<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



Cancer is on the rise among younger people and scientists don’t really know why, according to&nbsp;<a href="https://bmjoncology.bmj.com/lookup/doi/10.1136/bmjonc-2023-000049" target="_blank" rel="noreferrer noopener">research</a>&nbsp;published in&nbsp;BMJ Oncology&nbsp;on Tuesday, an unexplained trend that threatens to strain already stretched healthcare systems and upends much of what we thought we knew about the disease.



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



While cancer still tends to be more common among older people, the number of cancers among people younger than 50—when it is considered to be “early-onset cancer”—has risen over the past three decades, according to the peer reviewed analysis of health data.



Globally, there were 1.82 million new cancer diagnoses and 1.06 million deaths from cancer among under 50s in 2019, the researchers said, respectively a 79% and 28% increase from figures in 1990.



Early-onset cancers of the windpipe and prostate rose most steeply between 1990 and 2019, the researchers found, climbing an estimated 2.28% and 2.23% each year, respectively.



Breast cancer—the most&nbsp;<a href="https://www.who.int/news-room/fact-sheets/detail/cancer#:~:text=The%20most%20common%20cancers%20are,and%20lack%20of%20physical%20activity." target="_blank" rel="noreferrer noopener">common</a>&nbsp;type of cancer worldwide excluding non-melanoma skin cancer—was responsible for the largest number of cases and associated deaths among younger people, the researchers said, with rates of 13.7 cases and 3.5 deaths per 100,000 people.



Deaths increased most sharply among people with kidney or ovarian cancers and, following breast cancer, cancers of the windpipe, lung, stomach and bowel exacted the highest death toll.



The researchers noted that while rates of early-onset cancer were a concern globally, the rate of new cases in 2019 were highest in wealthy countries in North America, Western Europe and Australasia and lower income countries in Central Asia, Eastern Europe and Oceania suffered disproportionately high death rates.



<h2 class="wp-block-heading" id="h-what-to-watch-for">WHAT TO WATCH FOR</h2>



Given trends over the past three decades, the researchers predict new early-onset cancer cases and associated deaths will increase an additional 31% and 21%, respectively, by 2030. People in their 40s are likely to be the most at risk, the researchers said.



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<h2 class="wp-block-heading" id="h-crucial-quote">CRUCIAL QUOTE</h2>



Writing in a linked editorial, researchers from the Center for Public Health at Queen’s University Belfast said the findings “challenge perceptions of the type of cancer diagnosed in younger age groups” and “serves as a warning for future burden on healthcare systems” that are still recovering from the Covid-19 pandemic. Given the risks to people aged between 40 and 49, public healthcare systems should consider expanding screening programs, they said.



<h2 class="wp-block-heading" id="h-what-we-don-t-know">WHAT WE DON’T KNOW</h2>



It is still something of a mystery as to why cancer cases are on the rise among younger people. In essence, cancer is a disease of uncontrolled cell proliferation, with cells growing and spreading to other parts of the body. It happens when the genetic information in our cells responsible for keeping cell growth in check is damaged, which explains why it is more common in older people who have had more time to acquire these mutations. Many factors influence the risk of getting cancer, including genetic predispositions, exposure to certain viruses and environmental factors like pollutants, diet, exercise and the use of drugs like alcohol and tobacco and the researchers said there is no single explanation for the rise in early-onset cancers over the past three decades. Better detection through screening and medical system improvements, such as cervical cancer screening in the U.S., could explain part of the increase, the researchers said. Other factors like changing lifestyles, particularly increased rates of obesity and physical inactivity, as well as environmental pollution could also account for some of the increase, they said.



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



The researchers found that the rates of some early-onset cancers decreased over the three decades studied. New cases of early-onset liver cancer fell by an estimated 2.88% every year, the researchers said, the steepest decline of the cancers studied.



<h2 class="wp-block-heading" id="h-big-number">BIG NUMBER</h2>



10 million. That’s roughly how many people died of cancer in 2020,&nbsp;<a href="https://www.who.int/news-room/fact-sheets/detail/cancer" target="_blank" rel="noreferrer noopener">according</a>&nbsp;to the World Health Organization. Collectively, cancers accounted for nearly one in every six deaths. The WHO said around one-third of these are due to preventable factors like tobacco use, high body mass index, alcohol consumption, a diet poor in fruit and vegetables and physical inactivity.



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<a href="https://www.forbes.com/sites/roberthart/2023/02/23/cancer-will-cost-us-53-trillion-by-2050-researchers-estimate/">Cancer Will Cost U.S. $5.3 Trillion By 2050, Researchers Estimate</a> (Forbes)<a href="https://www.forbes.com/sites/roberthart/"></a>

UCSF Cancer Center Uses Latest Technologies To Battle Cancer

Cancer Is On The Rise Among Younger People—But Scientists Don’t Know Why

Dr Shaheenah Dawood says it’s an exciting time for oncology research and is spearheading change in cancer care in the UAE, making sure that all patients, whether they come from the Middle East or Africa, have access to medication and treatment.



