As the world unites for breast cancer awareness this month, Malawi, too, shares its troubles concerning the disease.
Dr Briony Acroyed-Parken, a breast cancer surgeon from the United Kingdom says Malawi’s biggest challenge is the lack of a coordinated breast care service.
“We are seeing probably about a hundred or so new cases each in Lilongwe and Blantyre. The number of new cases outside these areas is not known. The global incidence is increasing and the incidence in Malawi is increasing.
“Non-communicable diseases, particulary cancer, are a rapidly growing problem in low and middle income countries [LMICs] now that infectious diseases are under better control and it is recognised that the incidence is increasing rapidly year on year,” said Acroyed-Parken.
She observes that the World Health Organisation (WHO) now focuses on cancer in LMICs as a priority.
The doctor admits that because the country is are not able to collect the data on breast cancer accurately (despite having one of the best cancer registries in Africa), Malawi does not have accurate figures.
“Nevertheless, I can certainly assure you that the numbers are definitely not going down! We have just this year set up a one-stop diagnostic breast clinic in Blantyre and Kamuzu Central Hospital (KCH) in Lilongwe expects to follow within the next month.
“We also hope that Mzuzu and Zomba will join us in due course, so all regions will be covered from specialist services in the central hospitals which will mean that services are available for all Malawians, modelled on the best services in high income countries,” she said.
According to Acroyed-Parken, patients need clinical assessment from a breast specialist, who are very few in Malawi.
In addition, she says we lack mammography in all government centres and Malawi is very constrained with its pathological services, which poses a significant challenge.
“We are just managing this within Blantyre at present, but lack capacity for expansion as the service becomes better known and demand increases. I believe there is capacity in pathology at KCH and anticipate they will establish a satisfactory service very soon,” said Acroyed-Parken.
Once a patient has been diagnosed with cancer, she says the challenge is to provide necessary surgery as soon as would be desired.
Acroyed-Parken adds that the oncology service is also greatly overstretched and so far there is no radiotherapy in Malawi, which is an essential component of treatment for breast cancer in many cases.