Dr. Tshipayagae passionate about educating patients
Dr. Malaki Tshipayagae is one of the many specialists found at Lenmed Bokamoso Private Hospital.
Being a General Surgeon, Dr Tshipayagae runs his own clinic, Tshipayagae Surgical Associates. He treats a wide spectrum of surgical condition ranging from endrocrine, gastrointestinal, trauma and surgical emergencies. Notwithstanding the aforementioned, his key focus is on breast and colon cancers, bariatric surgery, endoscopy and laparoscopic interventions.
In his observation Dr Tshipayagae notes that in Botswana, generally people don’t go for routine screens for such diseases. Most of the patients that seek medical attention, come when the disease has already advanced, when the cost of care escalates and the outcome very poor. Therefore it is imperative that as nation to establish screening programs to address the rising levels of non communicable disease such a as breast, colorectal and prostate cancers.
To underscore how critical these programs are, while at Nyangabgwe Referral Hospital Dr Tshipayagae and his colleagues established a Breast Cancer Clinic which was dedicated to diagnosis and evidence- based Breast cancer management, as well as patient advocacy, and trying to get the requisite systems in place. These allowed better management of patients in terms of follow up and treatment.
During those times, they advocated for Botswana to get two mammograms and video endoscopy machines.
He is very passionate about advising his patients especially those are over the age of 50 years to screen for Non- Communicable Diseases such as colon cancer because of the situation on the ground.
They have been seeing an increase in the number of colon tumors, as well as those of breast cancer, affecting both the young and the old. What some patients might not know is that in its early stages, they might not be aware due to lack of or vague symptoms.
It is on this backdrop that he advises those over 50’ s, to do a baseline colonoscopy - a visual examination of large intestine. They must also be aware of key things such as change in bowel habits, blood in the stools, constipation, diarrhea, weight loss and vague abdominal pain are some of the symptoms associated with colon cancer.
A colonoscopy can also reveal things such as a polyp, colon cancer and other non cancerous disease such as diverticulosis, he says. What is interesting, he explains, is that removing these polyps is one of the colon cancer prevention measures.
He emphasizes early diagnosis, which translates into early intervention for cancers as this will give a patient better outcome.
The biggest concern according to Dr Tshipayagae is that people present very late. This means that the treatment becomes very expensive and the outcomes are poor.
As for breast cancer, his experience is that it affects both the young and elderly women, with incidence increasing with advancing age. I’m some instances men are also affected.
“Much of what should be done in the country is sensitizing both men and women because breast cancer can affect both men and women to actually know their breast, and do routine mammograms starting at age 40. It is very fundamental as a life saving measure,” he points out.
With the advent increasing obesity in Botswana, Dr Tshipayagae clinic offers weight loss surgery.
This however requires multidisciplinary approach involving psychologists, endocrinologist dietician evaluation prior to any surgical intervention.
Having trained in the USA, he did a lot of these operations and never thought there will be a time that there will be needed in Botswana. However, there is a certain section of society that will benefit from weight loss surgeries, especially those with diabetes, hypertension, sleep apnea etc.
Problematic weight, he says affects people as young as 18 years, with some growing up with the weight and others gaining weight in their 30s.
“Multiple interventions for weight loss exist such as insertion of balloons in the stomach offered by my colleagues.
For me, I do what is called sleeve gastrectomy, which involves reducing the size of the stomach to accommodate less food. This subsequently lead to weight loss due to eating less and loss of hormone that drives hunger.