Concerns as cases of cancer linked to HIV on sharp rise

Source:The Standard
June 29 2012
In his surgical career spanning over two decades, brain surgeon Patrick Akuku has seen many cancer patients. But today, the surgeon is a worried man. He is worried about the rapidity with which the disease is afflicting young people.

“We are seeing a situation where brain tumours which were common in people in their 50s now manifesting in people as young as age 20-25,” says Akuku, a senior lecturer at the Department of Surgery, Division of Neurosurgery at the School of Medicine at the University of Nairobi
“Is it just the changing lifestyle that is exposing young people to such cancers? Is it the environment or are they predisposed to something more sinister?” poses Akuku.

Dr Akuku’s work and that of other medics in Kenya suggest there is a strong link to the rising number of people affected by some cancers in Kenya with HIV. This development greatly complicates response towards HIV.

Changing lifestyles
“We see 20-30 cases of gliomas a month, which initially constituted elderly people of 50 years and above. But increasingly three to five of these cases are now young people in their late twenties and early thirties,” says Akuku who attend to such patients at Kenyatta National Hospital.

“Although no conclusive research has directly linked HIV with glioma, it is easy to suspect the former because many of the young people also have HIV.” Cancer is one of the deadliest opportunistic infections in HIV patients.

In what scientists now call the “axis of evil” between HIV and cancer, a higher percentage of patients who developed certain cancers were also found to be HIV positive, with more than half having no prior awareness of their HIV status.

The cancers associated with HIV include brain tumours such as gliomas (astrocytoma, oligodendroglioma and glioblastoma.) Others include Kaposi’s sarcoma, cervical cancer, non-Hodgkin lymphoma and bone marrow cancer.

Cancer statistics from Kenya Medical Research Institute (Kemri) show that 62 male patients who visited public hospitals in Nairobi County in 2011 had brain tumours, representing nearly three per cent of the total number of cancer patients, with 49 women reporting to the facilities with the same malignant tumours accounting for about two per cent of the cases.

GZ Mutuma, Kemri principal research officer, says cancer is increasingly manifesting itself in HIV patients — fuelled by lack of early testing and treatment and changing lifestyles that exacerbate the development of certain malignant cancers.

“Most patients who turn up with certain cancers are also HIV positive. In Kaposi’s sarcoma and lymphomas, the probability is anything between 70-90 per cent,” says Dr Mutuma, who is also head of Pathology and Oncology Research Unit at the institute.

“Even more disturbing is the developing scenario where certain brain tumours and bone cancers are being linked to the virus.”
tatistics gathered by the Nairobi Cancer Registry at Kemri in Nairobi County since 2003 show the cancers maintained a commanding presence accounting for between five and 20 per cent of the total number of cases, especially those that are now being linked to HIV.

For instance, in 2004 alone, 49 male patients visiting health facilities in the city were diagnosed with Kaposi’s sarcoma, representing six per cent of all patients while 13 females had the same cancer, which stood for two per cent of all patients.

While the disease accounted for between two and eight per cent of all cancer diagnosis, between 2003 and 2008, other cancers now being linked with HIV like bone cancer and non-Hodgkin lymphoma afflicted between 10 and 22 people per year, accounting for at least two per cent of all cancer cases.

Full blown crisis
Cancer of the cervix on the other hand maintained a frequency of 223.6 patients per year being an equivalent of 130 per cent of total patients who turned up for treatment with cancer between 2003 and 2008.

“Are we seeing an axis of evil being formed between these cancers and HIV? We need to move quickly and prevent a full blown cancer crisis,” Mutuma says.
But his wishes may be far-fetched going by the dearth of HIV and cancer testing and treatment services.

James Ooro* was ill with a skin lesion for years and for a long time he went to the nearest hospital in Kisumu. “However the problem did not go away. In fact, it got worse and I even lost weight considerably,” says the 31-year-old man when we caught up with him at a treatment centre in Kisumu.
“It was not until I saw a specialist that I was advised to take an HIV test because the skin disease could be linked to the virus,” he says.

In a similar case in Maseno, 10Km away from, James Mokua* discovered he had Kaposi’s sarcoma after his wife who also had the disease tested positive for HIV.

“After knowing my HIV status, I was put on anti-retrovirals (ARVs), which have reversed the situation,” he says.

Dr Cryspin Onyango who attends to both patients says many people discover their condition rather too late. He says many cases of cancer would be avoided if more people got tested and started treatment early. “Delay in knowing their status subjects them to severe pain and a loss of income through costly hospital bills,” he says.

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One Response to "Concerns as cases of cancer linked to HIV on sharp rise"

  1. Yulanda Luhnow says:

    The skin is the most visible part of the body and you need to take good care of it. However, there are times when you have unsightly moles, warts, and skin tags. These are skin lesions which can now be removed through various methods. It doesn’t really matter if your skin is white, pinkish, brown, or black; what matters is how you care for it and there shouldn’t be any skin lesions to affect your overall look. –

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