By Pat Carragher - March 07, 2023
In 2015, Ghana’s Ministry of Health launched its national strategy for cancer control. At the time, 16,000 new cancer cases were being reported annually and that number was expected to rise over time. The plan aimed to reduce cancer deaths by 30% through prevention, screening and early detection.
When it comes to kidney cancer, nearly 82,000 Americans will be diagnosed with the disease this year, according to the American Cancer Society. It’s much harder to estimate the number of cases in a developing country like Ghana.
“The challenge in developing countries is that often when patients are diagnosed with cancer, it’s usually with later stage disease,” said Dr. Michael Poch, associate member of the Genitourinary Oncology Program at Moffitt Cancer Center. “There’s limited screening ability and limited access to cross-sectional imaging. There’s no central tumor registry that we have access to, so I don’t know that we have a good sense of what their national rates are.”
Poch knows first-hand what cancer looks like in Ghana. He recently traveled to the Komfo Anokye Teaching Hospital (KATH) in Kumasi to perform a urologic oncology surgical workshop. The team consisted of Poch; Dr. Kyle Rose, a urologic oncology fellow from Moffitt; and Johns Hopkins surgeons Drs. Sunil Patel and Hasan Dani.
Upon arrival to Kumasi, Poch and Rose got right to work screening patients. What followed was four full days of surgeries and lectures. Approximately 30 urologists from around Ghana traveled to the workshop from as far as Accra, Tamale and towns along the Togo border.
“They scrubbed in with us and performed operations with us,” Poch said. “The idea was to show them how we do things in the operating room and bring some of the newer techniques that we use in the U.S.”
The team performed more than a dozen complex surgeries with the local physicians to treat patients with kidney, prostate and bladder cancers including four radical prostatectomies, a cystectomy with sigmoid resection and neobladder, two adrenalectomies, one nephrectomy of a 21 cm mass and one open partial nephrectomy.
According to Poch, the open partial nephrectomy his group performed was the first of its kind at the institution. The goal of the procedure is to surgically remove a kidney tumor while leaving as much healthy kidney tissue intact as possible. Alternatively, a total nephrectomy typically involves removing the entire kidney.
“You can read about it in books but it’s a lot different when you witness it firsthand,” Poch said. “That was one of the surgeries that the native urologists were excited to learn about. They saw the possibilities of being able to use it in their clinical practices and are hopeful that they can apply it to their own cases now.”
The group also performed four pediatric patients for undescended testis and ureteral obstruction.
Rose accomplished another milestone for the group, performing the first ever laparoscopic adrenalectomy at the institution. The procedure uses small incisions to remove tumors found in the adrenal gland, which is located at the top of the kidneys.
“This was a tremendous opportunity for our team to both teach the technique and procedure, while learning the resources available to the Ghanaian surgeons,” Rose said. “Performing these procedures captured the essence of lifelong learning in surgery, which includes getting the repetitions to exercise this skillset regularly. Our goal is not just to perform these surgeries, but to be able to set up this region to apply and replicate this skillset.”
Poch and Rose have almost daily follow-ups with the Ghanaian urologists to see how patients are doing and to provide guidance on future cases. Poch hopes to make the mission trip an annual tradition.
“The plan is to continue to lead the surgical workshops and maintain the relationship in perpetuity,” Poch said. “The goal is not just to jump in there and provide services and leave. If you can connect and train and give them the tools they need to carry forward, it can really have a lasting effect.”