12 - 2 March 2014 - The Observer
National AIDS Council on Cancer
O
n 4 February 2014, the
National AIDS Council
(NAC) joined the rest of the
world in commemorating the
World Cancer Day. Communicable diseases
remain the highest burden of diseases
in Zimbabwe. They account for 74%
of all deaths, whilst non communicable
diseases (NCDs) account for 21% of all
deaths in Zimbabwe. In 2011 cancer was
responsible for 18% of NCDs related
deaths and 4% of all the deaths in the
country (WHO, 2011). Cancer occurs when
cells in a specific part of the body begin to
reproduce uncontrollably. According to the
official data from the Zimbabwe National
Cancer Registry (ZNCR), the number of
cancer cases has been increasing in the past
few years, particularly for cancers related to
infectious agents such as bacteria or virus.
Statistics indicate that the vast majority of
Zimbabweans diagnosed with cancer will
die of the disease if no treatment is availed
to them early enough.
There are cancers which are more likely
to occur in people who are infected with the
human immunodeficiency virus (HIV) and
these are classified as AIDS-related cancers.
The most common AIDS-related cancers
are Kaposi Sarcoma, Non-Hodgkins
Lymphoma, Primary Central Nervous
System (CNS) Lymphoma and Cervical
Cancer. These cancers however, can also
affect people who are HIV negative. Other
less common types of AIDS-related cancers
include cancers of the mouth, throat, liver,
lung, colon, rectum, anus, testes, and skin.
The most common cancers in Zimbabwe
are Kaposi’s Sarcoma, prostate cancer,
oesophageal and liver cancers among men,
and cervical cancer, Kaposi’s Sarcoma,
breast and oesophageal cancers among
women, indicating an important burden
of infectious related cancers among both
sexes.
In Zimbabwe, the Ministry of Health
and Child Care (MOHCC) has led the first
national response to cancer control. The
National AIDS Council (NAC) has also
taken an interest in Cancer because of
the existence of HIV related cancers. In
Zimbabwe about 60% of all the cancers
are HIV related and because of this NAC
has been pushed to start to be involved in
activities related to cancer management,
control and prevention. NAC procures
antiretroviral drugs which have led to the
recovering of many patients thus reducing
the incidence of HIV related cancers. It
has also embarked on an expansion drive
for cervical cancer screening among HIV
positive women at most Opportunistic
Clinics in the country with the support
from its strategic partners. NAC has
started procuring anti-cancer drugs such
as Bleomycin, Methotrexate, Cisplatin,
Doxorubicin among others.
High on the National AIDS Council’s
agenda is the incorporation of cancer
prevention and control activities in its
planning. This will be in line with the
national policies, guidelines and strategies
on cancer control and prevention.NAC
will also assist in the decentralization of
treatment and prevention services of HIV
related cancers.■
The National AIDS Council (NAC) is aware that some forms of cancer
are HIV related and joins the rest of the world in commemorating
World Cancer Day
NAC has been working closely with the Ministry of Health and
Child Care in the procurement of anti-cancer drugs.
Get tested for HIV and get tested for cancer early and seek
treatment immediately where necessary. Those on medication
should take their medicines as prescribed by health personnel.
NAC: Coordinating the multi-sectoral response to HIV and AIDS
For more information visit our website: www.nac.org.zw or contact us on [email protected] (04)
791171/2/8 or 790575 or visit any of our provincial or district offices near you.
National AIDS Council of Zimbabwe
@naczim
Cancer treatment
breakthrough
T
Arthur Allen
he emergence of checkpoint inhibitors,
which Science magazine declared 2013’s
Breakthrough of the Year, is a high point in
the long story of cancer immunotherapy. In
1891, William Coley, a New York surgeon, discovered
he could keep certain cancer patients alive by giving
them bacterial infections, which caused their immune
systems to release a healing serum.
Over the years, many intrigued scientists tried to
extend Coley’s experiments, and in 1975 they isolated the
immune elixir and named it tumor necrosis factor. But
immunotherapy had few big successes until 1985, when
the NCI’s Rosenberg managed to cure several melanoma
patients with another immune chemical, interleukin-2.
This work was validated by outside investigators led
by Atkins — who was then at Harvard Medical School
— leading to FDA approval in 1997. Oncologists have
employed it since then against melanoma and kidney
cancer, with occasionally wonderful results, but it causes
severe side effects.
Many other immunotherapies are being tested on
cancers. In fact, when Harris received his diagnosis in
August 2012, his doctors recommended that he enter
one such clinical trial under Rosenberg’s care. Harris
spent eight weeks that fall and winter at the NIH
Clinical Center undergoing a delicate and complicated
care regimen.
Doctors zapped his immune system after culling
his blood for T-cells, which they genetically tweaked to
better fight his tumor and then returned to his body.
Rosenberg and his staff have had some dramatic cures
with variations on this therapy, but it didn’t work for
Harris.
By February, his cancer had shrunk a little, but in
April new tumors appeared. Rosenberg’s team pressed
for Harris to receive checkpoint-inhibiting antibodies.
When a trial opened at Georgetown in June, Harris was
the first of only 10 patients admitted.
“We had patients coming out of the woodwork
trying to enter the trial,” says Atkins, who with other
physicians at Lombardi is running several other studies
of the blockade inhibitors, sometimes in combination
with other drugs. “We had calls from Australia, Israel,
Eastern Europe.”
A fundamental difference
Immunotherapy is fundamentally different from
other cancer research funded by NIH. Many other lines
of investigation are aimed at identifying the genes that
turn off and on in a particular cancer and at matching
patients to drugs that target the genes of their particular
tumor.
These new, sophisticated forms of molecular
medicine are clearly a step forward from older
chemotherapies, which use powerful drugs to kill cancer
cells but often cause severe side effects and provide
benefit only as long as the cancer finds ways to evade
them — typically an average of six months.
Checkpoint inhibition therapy’s champions believe
that its approach holds more long-term promise.
Instead of aiming at the tumor and its mutations, or
accelerating the immune system the way interleukin-2
does, the checkpoint inhibitor antibodies are designed to
take the brakes off the system, Freeman says.
“Cancers are like the Road Runner cartoon character.
If you choose one target in the cancer, it will sidestep it
eventually by mutating,” he says. Chemotherapy usually
fails, eventually, because the tumor evolves a way to beat
it. Since the checkpoint inhibitor restores the immune
system’s ability to attack, the cancer “can’t change one
thing and escape detection, because it’s getting machinegunned,” Freeman says. “The immune system is an
evolutionary learning system. If you can engage it and
get it to work successfully, it learns how to attack the
cancer. And the wonderful thing is that it works.”
Helen Harris, Michael Harris’s wife of 35 years,
became ill too early for these new treatments. A lifetime
smoker, she received a diagnosis of lung cancer in
2008 and died about three years later, with severe,
heartbreaking complications in the final months.
Harris and his daughter don’t know whether the
treatments he received could have helped her back then.
“Dad was a wonderful husband to her. She was a lucky
lady,” Rhonda Farrell says. “We knew her kind of cancer
wasn’t going to go away.”
Allen is a freelance writer and author of “Vaccine: The
Controversial Story of Medicine’s Greatest Lifesaver.” –
Washington Post