THERE’S LAUGHTER IN THE BREAST CANCER WARD. Shaheenah Dawood is in her bright sunny office wearing a lab coat, a floral dress and a smile that can make anyone feel welcome and well.



The only thing that is infectious here, in these corridors at the Mediclinic Parkview Hospital in Dubai where we meet, is her energy. Working 7AM to 10PM seeing cancer patients and giving them care and cure, this Consultant Medical Oncologist and Professor of



Clinical Oncology can’t afford to not be that ray of light and hope, and to the care-giving staff around her as well – such as during the lockdown in 2020, when she ordered cheerful pink, blue and yellow scrubs and PPE for those in her department.



But the Emirati doctor’s 24-page CV and the assortment of papers, accolades and awards to her name apart, there is passion in her voice, and serious purpose to her work.



“I always knew oncology is what I wanted to do,” begins Dawood. “And for several reasons. One, I’m a chatterbox, and I could talk as much as I wanted to these patients; the people you’re going to form long-term relationships with. Two, if you get a patient with cancer early on, you can cure them, and the satisfaction you get from curing that one patient, there’s nothing like it&#8230; The last decade has been truly exciting in the field of oncology more than any other specialty.”



Typifying everything the United Arab Emirates (UAE) aims to be in the realm of healthcare for the world, with the glistening city of Dubai becoming the hotbed of healthcare innovation and medical tourism in recent years, Dawood is at the forefront of leading that change, with research, clinical trials, personalized medicine and breakthroughs in oncology to vastly change patient outcomes.



She trained in medical oncology at McGill University Hospitals in Canada, sub-specialized in breast cancer management at the MD Anderson Cancer Center, served as an Editorial Fellow at the New England Journal of Medicine and has an MPH degree from the Harvard School of Public Health.



She could have stayed on in the United States but decided to return home more than a decade ago to become one of the first female oncologists at the time in the UAE, and make a difference.



“I think the UAE, with our leader, is just unbelievable in the way it has put women out there in the healthcare sector. I came in with so many ideas that the first thing I did was put those ideas aside, and say ‘I need to develop something here that’s accommodating to the people here’. I became the head of oncology at Dubai Health Authority, but there was a lot of work to do.



“I developed multidisciplinary tumor boards and comprehensive cancer care programs, working with an excellent group of people. And then I decided to break off and do something other than just clinical work, so I started the Excellence in Oncology Care Summit, which started off with 120 people, and last year, we had 4,000 attending virtually as well as in-person from across Southeast Asia, the Middle East and Africa.”



The list goes on, and Dawood is now heading and establishing the oncology clinical trials program at Mediclinic City Hospital that will allow patients in the Middle East to access drugs they would otherwise not have been able to.



“Tests are horribly expensive, everywhere around the globe&#8230; There is data that compared to any other specialty, oncology medications cost the most&#8230; We need to have better access to treatment, and one of them is trying to overcome the cost&#8230; And we need to start addressing it seriously to be able to offer the same type of care to everyone, irrespective of their financial situation&#8230;



“I had a patient from Africa, I can tell you he sold his land to come here and get the medication. I have a lot of patients from Nigeria and Eritrea. We do hear their stories..,” says Dawood, her voice laced with concern but also hope.



In addition, she spends her time teaching at the Mohammed Bin Rashid University Of Medicine and Health Sciences and working with PhD and medical students on their research initiatives.



“The only thing that I keep telling the newer generation,” says the 40-something game-changer in the medical sector, “is that you can achieve what you set your mind to achieve by working hard, and that no problem is without a solution.”



Heartening words indeed in the world of cancer care.

Screenshot 2022-06-22 at 16.14.24

CANCER’S CURE: The Doctor Who is Spearheading Change in Cancer Care in the UAE

After battling months of treatment, cancer survivors often find a bigger struggle waiting for them when they return to work – the apathy of employers to reintegrate them into the system.



<hr class="wp-block-separator"/>



Brenda Swanepoel (name changed to protect identity) calls herself “a breast cancer warrior”.



The 40-something, who works as a business developer in one of South Africa’s largest law firms, has endured the pain and discomfort of the much-feared doctor’s verdict – “you have cancer”. 



We meet Swanepoel on a warm Thursday morning in her Johannesburg office. Beneath her warm exterior is a woman still grappling with her diagnosis, still battling to adjust to life in the workplace in the aftermath of the ensuing treatment. 



“I was in the shower in December 2016 and something in me said ‘check your breast’. I used to be fairly diligent about it but I hadn’t gone for a mammogram for a long time,” she says. 



She clearly felt a lump.



“It was the size of a lymph node. I thought I better not be procrastinating this so I went to a radiologist,” says Swanepoel. 



The doctor told her she suspected breast cancer. The words cut deep into her being, eating her up as cancer does. 



“When he told me that it could be breast cancer, I knew I had cancer. I was lying on the bed and one little tear crept out of my eye.” 



That evening, she got home and told her partner of 25 years that the vacations they were intending on taking on weekends would be replaced by visits to the oncologist. 



In January last year, the doctor confirmed she had cancer. Her life was going to change forever. 



For the next six months, cancer dictated her diary. Seeing other cancer patients at the oncologist&#8217;s ward when she went for her first chemotherapy brought a further sense of denial. 



