Oncology in South Africa

Oncology is the branch of medicine that focuses on the research, prevention, diagnosis, and treatment of cancer. A medical professional who specializes in diagnosing and treating people with cancer is called an oncologist.

An oncologist can design a treatment plan based on detailed pathology reports that shows the type of cancer the patient has, how much cancer has developed, how fast the cancer is likely to spread, and what parts of the patient's body are involved.

The field of oncology has three main areas, which include:

• Medical oncologists use chemotherapy, hormonal therapies, and other types of targeted treatments to treat cancer. Most people think of medical oncologist as their primary cancer doctor. Medical oncologists help monitor and maintain patients' well-being, as well as helping patients manage side effects. Often patients follow up with their medical oncologist once their treatment is complete.
• Surgical oncologists perform the surgical removal of the tumor and surrounding tissue. They will help patients prepare for and recover from any surgical procedure they undergo during their cancer treatment. If your primary doctor suspects that you have cancer, a surgical oncologist is likely one of the first doctors you see. Surgical oncologists can perform biopsies, which involves removing a small tissue sample to be checked for cancer cells.
• Radiation oncologists treat cancer using radiation therapy. They use high-energy photon beams to target and destroy cancer cells. Approximately one-half of all cancer patients will undergo radiation treatment during their cancer care.

Because most cancers are treated with a combination of therapies, you could see two or all three different oncologists during the course of your treatment.

Besides the three main areas, there are also several other areas of oncology. These include:

• Pediatric oncologists diagnose and treat cancer in children. Some types of cancer appear more often in children and teenagers, such as leukemia, brain tumors, osteosarcoma, and Ewing’s sarcoma. Some pediatric oncologists focus on conducting research on childhood cancers, while others specialize in certain types of cancer.
• Gynecologic oncologists treat cancers that affect women, such as cancer of the ovary, cervix, uterus, vagina, and vulva. Additionally, they also treat complicated gynecological conditions that are not cancerous, such as fibroid tumors and endometriosis.
• Hematologist-oncologists diagnoses and treats blood cancers, such as lymphoma, leukemia, and myeloma. They may also specialize in the management of solid tumors.

Oncologists usually work with a variety of other medical professionals, including pathologists, diagnostic radiologists, oncology nurses, and oncology social workers. They may also work with doctors from other areas of medicine, such as neurologists, dermatologists, or urologists.

What does Oncology Involve?

There are many types of procedures to treat cancer. The types of procedures that you receive will depend on the type of cancer you have and how advanced it is. Some people who have cancer will only have one treatment. However, most people have a combination of treatments, such as surgery with radiation therapy and/or chemotherapy. Below are the types of procedures to treat cancer:

Chemotherapy

Chemotherapy is a type of treatment that uses drugs to kill cancer cells in the body and prevent them from growing. The drugs can prevent cell division, target the food source of the cancer cells’ (the hormones and enzymes the cells need to grow), and trigger apoptosis (a process in which cancer cells kill themselves).

• Chemotherapy drugs can be given in several different ways, including.
• Oral – taken in a pill or capsule form.
• Intravenously – through an infusion into a vein.
• Shots – injected with a needle.
• Topical – applying creams or gels into the skin. This type is used to treat certain types of skin cancer.

Chemotherapy drugs can also be given directly to cancer or directly to an area of the body, such as the abdomen or central nervous system.

Immunotherapy

Immunotherapy, or biologic therapy, boosts your body’s natural defenses to fight cancer. It uses substances made by your own body, or in a laboratory, to improve or restore your immune system function. It can stop cancer from spreading to other parts of the body, stop or slow the growth of cancer cells, and help your immune system work better at destroying cancer cells.

There are several types of immunotherapy to treat cancer, including immune checkpoint inhibitors, T-cell transfer therapy, monoclonal antibodies, treatment vaccines, and immune system modulators. Different types of immunotherapy may be given in different ways, such as intravenous (IV), oral, intravesical (directly into the bladder), or topical.

Targeted therapy

Targeted therapy uses drugs that are designed to specifically “target” cancer cells without affecting normal cells. It targets the cancer’s specific proteins, genes, or other tissue environment contributing to cancer survival and growth. These proteins and genes are found in cancer cells or in cells related to cancer growth.

The targeted drugs can block or turn off chemical signals that tell cancer cells when to divide and grow, stop making new blood vessels that feed cancer cells, change proteins within the cancer cells so the cells die, trigger the immune system to kill cancer cells, and carry toxins in the cancer cells to kill them.

• There are two types of targeted therapy:
• Small-molecule drugs, which is given through pills or capsules that you swallow
• Monoclonal antibodies, which are given through a needle in a blood vein.

Radiation Therapy

Radiation therapy uses intense energy beams to kill cancer cells and shrink tumors. It most often uses X-rays, but other types of energy, such as protons may also be used.

