Surviving colon cancer

Source: The East African
31st July 2011
On the surface, Leah Aketch 31, is an ordinary businesswoman running a house help bureau.

But behind this facade, is the story of a colon cancer survivor living with a stoma — a piece of the bowel brought out after surgery through the abdominal wall.

Her ordeal began in December 2009 when persistent stomach upsets, constipation and later, diarrhoea with stains of blood raised the alarm.

Doctors performed several tests and put her under medication for typhoid. But it did not help as it was a wrong diagnosis. “I lost weight and shrank from a size 16 to 10, and attracted suspicious stares from those who knew me. Rumour had it that I was HIV positive,” says Ms Aketch.

Further tests revealed a cancerous growth in the colon, which needed to be removed surgically at a cost of $1,000.

From the treacherous journey of raising funds from friends and family to the shock of waking up to find a section of her intestines linked to a plastic bag via a tube after the surgery, Ms Aketch was a distressed woman.

“I was alarmed. The nurse said the bag would aid the removal of waste from my colon and I was going to have it for life,” she says.

Ordinarily, in cases of colon cancer, the section of the bowel where the cancerous cells are lodged is removed and the two ends reconnected. However, in Leah’s case, the tumour was too low in the rectum, hence the need to sever it.

The bowel was then brought out through the abdominal wall and joined to the bag — medically known as a colostomy bag.

The bag hangs outside the stomach and is changed three to four times a day depending on how fast it fills. Each bag costs about Ksh600 ($6.6).

As a member, Ms Aketch is lucky that the Stoma World Kenya Association provides her with the colostomy bags for free.

Estimates suggest that nine out of 10 cases of colon cancer can be treated successfully if detected early. Survival rates have doubled over the past 30 years due to early diagnosis.

Symptoms

Jane Macleod, general and oncologic surgeon at Aga Khan University Hospital says when one experiences symptoms such as blood flecks in their stool, a change in regular bowel habits, such as constipation or diarrhoea that’s severe or lasts for two weeks or more, a feeling that you need to empty your bowels even when you’ve just been to the toilet, unexplained weight loss, fatigue, dizziness or breathlessness, they need to go for screening — a process called sigmoidoscopy or colonoscopy.

A doctor may order more complex tests such as CT or MRI scans to detect if the cancer has spread to other body organs such as the liver. The scan is crucial in determining what treatment is most appropriate and estimating what chances the patient has to be cured.
If the tumour is cancerous, the only treatment is surgical removal followed by a combination of chemotherapy and radiotherapy treatment,” says Dr Macleod.

The exact cause of bowel cancer isn’t known, but in a few cases, it is suspected to be a genetic link.

For example, those with a family history of colon cancer are more likely to develop it especially if a member of the immediate family is diagnosed before the age of 45 years.

Dr Macleod adds that diet is also a key factor. People who eat a lot of meat and less fruits and vegetables face the risk of developing colon cancer.

Survival rate

“However, through early detection and prompt treatment, more than 90 per cent of patients with early stage colon cancer survive,” she said. “But the worry is that there is an increase in the cases of colon cancer in Kenya and other developing countries compared with the West. And unlike in the West where the majority of the cases are old people between the ages of 55 and 65, in the developing countries the cases occur in people as young as 30.”

Dr Macleod says there is a need for awareness campaigns that would prompt early treatment and push up the survival rate.