Tuesday,18 September, 2018
Current issue | Issue 1288, (24 - 30 March 2016)
Tuesday,18 September, 2018
Issue 1288, (24 - 30 March 2016)

Ahram Weekly

Enhancing quality of life

Work is being done to improve the quality of life for cancer patients in Egypt, writes Ghada Abdel-Kader

Al-Ahram Weekly

“A cancer patient may be disturbed both by the disease itself and by the medications related to it,” said Hamdi Abdel-Azim, a professor of clinical oncology at the Faculty of Medicine at Cairo University.

“In Egypt, we have 113,000 new cancer cases of all types diagnosed every year. As a result, almost every family or household is directly affected by cancer,” added Hisham Al-Ghazali, a professor in the Faculty of Medicine at Ain Shams University in Cairo.

“The good news is that the increase in cancer cure rate in the early stages to more than 90 per cent has come about because doctors are using the latest techniques to treat patients. The ratio is now close to the global cure rate,” he said. As a result, “patients are beginning to think more about the side effects of the medications and not about their illness.”

Chemotherapy-induced nausea and vomiting (CINV) is one of the most common and dreaded side effects of many cancer treatments. Fouad Al-Kammah, the General Manager of Mundipharma for Egypt, Libya and the Near East, told Al-Ahram Weekly that “according to an international survey, 18 per cent of cancer patients have dropped their treatment as a result”.

“Cancer treatments are associated with unfavourable symptoms like nausea and vomiting. So doctors try to shift to other medications. But if the treatment is not followed, the cancer cells can begin to grow again and spread in the patient’s body,” he said.

Abdel-Azim chairs the Qasr Al-Aini Hospital’s School of Oncology in Cairo, which is the official cancer education organisation within the Department of Oncology at the Faculty of Medicine at Cairo University.

Some patients postpone or refuse to receive chemotherapy due to these symptoms, which can have a large impact on the quality of life and overall health of patients. Cancer treatment can cause side effects, including anaemia, loss of appetite, hair loss, weight loss, fatigue, damaged liver and kidneys, bone marrow problems, memory problems, dehydration, constipation, diarrhoea, headaches, shortness of the breath, sleeping problems, skin conditions and difficulty chewing.

The exact nature of these side effects depends on the types of the drugs and the amounts taken. They also vary from person to person.

“Some stages of the disease can cause severe pain. Even after the pain has disappeared, the patient may have fears in his mind of its returning,” Abdel-Azim added. “In the late stages of cancer, patients suffer from loss of appetite, tiredness and exhaustion.”

Samir Shehata, head of the Department of Clinical Oncology and Nuclear Medicine at the Faculty of Medicine at Assiut University, said, “Before a patient starts cancer treatment, his doctors will carry out tests and make assessments of his overall health status. What we can’t always control as doctors is the patient’s feeling of pain or CINV as side effects of the medications. Other side effects can be managed.”

“We as doctors pay special attention to prescribing medicines or drugs that assist and support the patient to live a better quality of life without or with as little pain as possible and fewer side effects,” explains Abdel-Azim.

Al-Ghazali stressed that it is a doctor’s mission to treat patients as human beings and not as medical conditions. “It is not a case of fighting the disease and killing the patient, but fighting the disease and at the same time saving the life of the patient,” he explained.

Many pharmaceutical companies make medicines or drugs that reduce the side effects of CINV, but new generations of drugs are more effective than old ones and they are sometimes more expensive.

“It is important for our society that the international pharmaceutical companies have a presence and scientific activities in Egypt to be able to provide Egyptians with medicines,” Abdel-Azim said. “A large number of patients are treated at their own expense. There is a need for patients to be able to receive treatment at suitable prices.”

“Preventing side effects of cancer medications helps to increase the cure rate. In addition, the patient commonly takes the medication for a certain period, not for a lifetime like other drugs for diabetes, heart disease and high blood pressure, and this means that we only need to control the side effects for limited periods,” Al-Ghazali added.

One new anti-nausea drug is Aloxi (palonosetron HCI), which is given by injection. The drug has been approved by the US Food and Drug Administration. It prevents the acute and delayed nausea and vomiting associated with initial and repeat courses of moderately and highly emetogenic drugs (having the capacity to induce vomiting), a common property of cancer chemotherapy.

“The efficacy of Aloxi approaches 99.9 per cent. The drug has been approved and registered by the Ministry of Health in Egypt, and it was released on the market three weeks ago. It is already licenced in many countries worldwide,” Al-Kammah said. “In comparison with the current prices of other medications that are more expensive, however. One ampule of Aloxi costs LE350.”

“The patient takes a single intravenous dose 10 minutes before the start of the chemotherapy,” Al-Ghazali explained, adding that this “is the only drug that has been shown to have a long-lasting effect for five continuous days after the chemotherapy.”

Shehata added, “It saves money and effort for the patient to take a single shot instead of five shots for five days. It is very safe and has no side effects. It can also be used with all types of chemotherapy drugs or medications.”

On safety, Abdel-Azim said that all drugs “undergo very precise and accurate scientific research. They are subjected to and committed to follow the Helsinki Declaration on human research ethics and patient rights. Medical research can be done only after the approval of professional ethics committees in the academic research institutions and the ministry of health, whether in Egypt or abroad.”

For Al-Kammah, cancer treatment must be seen as a quality of life issue. Patients should not have to suffer from bad side effects or have to stay at home throughout their treatment. “We plan to introduce the most advanced treatment for preventing nausea and vomiting in Egypt in the form of a combination of two drugs from the first- and second-line treatments,” he said.

Cancer patients can suffer from fatigue and weight loss. “We want to introduce a new drug that will work on body mass and increase skeletal density, helping patients to gain weight and look healthier,” he said.

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