Fuck cancer !

Fuck Cancer is a title piece of an artwork created by the artist Evans Ngure. The piece itself encompasses a bicycle rim, old computer key pads ,test tubes filled with pieces of pink rugs from second hand clothes. The piece was greatly inspired by the fight women globally go through while facing breast cancer.
Each item of the artwork has profound symbolism. The bicycle rim represents the circle of self transition survivors have undergone, from the very moment they receive the news to when they have a full recovery from the illness. The keypads represent the online tedious research journey women or their family members have to do in order to find answers to the unending questions they have. And finally the test tubes represent the numerous clinical tests and exam the patient will be subjected to. Each item on the artwork was deliberately placed to form the overall pink ribbon, that is the universal mark of unity against breast cancer.

According to World Health Organization (WHO), cancer is the second leading cause of death after cardiovascular diseases and a growing health issue globally. Breast cancer is the most commonly diagnosed type of cancer among females accounting for approximately one-quarter of cancers in females globally and is now ranked the second most common cancer worldwide after lung cancer.

According to International Agency for Research on Cancer (IARC’s) and GLOBOCAN data on 2018, breast cancer caused 0.62 million deaths and another 2.08 million new cases were identified, which is 11.6% of all cancer types recorded. At the current rate, the number of incident cases is expected to rise to 3.05 million, and the mortality troll is expected to rise to a nerve-racking 6.99 million by 2040. Approximately 1 in 10 women will be diagnosed with breast cancer in their lives.

In sub saharan African an estimated 94,378 new cases are reported annually with rapidly increasing rates in Uganda and Zimbabwe. According to the International Agency for Cancer research the cases range from 27 per 100 000 women in central africa to 39 per 100 000 women in southern africa in 2012 with 48,000 deaths were reported in the whole Continent the same year.

In Kenya cancer is the 3rd leading cause of death after cardiovascular diseases.According to the 2015 Kenya Stepwise Survey of Non-Communicable Disease Risk Factors Report, the breast cancer cases report (34 per 100,000), accounting for 23% of all cancers of women.The top counties to be hit with breast cancer include Nairobi, Meru, Mombasa, Kiambu, Nakuru and Embu counties.

According to National Cancer Institute breast cancer remains the top fear for Kenyan women with Nairobi ranking the highest with 37.4% in Meru, breast cancer is leading with 20.2%. Coastal women, the survey indicates, are at risk of breast cancer more than any other type of cancer.

With such staggering statistics a great intervention and awareness must be put foreward in order to remedy the rising death cases among young women. Sadly the burden is projected to double by 2030 with there being very low survival rates.

Poor survival from breast cancer in Africa is largely attributed to;

Late stage of diagnosis

This is especially true for the young population, it is reported that the average time between self reported onset of symptoms and time of diagnosis is between (8-12) months. This is alarming due to the rate in which cancer spreads and manifests in the body thus lowering the survival rates.

Unhealthy lifestyle choices,

With breast cancer specifically targeting the younger generation (30-49) it is no wonder unhealthy lifestyle choices catapults the death cases among this age range. Poor diet choices, whereby diet richer in calories and poorer in fruits and fibre lead to obesity resulting in postmenopausal cancer. The increased use of animal based over plant based foods over time have also increased .cancer cases. Drugs such as alcohol and little to no physical activity have also been linked to a rise in cases. Young people are unfamiliar with living a healthy lifestyle and putting in account that we live in a fast paced digitized world the option of eating healthy and taking good care of ones well being is put at the bottom list in priorities.

Toxic substances,

Since the industrialization era pollution emission in our environment has been on the rise with an all time high record( UNEP 2019 records) .Toxic substances is all around us may it be from the air we breathe, water we drink and even the foods consume ex GMOs and the chemicals put in preservatives. This substances pose a grave threat to our lives due to the prevalence of diseases such as cancer thriving off from any toxicity found in our system.

Poor health care infrastructure,

Minimal treatment availability in most hospitals( radiotherapy) and little accessibility to remote parts of the country becomes a huge hindrance to dealing with the rising cancer cases. Most people need to travel far to seek treatment in the very few hospitals that offer such services. While the ‘lucky’ ones have to travel outside their own country to get it.

Lack of affordability by patients

It is common knowledge that the basic cancer treatment is extremely pricey with charges ranging from 50 to 1000 USD. This high cost renders most cancer patients helpless to seek out treatment with most opting to basic herbal treatment.

Socioeconomic class and background

The 21st century has resulted to the evolution of the modern woman. She is more career driven and up to date with the current trends thus more African women are entering tertiary education , with corresponding delays in first birth while greater number of women are limiting the average duration of breastfeeding due to short maternity leave. Use of modern oral contraceptives especially among women with high socioeconomic class has also played a huge role to the risk. Long duration of oral contraceptive pills interfere with the hormonal mechanism of the body making it susceptible to cancer.