“I was like this is not really happening,” says Swanepoel. 



But the reality of cancer would soon kick in. She underwent the first of three operations within a week of being diagnosed. 



<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow">“I called my partner and said ‘we have to go to the breast surgeon at half past three’ and he said ‘I don’t do hospitals and I don’t do doctors’,” she says. </blockquote>



He was unsupportive throughout the duration of her chemo-treatment and she eventually parted ways with him. 



“One thing that you would always hear from any warrior is ‘the hardest part of their journey was their partners’,” she says. 



Her advice to them is to always put themselves first. 



“This is all about you, this journey is about you. Everyone else has to pull themselves together. It is all about you and your healing journey,” says Swanepoel.



The journey to recovery does not just affect your family and those close to you, the more painful fact is that it also has an impact on your career. 



Swanepoel was among the luckier few – in the beginning.



“My firm was amazing, they wanted me to go on leave…I thought they were out of their mind, I didn’t want any one’s pity because work is work. My attitude was that I am on a healing journey.”



She would work from home during the days she had chemotherapy and she could cope with the workload. 



<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow">“I was tired but I was coping at that stage. I did not want it [the breast cancer] to beat me. The firm was supportive and understanding because we have had a few cancer warriors in the firm.” </blockquote>



The treatment stages advanced and her work started to suffer as she was bereft of energy and struggled to focus. 



Some of the side-effects of chemo are constant nausea and weight-loss, in addition to excessive fatigue. 



“It started getting harder because I had to have weekly chemotherapy and on the day, I would be out of it, I would be gone. I would be sleepy on the chair and I would sleep at home, as you get your head up, it would be chemotherapy again. My firm tried to get me to go on special leave but I was resistant, but on the other hand, I was exhausting my sick days,” says Swanepoel. 



She ended up taking four months off for treatment and two months to recover. The medical leave was covered by an insurance policy her firm had for employees which pays them while they&#8217;re on leave.



Throughout the process, she was grateful; she also attended therapy to help deal with the situation. 



She returned to work in March this year, but says re-adjusting mentally and physically to the workplace is something medication can’t help with. 



“The hardest part of my journey has been coming back to work. It’s is not only about adjusting [to the work environment] after being away for six months, but the stamina you need for work is very different to the stamina you need for anything else,” she says. 



The reintegration has been stressful and she says a constructive, planned program of support at her organization has been missing since her returning to work full-time. 



“I didn’t realize how exhausted I was. People think because you were away for so long, you were resting, forgetting that you were injected with medication which exhausted you on a regular basis. You were not on holiday, you were healing and surviving,” she says.



It is a popular belief that cancer ends with chemotherapy.



“So everyone had this attitude, that cancer was last year so everything is normal this year. But that is not the case, a year of treatment requires a year of the recovery period,” says Swanepoel. 



And recovery is the hardest. 



READ MORE | <a href="https://www.forbesafrica.com/life/2015/12/01/from-selling-bras-to-beating-breast-cancer/" target="_blank" rel="noreferrer noopener" aria-label="From Selling Bras To Beating Breast Cancer (opens in a new tab)">From Selling Bras To Beating Breast Cancer</a>



“You are not the same person you were. You have gone through major physical trauma and you have gone through major mental trauma.” 



One of the major setbacks of cancer is hair loss. 



“Hair represents beauty…it is also very much a part of your identity and the image you want to project to the world. So when you don’t have it, you are left naked,” she says. 



This is why she is adamant South African companies should have a standardized policy in place for cancer patients and survivors. This includes options such as extra leave days for treatment, as well as a proper structured support for reintegration of survivors back into the system.



“Companies really need to wake up to the fact the two occupational diseases that are going to affect them in years to come are cancer and mental illness,” she says. 



Currently, Swanepoel is working towards providing the necessary support to other cancer patients battling the disease. 







Johannesburg-based oncologist Dr Omondi Ogude says the pressures in the workplace can affect cancer patients based on residual side-effects and they may take a couple of months to disappear. 



“There is a cognitive issue that some patients get which is called a ‘chemo brain’. They have short-term memory, where they may forget people’s names and it takes some time for some people to recover and unfortunately it is not some well-described or written-about side effect but patients complain about it a lot especially after the first couple of months of treatment,” says Ogude.



Ogude adds that cancer patients may struggle to be productive in their jobs after treatment so he suggests extensive communication between oncologists and corporate companies for a better understanding of the disease. 



“The best aspect is interacting with the doctors and the patients from the get-go to understand what the nature of the problem is and how long they are going to be on treatment. And also understand the potential side-effects that are expected,” he says. 



He also suggests companies have realistic timeframes and goals regarding when the patient would be at work and how they should be reintegrated just as they would with an employee who has been in a car accident.



“I think one of the problems is that cancer patients don’t look as ill as people perceive them to be. They look normal and a lot of them might still have their hair after chemotherapy and because they look normal, people might have a very short memory about what they have gone through. But even though they look well on the outside, they might not feel well inside and emotionally and physically as well,” says Ogude. 



He also says some patients may experience problems with their nerves, which could make it difficult for them to type. 



