in July 2018 for cervical & prostate cancer procedures.  Through such investments, training and partnerships we stay true to our mission to take away the burden of cancer in everything we do.

Suffice to say that, although cancer remains a stigma in our part of the world and doesn’t receive as much recognition as other chronic diseases, there has been tremendous improvement in cancer management both in the private and public sectors in various African countries. As well, previously neglected regions of Africa are now increasing efforts to support cancer awareness, screening, treatment and financing.  We can say with certainty that receiving a cancer diagnosis in Africa is not a death sentence! Treatment is available and one can be cancer-free. There are many success stories of patients who have survived cancer treatment in Africa and benefited from a high quality of life. You or your sick relative can be a success story too!

In countries like China, alternate/ herbal products have been used solely or in combination with conventional processes – surgery, chemotherapy and radiotherapy – in treatment of liver and gastric cancers. Research indicates various responses such as reduced recurrence, minimal side effects and lowered mortality were obtained by incorporating well-researched traditional herbal medication into standard care. In other parts of the world i.e., the UK, US and Canada, the use of herbal medicine among cancer patients has been evaluated and reported on.

A general belief is that herbal medication is natural and thus less harmful than conventional treatment. However, this idea is not entirely true as herbal products can carry notable risks. These risks are further compounded when users who are also benefiting from conventional therapies do not inform their doctors. Such use can result in adverse effects such as bleeding and liver failure, affect efficacy of prescribed drugs and interfere with radiation therapy leading to undesirable effects.

So are there herbal remedies that can treat cancer? The answer is No. An article from the science-based medicine magazine details studies that have looked into alternative medicine and the findings suggest that rather than protect, alternative medicine kills more cancer patients. In fact, many patients return to the hospital once they find out that the alternative/herbal remedies are not working; at which point it might be too late.

To conclude, although there are numerous health benefits of alternative medication, there aren’t enough clinical trials to inform their efficacy in treating cancer. Thus, resorting to herbal supplements alone to treat cancer will result in treatment failure and ultimately death. It is important for health workers to know what alternative treatment options their patients are considering, its possible interaction with conventional procedures and safety for use in order to advise appropriately. On the bright side, with certain plant drugs gaining FDA approval for managing conditions like warts, diarrhoea and fever, we are hopeful there will be development of various herbal remedies for the treatment of cancer in the future.