Radiation therapy can be done in two ways:

• External-beam radiation therapy – this type of radiation therapy delivers radiation from a machine outside the body. You will lie on a table, and the machine (called a linear accelerator) moves around you to deliver radiation from several different angles. It is a quick and painless procedure.
• Internal radiation therapy – also called brachytherapy, involves both temporary and permanent placement of radioactive sources in the body. During the placement of the radioactive sources, you will be given anesthesia.

Hormone therapy

Hormone therapy stops or slows the growth of cancer that uses hormones to grow. It works by blocking your body’s ability to produce hormones or interfere with how hormones behave in your body. It can reduce the chance that cancer will return by stopping or slowing its growth, as well as preventing or reducing symptoms in men with prostate cancer.

Hormone therapy is usually used to treat breast and prostate cancer. It can be taken in many ways, including orally, through an injection, and surgery.

Stem Cell Transplant

People whose blood-forming stem cells are damaged by the very high doses of radiation therapy or chemotherapy can undergo stem cell transplant to restore the cells. Blood-forming stem cells are vital since they grow into different types of blood cells that you need to be healthy. The stem cells will be given to you through an IV catheter. The process is very much like receiving a blood transfusion.

Surgical treatment

Surgical treatment for cancer is a procedure to remove cancer from your body. There are many types of surgeries to treat cancer, which differ based on the part of the body that requires surgery, the purpose of the surgery, the amount of tissue to be removed, and your preference. In general, the surgery can be open or minimally invasive.

• During open surgery, one large incision is made to remove the tumor, some healthy tissue, and some nearby lymph nodes.
• During minimally invasive surgery, a few tiny incisions are made instead of a large one. These incisions are made to insert a laparoscope (a long, thin tube with a camera on its end) and special surgical tools. The laparoscope allows your surgeon to see the inside of the body, and the surgical tools are used to remove the tumor and some healthy tissue.

How Long Should I Stay in South Africa?

For chemotherapy, radiation therapy, immunotherapy, hormone therapy, and targeted therapy, the treatment schedule may vary. You may have treatment every day, week, or month. It may also be given in a cycle, which is a period of treatment followed by a period of rest to give your body a chance to recover. For surgical treatment, you may need to stay in the hospital for a few days, and you need to stay in South Africa for at least 10 to 14 days. Your oncologist and/or medical tourism team will advise you on the length of stay in South Africa.

What's the Recovery Time?

The type of procedure you undergo determines the recovery period. While you may be able to get back to your normal routine within 10 days after laparoscopic surgery, you may need to wait around 6 weeks to fully recover from open surgery. Your oncologist will give you a detailed recovery timeline.

What About Aftercare?

You will be given instructions on how to take care of yourself. Your surgeon or nurse will explain how to control your pain, how to take care of your wound, activities you can and cannot do, and how to spot signs of infections. You may also need to talk to a dietitian to help with eating problems caused by the treatment. You will need to attend follow-up checkups to monitor your condition.

What's the Success Rate?

Cancer survival has improved significantly due to constant advancement and improvements in the field of oncology, including improvement in treatments and screening (allowing for earlier diagnosis). Still, you need to be aware of the risks, such as infection, bleeding, nerve damage, fatigue, nausea, vomiting, and hair loss.

Are there Alternatives to Oncology?

There is no other alternative than to see an oncologist when it comes to cancer treatments. Some people may choose to undergo meditation, hypnosis, and acupuncture as well, usually to relieve the stress, anxiety, and pain that cancer can bring.

Oncology in and around South Africa

About South Africa

South Africa is home to some of the world's most luxurious private game reserves and lodges. Wildlife lovers come here from all corners of the globe in search of the "Big Five": lion, buffalo, leopard, rhino, and elephants. Coral reefs, shark dives, dragon-backed mountain ranges, white-water rafting, and golden beaches lapped by legendary surf breaks are some of South Africa's many other attractions. Traveling around this vast land and touring the vibrant cities, visitors can learn about the nation's turbulent history. Travelers coming to South Africa for medical treatments do so for cost savings, advanced medical technology, and the internationally qualified and skilled doctors. The country welcomes an ever-increasing number of medical tourists each year, many of which travel for Oncology procedures. Medical Tourists travel from all across the globe, particularly from African countries with an inferior healthcare system. Popular destinations include the capital city, Pretoria, neighboring Johannesburg, and the stunning Cape Town.

