An Overview of Cancer and its Impact in Yemen

Afrah Borji – Sawt Al-Amal (Voice of Hope)

Cancer is a serious disease facing Yemen, posing a significant challenge to the healthcare sector, which is severely affected by a lack of resources and specialized medical facilities. Despite significant advances in cancer treatment in many countries, Yemen suffers from a major weakness in providing the necessary medical care for cancer patients due to the effects of the conflict, which has caused a comprehensive deterioration of the health situation.

Yemen is witnessing a noticeable increase in the incidence rates of various types of cancer, such as breast cancer, liver cancer, and leukemia. This increase is due to several factors, including deteriorating living conditions, widespread environmental pollution, malnutrition, and a shortage of medical resources. The lack of awareness about the importance of early detection also plays a significant role in delaying diagnosis, reducing the chances of effective treatment.

The Concept of Cancer

Cancer is a general term for a wide range of diseases that can affect any part of the body. Cancer is also known by other terms, such as malignant tumors and neoplasms. Cancer is characterized by the ability of its cells to reproduce rapidly, leading to their abnormal growth outside the natural boundaries of the tissues from which they originate. These abnormal cells can invade adjacent tissues and spread to other parts of the body—a process known as metastasis.

According to the World Health Organization (WHO) in its 2022 report, widespread metastases are the leading cause of cancer deaths. This is because the spread of cancer cells to different parts of the body complicates treatment and increases the severity of the disease.

According to international reports, the human body consists of millions of cells, such as heart, skin, liver, and muscle cells, which play vital roles in maintaining the body’s health by dividing and growing as needed. Cancer is an abnormal growth of cells caused by a malfunction in the mechanism controlling cell division and proliferation. This malfunction causes old cells not to die and continue to grow, leading to the formation of abnormal cells. As these cells accumulate, they form masses of tissue known as tumors, which are a characteristic symptom of cancer.

When cancer arises, the body loses its ability to control tumor cell growth. These cells continue to grow without stopping, and in advanced stages, these cells may travel to other parts of the body through the lymphatic system or blood, spreading and affecting surrounding tissues and organs, leading to their damage and posing a risk to human health.

The Mechanism of Cancer Development

Scientific reports indicate that most body cells have a specific lifespan depending on their type, ending within a biological process in the body known as apoptosis. Apoptosis is a biological process in which the body gets rid of unnecessary cells, allowing the body to replace old cells with new ones that perform their functions better.

As for cancer cells, they avoid apoptosis in several ways. Genetic mutations can disable or eliminate the mechanisms responsible for regulating cell growth and death, resulting from changes or deformities in genes or DNA.

This leads to the accumulation of these cancer cells and their use of oxygen and nutrients intended for other cells, which may result in tumor growth, immune system problems, and the development of many health problems that prevent the body from performing its functions normally.

Types of Cancer

Cancer isn’t always associated with tumor formation, as with leukemia. In leukemia, cancer develops in blood cells or bone marrow without forming a solid tumor. Cancer cells spread through the blood or other tissues, disrupting organ function without creating palpable masses.

Regarding tumors, it’s crucial to distinguish between types. Benign tumors are non-cancerous, slow-growing, and don’t spread to adjacent tissues or other body parts. They’re easily removed and rarely reappear. While they may cause complications (e.g., pressure on surrounding organs/tissues), they don’t directly threaten life.

Malignant tumors, conversely, grow abnormally, invade surrounding tissues, and metastasize. Cancer cells detach from the original tumor, and travel via the bloodstream or lymphatic system to other body parts, forming new tumors distant from the primary site. This spread marks advanced cancer, complicating treatment.

Metastasis can affect vital organs (lungs, liver, bones, brain), increasing treatment complexity and the need for intensive, ongoing medical care.

Cancer Symptoms

Dr. Muhammad Mareesh, head of the Oncology Unit and consultant, lists common cancer signs. It’s crucial to note that these symptoms can also be associated with other health conditions and don’t necessarily indicate cancer, but warrant medical evaluation.

He also added that symptoms include: weight changes, extreme fatigue (due to cancer’s effect on the body), persistent bone and joint pain (from metastasis), skin changes (color, texture, e.g., pallor or jaundice), unusual bleeding (internal or external), difficulty swallowing, and chronic cough (indicating lung problems).

