Cancer care … Namibia Oncology Centre

I SHIVER as I look at the bed she is lying on rotate 360 degrees for her radiotherapy treatment from the screen outside the radiation room.

Two minutes later, she staggers out of the room at the Oncology Centre in Eros, Windhoek. She is wearing a loose grey shirt and black pants. Waving, she manages to pull a smile.

She walks on and continues her conversation with the nurse in a light tone after saying greetings to the unit manager, Anthea van Wyk.

She is a breast cancer patient who has just gone through radiation treatment. She has been here before.

The patient was alone in the room, but there is a closed circuit TV and an intercom in the room. We could see and hear her at all times. The machine moves around her and it makes noises.

Van Wyk says if she ever thinks she needs to move, she tells the therapist and the machine can be turned off at once.

Although she looks a little pale, I say to Van Wyk: “She is smiling.”

“Yes, people expect them to come out of there unable to walk and all but it is never really that bad,” she says. “There is still stigma attached to cancer diagnosis. It is treatable. People should understand that cancer patients can get better and go home to carry on with their lives… but only if it is detected early.”

Van Wyk says: “It is rewarding to work here. We are able to comfort them (patients) and help them in their time of need.”

She says it takes about 15 minutes to undergo radiation treatment depending on the extent of the disease. The treatment lasts about seven weeks at 15 minutes every day.

Van Wyk explained why the other patient had taken about two minutes on the rotating bed. “When we say 15 minutes, the other minutes are spent on the preparation process for patients. The treatment varies and takes various lengths.”

She tells The Namibian as we head towards the radiation room that the centre treats about 40 patients per day. She explained that the radiation room is made of three-metre thick walls because of the strong electromagnetic energy from the machine.

The radiation is delivered by a special machine with a linear accelerator, which focuses a beam of energy onto the cancerous cells.

The off-white and grey room’s temperature is warm. Van Wyk shows the hard, moveable bed. In some instances, she says special blocks or shields are used to protect organs so patients are positioned using special holders, moulds or boards.

Van Wyk said radiation is used to treat cancer to cure the patient but if curing is not possible, she says: “We can at least relieve the symptoms and extend survival depending on the type, location and stage of the cancer as well as the general health of the patient.”

Treatment is administered by therapists and monitored by a physicist and oncologists.

She says the private centre opened its doors end of July 2015 to compliment State facilities because they recognised the need for its services in Namibia. Before that, people who could afford treatment had to travel to South Africa. She concedes that one of the challenges for patients is the expensive treatment.

“We try to provide services at reasonable costs but specialists come here at a price. Chemotherapy starts from N$3 000 to N$30 000. Radiation on average takes six weeks and costs N$100 000,” van Wyk says.

She said patients go through an emotional journey but they have a full-time social worker to counsel them and their families. This service is free. Van Wyk says the World Health Organisation recommends that there should be one radiotherapy machine per one million people. This was not the case with Namibia which only had the machine at Windhoek Central Hospital to cater for more than two million people.

She explained that the centre does not only offer radiation treatment but it can also be used in conjunction with other modes of treatment such as surgery and chemotherapy as well as palliative care.

“This means when we are no longer able to treat the cancer, we try to keep the patient comfortable for the last days of their lives.”

The centre has a complement of 30 staff members consisting of nurses, doctors and oncologists.

Van Wyk said the mission of the centre is to provide the most advanced and comprehensive medical services, particularly those related to cancer care, in a safe and compassionate environment.

The centre also aims to promote cancer prevention and early detection, through the education of patients, their families and healthcare professionals in Namibia, and through the development of partnerships with other healthcare organisations, both local and international.

During a tour of the centre, Van Wyk said the centre has a laboratory in addition to an independent pathology laboratory that has established branches in the North and offers accurate and efficient specimen testing.

The chemotherapy medicines can be administered through various routes such as intravenous infusion, an injection into the muscle or skin or even orally. The chemotherapy area is spacious and comfortable, allowing patients some degree of privacy and allows family members and friends to sit with them while they receive treatment. The centre takes about 300 radiotherapy patients.

The treatment room leads directly into a courtyard garden where patients can bask in sunshine and catch a breath of fresh air in between treatments. The centre has a 12-bed private ward.

Dr Annelle Zietsman, the head of the Medical Oncology Cancer Centre at the Windhoek Central Hospital, said the most common cancer in Namibia is skin cancer. This is followed by Kaposi’s sarcoma which is HIV/AIDS related, breast, prostate, cervical and oral cavity cancer.