“So it is about being conscious at work and understanding that they have gone through all of these things; so allow them to work partly at home,” he offers. 



One in four South Africans is affected by cancer, according to Lathasha Subban, the Director of Tri-Core Specialist Advisory. The survival rate is only six out of 10. 



<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow">“This disease is impacting our workforces and our families. The disease does not discriminate, and the awareness around the cancer needs more support and advocates. There is much work to do,” she says.</blockquote>



Subban, whose company deals with human resource management, business strategy, coaching and policy development within the workplace, says that in her experience, people with cancer stood the risk of being boarded off, needed more sick leave than the norm, and are worried as to whether or not their medical aid would be sufficient to cover their expenses. 



“We realized that cancer was becoming more common in the workplace, and human resource managers and directors needed to understand that this disease was growing more rapidly, and it needed significant attention and planning,” says Subban.



She says that according to the Breast Cancer Control Policy by the Department of Health, South Africa (June 2017), breast cancer and cervical cancer are the leading causes of cancer-related deaths in South African women, together accounting for 38.5% of all cancers diagnosed in women. 



“We also found that people didn’t know how to handle the stress of someone related to them being diagnosed with cancer. And when they themselves have cancer, then the stress is heightened over the worry of costs and surviving the disease,” says Subban. 



Subban emphasizes that as much as wellness programs are in place, cancer patients are left out as cancer is very different from other diseases such as HIV/AIDS.



“People diagnosed with cancer have no control over their illness, so employers need to be able to apply their empathy and create knowledge programs and awareness around the sensitivity and seriousness of cancer,” says Subban.



“Cancer is not like flu where you just go on antibiotics or you go and get a flu jab. Cancer does not only impact the physical body, it is a mental, psychological, personal and sensitive breakdown of a person,” she says. 



This is why empathy is needed by both parties.



“To create the best solutions, always put yourself in the employee’s position and the employer’s position. You need to support the affected employee, whilst managing the fairness to other employees in the workplace. Companies need to find that middle ground in this aspect. Nothing stops you from creating those policies for employees who have cancer. The workplace needs that innovation and companies should lead in this respect.” says Subban.



Addi Lang had a booming business supplying talent to advertising agencies until she was diagnosed with stage three breast cancer. After undergoing chemotherapy and mastectomy, she stopped going for tests when her last results were unclear. 



Now, she is on a mission to spread awareness and about treatment options available through the Forever Changed Global Awareness Campaign, which she has co-founded which her partner David Salomon. The campaign serves as a roadmap for newly-diagnosed cancer patients. 



They are working with the SA Board for People Practices (SABPP) and global organizations to change the legislation around people battling with cancer in the workplace. 



“In South Africa, there is no formal policy for cancer patients in the workplace. Whereas, in the United Kingdom, cancer is a disability in the workplace, it is recognized and acknowledged. But in South Africa, it has not been on any one’s agenda, until we reached Parliament, after our recent press conference,” says Lang. 



Lang and Salomon have developed a corporate program accredited by SABPP called ‘Live Life Deliberately’ and is a wellness solution within the Forever Changed Global Awareness Campaign. 
The program involves intervention with managers and line managers who need to understand what the cancer journey is (from diagnosis to treatment and then reintegration) and the impact on companies. 



The purpose is to prevent employees from collapsing after diagnosis, and offer step-by-step solutions for the company in developing policy for chronic illness and cancer-specific programs. 



“If no one in your company has been touched directly by cancer, it is not going to be an important item for human resource to address; it is like an elephant in the room until somebody in your staff has cancer, and then it is too late. We are saying companies need to be proactive instead of reactive,” she says. 



She added that there are financial implications as well for the company. 



<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow">“Because now the company has got to start getting other staff members to cover [work not done by the cancer patient] for them,” says Lang. </blockquote>



Annually, more than 100,000 people are diagnosed with cancer. The Lancet Medical Journal indicates that South Africans can expect to see a 78% increase in cancer cases by 2030.



According to the World Health Assembly Cancer Resolution event held in Switzerland in 2017, cancer is estimated to cost world economies as much as $1.16 trillion annually. They project the figure will grow exponentially if action is not taken now to reduce the spiralling growth in the number of cases and the impact on both individuals and healthcare budgets. 



“The greatest financial and human impact of cancer is felt within low- and middle-income countries, where only 5% of global resources for cancer prevention and control are spent,” read the outcome of the assembly. 



Claudelle Naidoo, Head of Insights &amp; New Business Director, MediaCom South Africa, says it is the responsibility of organizations to be active in dealing with cancer in the workplace. 



“Every organization should put their people first and in doing so, having a process to deal with serious illnesses in the workplace should naturally be in place. This will empower any organization to deal with the situation and be able to assist the employee in the best way possible without compromising the business,” says Naidoo.



Cancer awareness in the workplace has increased and it now has the attention of parliament. How soon effective policies will be formulated is the question, before time runs out for most patients. 



One thing is for sure, warriors such as Lang and Swanepoel will keep up the fight for their seat at the table.