Dr. Mareesh also notes cancer cells’ ability to evade the immune system. Some cancers develop mechanisms to avoid immune responses; cells may camouflage themselves or release substances that hinder immune function, allowing growth and spread without easy detection.

Cancer in Yemen: Growing Challenges

Dr. Rami Al-Hakimi, a general physician at the Oncology Unit in Al-Hudaida’s Cancer Center, describes Yemen’s cancer situation as extremely dire due to several key factors: ignorance and poverty. Most residents lack awareness of early detection’s importance, coupled with limited financial resources hindering access to appropriate healthcare. The ongoing conflict has worsened the health situation. The introduction of unregulated chemicals for agriculture has also increased cancer rates. Difficult terrain hinders timely access to health centers, often leading to severely deteriorated conditions before treatment can be administered, limiting the chances of effective therapy.

Yemen faces significant challenges in combating cancer amidst deteriorating health and economic conditions. Greater efforts in awareness campaigns, healthcare, and improved medical infrastructure are needed to confront this serious disease.

Cancer Before and After the Conflict

Numerous news reports confirm that the health situation of cancer patients in Yemen reflects a major humanitarian tragedy. Patients face severe health and social challenges amidst the ongoing crisis. Even before the conflict, the situation was difficult, marked by shortages of medicines and medical equipment, diagnostic and treatment difficulties, a generally weak healthcare system, and a lack of trained medical personnel.

With the outbreak of the conflict, these challenges worsened dramatically, directly impacting patients’ lives. Many healthcare facilities were damaged, and infrastructure destroyed, making access to cancer care far more complex. This led to shortages of medicines and medical supplies, and a deterioration in patients’ health due to interrupted treatment and its escalating costs, placing it beyond the reach of many families.

Dr. Muhammad Mareesh, head of the Oncology Unit and consultant, sadly recounts the story of cancer patients in Al-Hudaida: “They face almost unbearable challenges, starting with the difficulty of reaching the few hospitals that haven’t been destroyed, continuing with the struggle to obtain essential medicines, and ending with constant worry about treatment and transportation costs.”

Dr. Muhammad describes children, men, and women traveling for hours to reach hospitals, only to discover that treatment has run out or that the cost is beyond their means. He says, “The pain isn’t just physical, but also psychological and social; patients feel like a burden on their families, especially in the absence of psychological and social support.”

In closing, Mareesh appeals to international organizations and the international community to look upon Yemen with compassion, as patients are battling both cancer and conflict simultaneously. He calls for the provision of medicines and equipment and easier access to healthcare to save thousands of lives caught between pain and hope.

Statistics (The Cancer Foundation in Al-Hudaida as an Example)

The National Cancer Control Foundation (Al-Hudaida branch) provides a detailed report on the number of beneficiaries of the oncology treatment unit in 2023, reflecting the scale of health challenges faced by cancer patients in this region amidst the difficult conditions of the ongoing conflict.

The report indicated that a total of 13,571 cases benefited, with 4,947 males and 8,624 females. This includes new cases received at the unit, recurring cases at outpatient clinics, and cases received at the chemotherapy preparation unit.

The report also highlighted the scale of the health problems related to cancer in the areas covered by the foundation, including Al-Hudaida Governorate and neighboring areas. The number of beneficiaries of services provided at the oncology treatment unit in 2023, including laboratory tests and free prescriptions from the unit’s pharmacies, reached 53,342, with a total value of 235,025,039 riyals.

These figures show the extent of the suffering of families in these areas struggling to provide the necessary care for children and adults with cancer. These numbers also represent a fraction of the immense challenges faced by cancer patients given limited resources and weak infrastructure.

The report stated that the National Cancer Control Foundation in Al-Hudaida provided services to 520 beneficiaries from Al-Hudaida, Rayma, Hajja, Dhamar, Sana’a, and Al-Mahweet.

This data underscores the urgent need for immediate support from humanitarian and international organizations to provide the necessary medicines and treatment for these cases and highlights the need to improve access to specialized medical care in conflict zones.