Causes of breast cancer are numerous but the ones highlighted above are some of the very key important ones. ‘Prevention is better than cure’ is a wise adage known in society and this could not be any further from the truth when it comes to breast cancer. Below is a list of proven effective methods of prevention:

Early screening and detection

This goes without saying but the sooner cancer is detected in the body the faster and effective treatment will be. Women aged 40 and older should go for yearly mammogram and breast exam while women 20s- 30s should have a clinical breast exam every three years and any age should report if they feel a lump or any breast change to a doctor.

Dietary changes

Eating and maintaining a healthy diet is key to preventing breast cancer. A low-fat diet might decrease the risk of breast cancers through hormonal mechanism. It has been reported that dietary fat and postmenopausal estrogen levels are directly related. Low-fat and high carbohydrate diet lead to a significant reduction in mamographic breast density . Fresh fruits and vegetables greatly boost immunity and keeps weight check to a healthy standard thus lengthening the survival chances against breast cancer.
Consumption of micronutrient and vitamin intake may play a role in reducing the risk for breast cancer. Vitamin A, vitamin E , Vitamin C or beta carotene together with a diet high in folate and soya are all proven to have a great effect on the decrease of cancer risks.

Avoiding drugs

Alcohol and smoking are the major culprits of causing breast cancer among women. Studies show women who have had an early exposure to drugs set themselves to an easy target of getting cancer by the time they reach there 30s. Limiting the usage of drugs is a great preventive measure.

Breastfeeding

Breast cancer risk is reduced by 4% to 7% for every year of breastfeeding. Extended breastfeeding has a strong protective effect from oestrogen receptive positive cancer tumor ER+. Women who breastfeed longer for a total of 1year or more ( combined for all children) protects themselves from the likelihood of getting breast cancer.

Physical activity

Women who do heavy manual labor or strenuous activity have a low risk of breast cancer. The protective mechanism of physical activity is not known but physical activity may have an effect on the endogenous hormone. Epidemiologic data indicate that obesity (body mass index ≥30kg/m2) increases the risk of breast cancer. The risk for breast cancer in a postmenopausal woman who gained more than 20 kg after age 18 is approximately twice the risk for women who did not gain weight.

SERMS as a preventive measure

The term SERM is an abbreviation for selective estrogen receptor modulators. These agents include tamoxifen, raloxifene and tormifene. The mechanisms of action of these agents are either estrogenic or anti-estrogenic effects depending on the specific end organ. The main finding of the breast cancer prevention trial (BCPT) was a 49% reduction in the incidence of breast cancer among the participants who were randomly assigned to receive tamoxifen. Tamoxifen was the first agent for primary cancer prevention to be approved by food and drug administration (FDA) of USA in 1998.
Tamoxifen and raloxifene when taken together, demonstrate a significant reduction in the risk of breast cancers in women. These drugs reduce the risk of only breast cancer positive for estrogen receptor (ER) but the risk of breast cancer negative for ER is not affected.

Avoid birth control pills

It appears there is increased risk of breast cancer in young women (younger than 35 years) with current prolonged use of oral contraceptives (OC) more than 5 years. This risk appears to level off after the use of OC has stopped. It is therefore advised for women not to use oral contraceptive pills more than 5 years unless it is medically indicated.

Limit use of hormonal replacement therapy

Combination hormone therapy for more than three to five years increases the risk of breast cancer. If you’re taking hormone therapy for menopausal symptoms, ask your doctor about other options.Studies suggest that hormone replacement, especially therapies with a combination of estrogens and progestins, can increase the risk of breast cancer. You might be able to manage your symptoms with non-hormonal therapies and medications.

Awareness programs

More awareness and breast cancer information should be taught in the society especially the most remote parts of the country. This will go a long way to debunking myths regarding the illness and will also have better results in sensitizing the most conservative religions. I.e Islamic where most Muslim women are sceptical to go for their annual breast screening exam.

Once one is diagnosed with cancer it brings fear, anxiety, panic and a huge sense of loneliness. This burden sadly is not just a personal one but the whole family as well. The feeling of knowing your loved one is about to go through a traumatic journey that could result in a matter of life or death can be a huge reality to bear. However there is always a light of hope at the end of the dark tunnel.

Despite its efforts to destroy and break a persons spirit and those around them it has little to no effect on the bond love holds together a person, family and society.And that is why every October worldwide we celebrate breast cancer month to commemorate and salute all those brave and strong women fighting a battle that they have already won. We celebrate you.