<hr class="wp-block-separator"/>



What needs to be done? • Acknowledge the concern • Get the stats in your workplace • Start educating and sensitizing • Look at your policies • Look at the stress levels and causes • Accept the responsibility that cancer is real and common • Look at affordability – pay and medical aid • Quality of life • Value and support • Be aware

FRANCE-HEALTH-CANCER

Cancer in the workplace

Legendary African jazz musician Hugh Masekela has died at the age of 78.
&#8220;After a protracted and courageous battle with prostate cancer, he passed peacefully in Johannesburg, South Africa, surrounded by his family,&#8221; read a statement released by his family.
He had been battling cancer since 2008.
Masekela used his music as a political tool, often against apartheid in South Africa, with songs such as Stimela, Soweto Blues and Bring Him Back Home (Nelson Mandela). 
Masekela first started playing the piano when he was five years old.
&#8220;I didn&#8217;t go into it for notoriety or fame. I just went into music because I love it,&#8221; he told FORBES LIFE AFRICA, when he was on the cover in 2014.
At the age of 14, he was given his first trumpet by Archbishop Trevor Huddleston, the late British anti-apartheid activist. Hugh began to develop his signature sound in the late 1950s, melding jazz with African influences.
His first album, Trumpet Africaine, was released in 1963. He went on to release more than 40 albums and performed with Dizzy Gillespie, The Byrds, Fela Kuti, Paul Simon, Stevie Wonder and Miriam Makeba.
&nbsp;
<iframe loading="lazy" title="Hugh Masekela - Stimela" width="500" height="375" src="https://www.youtube.com/embed/n4Bb7p9gggc?feature=oembed" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen></iframe>
&nbsp;