Popular Parts of South Africa

With more than 57 million inhabitants, South Africa is the world’s 24th most populous nation. It is a multiethnic society with a large variety of cultures, languages, and religions. Known for its exhilarating outdoor adventure, fascinating wildlife, magnificent landscapes, and opulent history makes South Africa a truly magical destination

• Cape Town is the oldest city and the legislative capital of South Africa. This pleasant city has a lot to offer as you can Hike the Table Mountain, take a wine tour, cruise to Robben Island, relax on beautiful beaches, visit District Six Museum, discover Kirstenbosch Botanical Gardens, and watch the Boulders Penguin Colony or shop in trendy markets. 
• Johannesburg is the largest and the most populous city. It is changing rapidly into an ultra-modern metropolis. Other than being an urban city, it also boasts a rich history. Tourists can visit the Apartheid Museum to learn more about the country’s difficult past through exhibitions. Other museums such as MOAD and MuseuMAfriCA are also worth a visit to view the city’s art and history.
• Durban is a cosmopolitan city with sunny beaches and charming Afro-Indian culture. There are more Indian nationals residing in this city than any other country outside of India. It is the place to go if you want to see marine life. Visit uShaka Marine World where you can snorkel, dive, and interact with animals. 
• Pretoria is a scenic city and you will find various historic buildings with astounding architecture such as the Voortrekker Monument, Union Buildings, and Church Square with its statue of Paul Kruger. Those who are looking for some outdoor activities can explore Pretoria National Botanical Garden and Rietvlei Nature Reserve for some wildlife viewing.
• Kruger National Park is one of the largest national parks and one of the most exciting safari destinations in the world. Here you can view all of Africa’s safari species such as Lion, Elephant, Rhino, Leopard, Buffalo, Hippo, and Giraffe along with more than 100 mammal species and 500 varieties of bird.

Weather and Climate in South Africa

South Africa’s climate is determined by its situation in the Southern Hemisphere’s subtropical zone and between the Atlantic and Indian Oceans. The country is a year-round destination thanks to its varying regional climates. May to September is the Dry Season with little to no rain. The days are mostly sunny, but it gets cold in the evenings and mornings. The average temperature during this season is around 14 °C with June to August as the coldest months. The wet season starts in October and ends in April. There will be occasional short rain showers in the afternoon. The average temperature during the wet season is around 20 °C, but it can also be as high as 35 °C, especially in December, January, and February.

Getting Around in South Africa

The main and the busiest airport in South Africa is the O.R. Tambo International Airport. The airport is located in Kempton Park, near Johannesburg and Pretoria. It serves as the primary domestic and international gateway to and from South Africa. The airport operates flights to other cities in South Africa as well as numerous major cities in the world including London, Singapore, Sydney, Abu Dhabi, and Atlanta. There are also two other major international airports: Cape Town International and King Shaka International. The inexpensive way to travel around the country is by flying with budget airlines such as FlySadair, Kalula.com, and Mango.

South Africa has an excellent infrastructure and is easy to navigate. However, if you wish to visit several cities, expect to have at least one long-distance trip. You can travel around by bus, train, or rental car. There are several long-distance bus companies you can choose, such as Intercape, Translux, and Greyhound. The buses are relatively affordable and safe. They are generally equipped with air-conditioning and an onboard toilet. For short-distance travel, Baz Bus is the best choice. A one-way ticket fare starts at around 500 ZAR.

Although trains are slow, they are less expensive than flights and more comfortable than buses. Shosholoza Meyl long-distance trains serve Cape Town, Johannesburg, Durban, Bloemfontein, and several other major cities. This train is very affordable with tickets costing as low as 400 ZAR for a sleeper train. If you’re looking for a more luxurious train, try the Blue Train which offers comfortable compartments, good food, and wine for around 18,300 ZAR. 

Taxis are available to get around major cities. Tourists can hail one directly from the streets. However, since the taxi ranks are not common, it is best to call for one. The base fare can be different in every city, ranging between 11 ZAR to 20 ZAR. 

Tourist Visas in South Africa

A valid visa is required if you wish to visit South Africa. Citizens of more than 60 countries can enter and stay for up to 90 days. Other countries not listed in the visa exemption agreement must apply and obtain a visa to the nearest South Africa embassy or consulate. All visitors must hold a passport valid for at least 30 days after the expiration of their intended visit, and the passport must have at least two unused pages. 

Additional Information

1. Local Currency: South African Rand (ZAR) is the official currency. 1 USD converts to 14 ZAR.
2. Money & Payments: Tourists can find ATMs all around the country. Credit Cards are widely accepted. However, since South Africa has a reputation for scams, you should inform your bank about your travel plans to avoid declined transactions. It is also advisable to always bring some cash with you. Tipping is expected here and you can tip around 10% to 15% of the bill in restaurants and cafes and the standard tip in hotels is 10 to 20 ZAR. 
3. Local Language: There are 11 official languages in the country, including Zulu, Xhosa, Afrikaans, Northern Sotho, Tswana, Southern Sotho, Tsonga, Swazi, Venda, Southern Ndebele, and English. Zulu is the most widely spoken language.
4. Local Culture and Religion: As a secular state, South Africa has a diverse religious population. Most of the population follows Christianity. Other religions such as the traditional African religion, Islam, Hinduism, and Judaism are also freely practiced.
5. Public Holidays: The country has 12 public holidays such as New Year’s Day, Good Friday, Freedom Day, and Christmas Day.