The road to health sometimes leads to hell and back. As the shadow of death looms, people will try anything that promises to effect a cure – even if it almost kills them.
Some cures work, others don't.
The desperate and the gullible are easy targets for snake oil merchants who have been around since the dawn of time. Miracle cures at knockdown prices: who could resist? Many cures involve wretched side effects. But when the cure, side effects and all, does save your life, it's often worth the agony.
African sleeping sickness
Take for example the unsavoury cure prescribed for African trypanosomiasis, otherwise known as sleeping sickness.
This vector-borne (disease transmitted by animals to people) parasitic disease is spread by the infamous tsetse fly, and is a major public health problem in many African countries, particularly Angola, the Democratic Republic of the Congo, Uganda and Sudan.
After an infected tsetse fly bites a human or animal, the parasite multiplies in the subcutaneous tissues, blood and lymph, and then, weeks, months, or even years later (depending on the parasite involved), symptoms begin to surface.
During the first stage of the disease the infected person experiences bouts of fever, headaches, joint pains and itching. Once the parasites have crossed the blood-brain barrier, the central nervous system is affected. At this point (stage two) things take a turn for the worse and sufferers begin to experience confusion, poor co-ordination, disturbance of sleep cycle (hence the name) and finally, death.
Fortunately, the disease is curable, particularly when detected early on. On the other hand, second-stage treatments are more complicated, and potentially fatal.
You’re more likely to associate arsenic with murder and certain death than with healing and recovery. But if you’re suffering from second-stage African sleeping sickness, a potentially deadly dose of the stuff may be your only hope.
Melarsoprol, an arsenic-derived treatment, is the preferred drug for the treatment of second-stage sleeping sickness. It kills between 5% and 10% of patients. But it's either that, or death...
Much closer to home is the destruction brought about by another killer of our time, cancer.
In order to combat rapidly dividing cancer cells, many anti-cancer drugs are designed to kill growing cells. Unfortunately, this means that the treatment may harm some healthy cells that also divide quickly. The cells most likely to be affected are the blood cells forming in bone marrow; the cells in the digestive tract (including the mouth and stomach); the reproductive system; and the hair follicles.
Because of the treatment’s tendency to damage healthy cells, many cancer patients experience severe side effects. These may include fatigue, nausea, pain and hair loss, as well as effects on the nerves, muscles, kidneys, bladder and sexual organs.
It's challenging if you're going through it, and it's difficult for concerned friends and family. But it's worth it: the success rate is high.
South Africa's HIV-infection figures are harrowing. But giant leaps in the treatment of the disease mean that for many, living with HIV is like living with any other chronic disease - it is no longer necessarily a death sentence.
Although antiretroviral therapy (ART) is not a cure for Aids, ARVs slow down the virus and the loss of CD4 T-cells that the HI virus destroys. This means that ART limits damage to the immune system and helps to prevent opportunistic infections. It also reduces the need for medication and lengthy hospital stays.
Like many drugs designed to treat chronic illnesses, ARVs can cause unpleasant side effects such as nausea, diarrhoea and headaches. In rare cases, ART has been associated with more severe, potentially life-threatening side effects such as myopathy (a neuromuscular disease) and lactic acidosis (when lactic acid builds up in the bloodstream faster than it can be removed).
And it's so worth it.
When risks are worth taking
Decisions about severe treatments are never easy. Every individual has to decide whether the discomfort and the inconvenience brought about by certain treatments are indeed worth it. Also worth considering are those who support the patient – a decision regarding treatment affects their lives too. Sometimes suffering from grim, but temporary, side effects is a small price to pay.
(Donna Steyn, Health24, updated May 2013)
Centre for Disease Control and Prevention
World Health Organisation