Legendary Hugh Masekela Has Died

After cancer had spread throughout her body, and death was inevitable, Patricia Ferguson decided she wanted to be in control of it. So, she went on a hunger strike.
“She had always said she would rather take an overdose than become a burden,” says her son, Sean Davison.
Having flown from Cape Town, South Africa, to Dunedin, New Zealand, to be with his mother during her final days in 2006, Davison was confronted with a horrific scenario and a decision that is hard to comprehend.
Unable to move her limbs, Ferguson was bedridden. Bruises and bed sores covered her body and her flesh was starting to rot. She wished her pain would end and no longer wanted to be a burden on her loved ones. She had starved herself for more than a month but her body refused to give in.
Finally, she pleaded for her son to give her a lethal dose of morphine pills that she had saved up over days. Witnessing her suffering for weeks, Davison sorrowfully agreed to help his mother.
“My instinct was to keep her alive. But I realized that this was what she wanted, and if I didn’t help her she would have suffered a lot more,” he says.
He crushed the pills, mixed them in a glass of water, and handed it to his mother. After about an hour she peacefully fell asleep.
Davison says this was an act of compassion; New Zealand authorities said it was a crime. He was arrested and later sentenced to five months house arrest.
Helping his mother die seemed to split society. Although many sympathized with Davison – including Archbishop Desmond Tutu, who wrote a letter that helped prevent him spending time behind bars – others were appalled by his actions. While being kept as a prisoner in his mother’s house, Davison received two death threats.
In 2010, while awaiting his trial, Davison, now the Head of the Forensic DNA Laboratory at the University of the Western Cape, founded Dignity SA. It is an organization that is fighting to legalize assisted dying in South Africa.
“My mother would never have gone on that ill-fated hunger strike if she knew she had the option of an assisted death,” Davison wrote in a column in December last year.
But, just like he faced resistance in New Zealand, Davison has detractors in South Africa. Dr Albu van Eeden is the CEO of Doctors For Life, a group of doctors that campaigns against controversial issues, such as euthanasia, abortion and homosexuality. He claims suicide is an infectious disease.
“The concept of suicide contagion is a very well established principle in psychology and psychiatry,” he says.
Suicide contagion is defined as the exposure to suicide or suicidal behaviors from family, friends, or media, and can result in an increase in suicidal behavior. Van Eeden believes that 99.9% of suffering can be effectively treated with medicine.
“It’s just erroneous now when we have the most effective pain treatment in the history of the world, now suddenly there is a need for assisted suicide,” he says.
Assisted suicide is when a doctor provides the medication and/or information for a terminally-ill patient to end their own life, while euthanasia involves a doctor administering the medication. Today, euthanasia is legal in the Netherlands, Belgium, Colombia, and Luxembourg. Assisted suicide is legal in Switzerland, Germany, Japan, Canada, and in the US states of Washington, Oregon, Colorado, Vermont, Montana, and California.
In South Africa, assisted dying is illegal but some are trying to change that in courts and Parliament. The most recent case is that of the well-known advocate Robin Stransham-Ford, who insisted his cancer and kidney failure infringed on his constitutional right to dignity. In 2015, on the day Stransham-Ford succumbed to the cancer‚ the High Court ruled that a doctor could help him end his life. Numerous organizations, including the Department of Justice, the Department of Health, and Doctors For Life, asked the Supreme Court of Appeal to review this. In December 2016, the decision was overturned.
Aubrey Magerman, Attorney and Director at Magerman Attorneys, feels that assisted dying should be legalized; he says it is still a crime in South Africa.
“We’re back at square one, where we would be criminally culpable to assist someone in ending their life,” he says.
Magerman believes everyone should have a constitutional right to a dignified life and a dignified death.
“I have had my own grandparents pass away out in the rural Northern Cape under terrible circumstances, with no assistance, and in horrible pain, and being unrecognizable for weeks on end. It is terribly traumatizing for anybody. I wish, when it come to my time [to die], I will have the opportunity [to undergo assisted suicide].”
Magerman refers to the popular MP Mario Oriani-Ambrosini, who had stage-four lung cancer.
“One day he couldn’t take the pain anymore and he killed himself. His family found him with his brain and blood splattered all over the bedroom walls and on the bedding. So, I don’t think the State should tell us how to die,” he says.
Despite this, Van Eeden says assisted dying can have consequences beyond easing a person’s suffering.
“Once you allow it you are stretching man’s tendency to stretch the limit or the borders which makes the slippery slope happen,” he says.
“In Canada, they now want to make it possible for people who are asking for euthanasia to donate their organs. Suicide was originally only meant for terminal illness, for people with unbearable suffering, until they said ‘on what basis is physical suffering worse than mental suffering?’ So then they said ‘ok, we’ll allow it for mental suffering as well’.”
“So now you find a person can go to their doctor and say ‘I’m depressed, I’m worthless’. Maybe he’s a disabled person or an old person, and he says I don’t mean anything for anybody, I’m a burden to society, to my children, I think I’m in the way. I want to rather commit suicide and please you’re the doctor, you must do it for me. Now they can say to him, ‘You know what? Your life is worthless but it can have purpose, you can give your organs for donation&#8230; And this just shows you what a monster suicide becomes.”
Van Eeden is also worried about the regulation of the laws.
“Holland was not able to keep its regulations. Firstly, they said there would be a waiting time, and two or three doctors must agree with the decision, but all these things went out the door. Initially, it was only for patients above the age of 18, now it’s changed so that children above the age of 12 years old can ask for euthanasia without the consent of parents. The limits are constantly being stretched,” he says.
Magerman agrees that regulation is vital if assisted dying laws are introduced.
“What is required here is for the State to step in. It should be up to Parliament, which is the body charged with making legislation. It is not something that can be regulated in the courts.
“It creates absolute uncertainty. It is simply for Parliament to say we will for now on regulate assisted suicide or euthanasia and the parameters of that will be set.”
But Van Eeden has concern that State regulation opens the door for laws to be abused.
“It will always be cheaper to take a life than to treat a person and try and help him. So there’s a very strong financial incentive to any government once you start allowing assisted suicide.”
It’s a complex issue with many legal, ethical and religious variables to consider. Those against assisted dying say that it goes against the sanctity of life that is stressed by most religions.
One iconic religious leader defies this. Archbishop Desmond Tutu, in October 2016, said he would like to have the option of assisted dying.
“I have prepared for my death and have made it clear that I do not wish to be kept alive at all costs. I hope I am treated with compassion and allowed to pass on to the next phase of life’s journey in the manner of my choice,” he wrote in the Washington Post.
“For those suffering unbearably and coming to the end of their lives, merely knowing that an assisted death is open to them can provide immeasurable comfort,” he added.
In 1998, South Africa’s President Nelson Mandela asked the Law Reform Commission to look into assisted dying.
The commission decided that assisted dying should be legalized, even writing a draft bill. Despite this, it was never debated in Parliament, and continues to gather dust.
In 2014, Tutu lambasted the way Mandela was used as a political prop days before his death, calling it ‘disgraceful’.
“My friend was no longer himself. It was an affront to Madiba’s dignity,” wrote Tutu, who is often referred to as South Africa’s moral conscience.
Would assisted dying legislation have allowed Mandela to die with more dignity? It’s impossible to answer definitively, but a sobering thought nonetheless.

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Mercy Or Monster?

