The C word - cancer - brings shivers and fear to many people as it is perceived as a death sentence and a source of poverty. Once a family member is diagnosed with cancer, families may end up selling their properties, while those with insurance it is depleted in no time, then endless fundraisings.
Many people, particularly men, who suspect they could have cancer, will not disclose it to their relatives. Today, the world commemorates the World Cancer Day. This year's theme is: Close the Care Gap.
In this spirit, we will look at the strides Kenya has taken to close this gap. There is a steady increase in the number of new cancer cases in Kenya. Nearly every family has a relative diagnosed with cancer.
Unlike in the West where cancer is diagnosed in the elderly, here we see younger cancer patients in their prime age, putting a heavy toll on our workforce and economy. Although there is no clear answer to this, it has been attributed to copying Western lifestyles such as diet, sedentary life, and reproductive health.
That's why breast, colon, cervical and prostate cancers are becoming more common in our young population. Moreover, many patients in Kenya are diagnosed when the cancer is at advanced stages when a cure is impossible. Contrarily, in the US and Europe, there are many cancer survivors as patients present in early stages when it is manageable and curable. Unless we change our attitudes and embrace cancer screening and early detection, we will lose a large proportion of the population to this menace.
Usually, cancer is diagnosed by taking a biopsy (a small tissue from the abnormal growth) and then taken to the laboratory where it is viewed under a microscope by pathologists. Currently, the number of labs and pathologists has increased making the turnaround time shorter. Once the cancer has been confirmed the whole body will be screened by images such as ultrasound, chest x-ray, CT scan, MRI, and/or recently the PET-CT scan (a form of precision diagnosis) to determine how far the cancer has spread - the staging.
Kenya has two PET-CT scan machines, one is at the Kenyatta University Teaching Research and Referral Hospital (KUTRRH) serving patients not only in Kenya but also in East and Central Africa. Fortunately, this service is fully covered by the National Hospital Insurance Fund (NHIF). This is a huge relief for our cancer patients, as the PET-CT can also be used to monitor how effective the cancer treatment is.
Treatment involves use of surgery, hormonals, chemotherapy, target/immunotherapy, and radiotherapy. A hospital where all this can be done is known as a comprehensive cancer centre. Previously, patients had to travel abroad or to Kenyatta National Hospital to seek cancer treatment. This caused many patients to die helplessly at home as either they could not afford to travel or were not willing to be far from loved ones. The good news is there are now three regional comprehensive cancer centres (Garissa, Mombasa and Nakuru) and two referral hospitals (KUTRRH in Nairobi and Moi Teaching Referral Hospital in Eldoret) providing one-stop cancer care.
In addition, KUTRRH has a state-of-the-art radiotherapy machine known as cyberknife, the only one in Sub-Saharan Africa that can deliver radiotherapy in a short period of one week. The cyberknife is indicated where surgery is risky such as in some parts of the brain, spine and lungs.
Further, the number of cancer specialists has increased in the country. We now have approximately 50 oncologists (haemato-oncologists, medical oncologists, clinical oncologists, breast surgeons, surgical oncologists etc) serving a population of more than 50 million.
The nursing oncology and clinical officers' oncologists who play an important role in the cancer continuum their numbers have also increased. Although the country is moving in the right direction, the government should put more effort to ensure no shortage of cancer drugs, minimise and hasten repair of the radiotherapy machines immediately after they break down.
Kenyans need to change their attitudes and take cancer screening seriously as early detection saves lives. We urge people to come out in large numbers and go to cancer screening camps taking place throughout the country in marking World Cancer Day.
-The writer is a consultant clinical oncologist at Kenyatta University Teaching, Research and Referral Hospital
