Agony for cancer patients who can no longer earn, socialise

Fridah Kambayi is confined to her single-room at Railways Estate in Nakuru town, knitting breast prosthesis.

Behind the broad smile of the 53-year-old cancer patient is an anxious soul

Despite her hard work, she has nowhere to sell the fabrics and also has difficulties in getting the raw materials.

She had hoped to sell the products and get money for cancer treatment. But she has skipped treatment and her health is deteriorating.

“What can I do to get money for treatment? I have left my life in the hand to God since selling prosthesis was my only source of income. But since coronavirus struck, things have been very difficult,” she says.

Kambayi is a member of a cancer advocacy group known as Uzima Foundation, which was established in February last year to support women diagnosed with cancer.

Before the virus struck, the 60-member group made artificial bras, which they sold for Sh2,000 per piece. The money would be used to buy medicine for the members, most of whom have undergone mastectomy. They would also use the money to enroll for the National Health Insurance Fund.

Before Covid-19, the group would meet at Nakuru Hospice to knit prosthesis using raw materials from Nairobi. “With Covid-19, we can neither meet nor travel to Nairobi to buy raw materials,” she says.

Kambayi says most of them cannot afford cancer drugs that help reduce pain. Each month, she spends about Sh11,000 on medicine, and Sh5,100 on regular check-ups.

She was diagnosed with breast cancer in 2016. She has undergone radiotherapy and chemotherapy sessions, and is now on a five-year treatment.

She has been on medication for the past two years.

Apart from meeting to raise money by knitting prosthesis, the group would also meet for psycho-social support. That, too, has stopped.

Sitna Mwanzi, a consultant medical oncologist at the Aga Khan University Hospital in Nairobi, says defaulting on treatment increases the chances of cancer coming back.

Dr Mwanzi said breast cancer patients are usually placed on five- to 10-year treatment to reduce cancer recurring.

Cancer risks

“Breast cancer patients who undergo surgery, chemotherapy and radiotherapy ...  are given tablets to reduce risks of cancer coming back, if they miss medication, they risk cancer coming back,” Dr Mwanzi told The Standard in an interview.

He says because cancer patients have low immunity, they should adhere to treatment and undergo regular check-ups.

“Patients should resort to telephone or video-consultation with their doctors if they have a problem accessing drugs. Adhering to treatment is necessary, especially during the pandemic,” he says.

A study published in the Journal of Clinical Oncology by an American Society of Clinical Journal states that default on treatment is prevalent among cancer patients, resulting in worse clinical outcomes.

Clinical outcomes associated with default include disease progression, treatment resistance and poor survival.

The study noted that cancer patients who are psychologically distressed were more likely to refuse, delay and discontinue treatment and routine patient follow-ups.

At least 467 patients were involved in the study, out of which 159 were defaulters. Of the 159, 89 desired psychological support, compared to 13 of 308 non-defaulters

“Our results show that defaulters had higher psychological distress but greater desire for support compared to non-defaulters,” says the report.

Researchers involved in the study recommended provision of psychological support to defaulters and re-evaluation of their treatments.

Support system

Apart from financial support from knitting of the prosthesis, Uzima Foundation has been a strong support system for cancer patients, providing psycho-social support.

The group provides guidance and counselling, an initiative that has helped many to accept their condition and seek medication religiously

Gladys Wanjiru, 35, is breast cancer survivor who spends most of her time in the house for fear of contracting Covid-19.

At her house, she wears face mask, cleans her hands with soap and water and avoids inviting visitors.

“I am worried about my fate. That’s why I prefer staying indoors,” she says.

After being diagnosed with breast cancer in 2016, she was rejected by her husband after she underwent mastectomy.

She lost her self-esteem and would lock herself in the house for fear of being stigmatised.

One day, as she walked to the oncology department at the Rift Valley Provincial General Hospital for a chemotherapy session, she met a group of women with bright faces.

Members of the group would encourage and tease one another and together they would have a good laugh despite sometimes being in pain.