<h3> The Famous Face</h3>
<h3>Zoleka Mandela</h3>
<h3>Age: 34</h3>
“The suspicion was there. It was nine months after I lost my son. It was on the 15th of March 2012,” says Zoleka Mandela as she tries on her dress for this photoshoot.
Despite her famous name, Mandela has been through a lot. Her diagnosis came after a string of personal tragedies including the death of her daughter during the 2010 World Cup followed by drug and alcohol addiction.
The day she got the news, she was surrounded by family. “My father’s older sister had died from breast cancer. So I thought I was going to die,” says Mandela. Recalling her aunt’s experience with the disease, she chose to remove her left breast. She has since gone through reconstructive surgery.
Mandela considers her scars ‘battle wounds’. She says: “I’m not too concerned about my scars. If anything, the breast cancer I felt would have robbed me of being a mother again.” Five months ago, she did become a mother – again. However, because of the surgery, she could no longer breast-feed. This, she says, is what pains her the most.
Mandela’s book When Hope Whispers chronicles her battle with breast cancer.
On these pages are clothes from David Tlale’s Pink Collection. “Purely a celebration of life, it was conceptualized when we [the brand] were celebrating our 10th anniversary. Our focus for the collection was celebrating femininity, the beauty of a woman across color and job description,” says Tlale’s manager Thapelo Ramalope, who put it together.
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<h3>The Mother</h3>
<h3>Hazel Pieterse</h3>
<h3>Age: 44</h3>
<img loading="lazy" decoding="async" class="size-medium wp-image-29557 alignleft" src="http://www.forbesafrica.com/app/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-002-220x300.jpg" alt="" width="220" height="300" srcset="https://cms.forbesafrica.com/wp-content/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-002-220x300.jpg 220w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-002-300x409.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-002-600x818.jpg 600w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-002-751x1024.jpg 751w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-002.jpg 750w" sizes="(max-width: 220px) 100vw, 220px" />
Hazel Pieterse lives in Klerksdorp, several hours’ drive from Johannesburg, and often leaves her home around 3AM to make her appointments at her clinic. She has recently undergone a full mastectomy. The mother of five says she’s fighting to stay alive for her children, especially her youngest who is just 10 years old.
Pieterse was diagnosed in November last year with an aggressive cancer in the breast and the lungs. “I am fine, I am strong,” she says. She credits her recovery to her family. A day after her breasts were removed, she became a grandmother for the first time.
Ever since she received the diagnosis, she’s been documenting her experiences in a journal which she carries with her everywhere.
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<h3></h3>
<h3>The migrant</h3>
<h3>Ida Ndlove</h3>
<h3>Age: 46</h3>
<img loading="lazy" decoding="async" class="size-medium wp-image-29558 alignleft" src="http://www.forbesafrica.com/app/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-003-229x300.jpg" alt="" width="229" height="300" srcset="https://cms.forbesafrica.com/wp-content/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-003-229x300.jpg 229w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-003-300x393.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-003-600x786.jpg 600w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-003.jpg 620w" sizes="(max-width: 229px) 100vw, 229px" />
Ida Ndlove is originally from Zimbabwe and was worried about her diagnosis because of this. She had no health insurance and her only option was public hospital. She eventually found her way to the Helen Joseph Breast Clinic in Johannesburg and her Zimbabwean identity did not hinder her treatment.
Ndlove, a domestic worker, initially found the commute from her home – quite a trek from the clinic – difficult especially on the days she had chemotherapy. However, her employer offered some relief by housing her and her husband for a month as she underwent treatment. “I started to feel better,” she recalls. The brief move also lifted her spirits, she says: “[The people where I stayed] were saying that you are going die.” She found a more positive environment there and around the women of the clinic.
Ndlove was diagnosed in December last year and has completed several cycles of chemotherapy as well as the removal of one of her breasts. She is currently undergoing radiation treatment.
<h3></h3>
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<h3>The Pillar</h3>
<h3>Elaine Harrington</h3>
<h3>Age: 58</h3>
<img loading="lazy" decoding="async" class="size-medium wp-image-29559 alignleft" src="http://www.forbesafrica.com/app/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-004-229x300.jpg" alt="" width="229" height="300" srcset="https://cms.forbesafrica.com/wp-content/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-004-229x300.jpg 229w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-004-300x393.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-004-600x786.jpg 600w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-004.jpg 620w" sizes="(max-width: 229px) 100vw, 229px" />
“It was only going to be the best,” says Elaine Harrington, all smiles after this photocall. The grandmother of ten was diagnosed two years ago, on the day of her wedding anniversary. And after receiving the grim news, she says she was at a loss.
“It only hit me when I walked out the door&#8230;[I thought] my family is not strong enough to handle this. I am the strong one in the family. Who am I going to tell?”
She had gone on holiday and returned to the difficult news. “My tumor went to 14cm, it was very long.” After sharing the news with her sister, Harrington made an important decision, “I decided that this is it and it was not going to get me down.” After rounds of grueling chemotherapy and an operation to remove one of her breasts, Harrington remains in remission.
She has remained very close to the Breast Clinic where she was diagnosed, sharing her strength and support with other women going through what she did. She is also contributing to the fight for a cure in other ways, making pink ribbons and trinkets to further the cause. Two of Harrington’s sisters have also been diagnosed with breast cancer and she thinks the most important part of recovery is having your family around you.
“It’s very important for your family to support you. Without that support, you can’t make it,” she says.
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<h3>The Young One</h3>
<h3>Motsedisi Mosia</h3>
<h3>Age: 24</h3>
Breast cancer is rare in women like Motsedisi Mosia. She is one of the younger breast cancer patients at the Helen Joseph Breast Clinic in Johannesburg.  When she received her diagnosis late last year, she was working as a waitress at a local restaurant. The news was unwelcome and unsettling.<img loading="lazy" decoding="async" class="size-medium wp-image-29560 alignright" src="http://www.forbesafrica.com/app/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-005-229x300.jpg" alt="" width="229" height="300" srcset="https://cms.forbesafrica.com/wp-content/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-005-229x300.jpg 229w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-005-300x393.jpg 300w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-005-600x786.jpg 600w, https://cms.forbesafrica.com/wp-content/uploads/2017/05/FWA-2014-Oct-Nov-018-022-Breast-cancer-005.jpg 620w" sizes="(max-width: 229px) 100vw, 229px" />
She has since had both her breasts removed and has taken time off to recover. Her worries now turn to finding someone to settle down with. “I was worried that I am not going to date anyone anymore,” she says. Mosia’s breasts, to her, spelled out more than her femininity – they also pronounce her beauty. Now, post-op, she claims she really doesn’t feel beautiful any more.
However, she is being strong. Throughout the process, she has leaned on her sister, who she considers her best friend, for support. She hopes for more confidence and a return to the dating world after a breast reconstruction surgery.
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TOGETHER WE OVERCOME

She has been listed as one of the ‘12 Names to Change the World’ by the Spanish National Centre for Research on Human Evolution as well as one of the top 10 most influential women in science and technology on the African continent by technology news website IT News Africa.
That’s 62-year-old professor Tebello Nyokong from Rhodes University in South Africa’s Eastern Cape, who is breaking the boundaries of science in cancer research.
Meeting her in her office at the university, one is immediately drawn to her warm personality and the twinkle in her eye. By her own admission, she likes to laugh a lot, and loudly.
Yet, the work she does is no laughing matter.
As Professor of Medicinal Chemistry and Nanotechnology at the university, as well as Director of the DST Mintek Nanotechnology Innovation Centre, Nyokong has attracted millions of rands in funding towards her research based on photodynamic therapy (PDT) of cancer.
PDT, which uses dyes and light, is already available for some cancers in the United States (US), Europe and Russia, but currently has strong side effects as the drugs hone in on healthy as well as cancerous tissues.
“Our whole aim is to make molecules that are cancer-specific so that healthy tissue will not be affected,” says Nyokong, going on to detailing the specifics, which any lay person would find hard to understand.
“In our research, PDT is combined with nanoparticles that absorb and re-emit light, thus enabling for visualization in addition to cancer treatment. In cancer therapy, nanoparticles act as delivery agents of the drugs selectively to the cancer tissue. This is due to the fact that cancer has leaky vasculature which allows nanoparticles to enter.”
Simply put, this means the drugs will specifically target cancer cells, which will see cumbersome treatments such as chemotherapy move into the dark ages.
Having overseen several formal collaborations with counterparts across the globe, Nyokong has also been awarded a prestigious Adjunct Professorship by the University of Tromsø in Norway and numerous international scientists have visited her laboratory. She has also hosted many postdoctoral candidates from around the world.
But she is quick to point out that her research is still in the pre-clinical trial phase and many years away from reaching the market.
Considered an icon in the world of science, Nyokong’s state-of-the-art laboratory is a far cry from her primary school days in Lesotho where as a child, she spent alternate days tending sheep and on the weekends, assisted her father who was a construction laborer. These tasks led her to conclude she could do anything a boy could do.
“At the start my father influenced my path. He believed that the apartheid system could only be defeated through education and I was encouraged to excel at a very young age,” she says.
And excel she did, having chosen art subjects for her matric, she changed to science two years before sitting her matric exams.
“The teachers accepted me after this mad move from arts to science and when I entered the University of Lesotho, I was greatly influenced by my lecturer, Dr Gray. After that I was driven by my desire to beat the odds,” she says.
Nyokong went on to obtain her PhD from the University of Western Ontario in 1987 and a Fulbright Fellowship for postdoctoral study at the University of Notre Dame in the US.
“I had academic loneliness, since there were very few women when I started. Now my past students have become professors and are my academic colleagues,” she says.
And she is excited and outspoken about Africa’s potential to excel in science.
On being awarded the National Research Foundation Lifetime Achiever Award last October, she says, “I am driven by being an African, completely, I’m passionate to see us succeed.”
And she is equally passionate when it comes to her students.
“I urge all young people in the country to study to the highest possible level [PhD]. The development of South Africa will depend on highly skilled labor. No country can have lasting economic growth or development without a solid science base. Science is thought to be hard, no, it’s not difficult,” she says. She wishes schools were not judged on their pass rate, but rather on their pupils’ abilities in maths and science.
Her work ethic is phenomenal and her research output has been described as simply extraordinary. In 2012, she published 51 articles, all of them internationally peer-reviewed; in 2013, she released 52 publications and 17 so far this year.
Nyokong admits she has a hectic schedule, between supervising students and attending scientific conferences around the world, which includes going to Oman this year for the World Academy of Sciences conference, where she will be the global representative in chemistry.
And when she’s not in the lab or traveling, Nyokong loves walking, as well as gardening, which she describes as “physical activity with a purpose”. She confesses a great weakness when it comes to beautiful bags and shoes and her ‘must reads’ are Malcolm Gladwell’s  David and Goliath
and Outliers.
A grandmother of two, her favorite holiday destination is Mauritius. As we end the interview,
3I ask her what it’s like to have come from a shepherd girl to a leading woman of science.
“Sometimes I think gosh, that is not me. I’m just doing my work, that’s all it is. I love my students and I embarrass them a lot sometimes.”
When she laughs, it’s from the core of her being. And with the list of honors and accomplishments she has garnered, no wonder she smiles – and the world of science with her.

Tag: Cancer