I conquered the cancer beast
Before Rhoda Wangui Thuo developed a lump on her left breast in November 2010, she had been plagued by fatigue and weight loss for about three months before visiting Kiambu Level Five Hospital, where she was subsequently put on cancer treatment.
“I underwent surgery to remove the lump. And once the incision healed, I was referred to Kenyatta National Hospital (KNH) for chemotherapy and hormone therapy,” the 55-year-old mother of two says.
Dr MD Maina says the cancer might have resulted from a malfunction of her hormones. She was thus put on hormone therapy for five years.
With her diagnosis came various challenges. She was employed as a secretary, and due to many requests for medical leave, her employer summoned her. “My employer offered to give me permission to go get treatment, however, I saw it as a polite way of sacking me. Since it’s not normal to go back to work after two years of hospital visits and medication, I decided to quit,” she says.
When Wangui started chemotherapy, the doctors at KNH prepared her on what to expect. “He explained the effects of chemo and what to expect during the journey. Even when my body started changing, my family were not afraid. On the third round of chemo, my hair started falling off and my body turned dark and black. I vomited so frequently that I developed a sore throat. I was not sure I would make it despite my doctor’s encouragement. It’s human to want to give up, but I really had no option, but to fight the cancer,” she adds.
Wangui was lucky to be diagnosed early. The World Health Organisation (WHO) cites delayed diagnosis as the main barrier to accessing treatment. “Death rates are higher in low and middle-income countries such as Kenya due to late diagnosis, which is attributable to mainly lack of awareness on early detection and barriers to health services,” the health agency explains.
WHO classifies breast cancer as the most frequent among women, impacting 2.1 million of them each year. It causes the greatest number of cancer-related deaths among women. There are different types of breast cancer, which the American Cancer Society, says emerge depending on breast cells affected such as ducts, the lobules, or the tissue in between.
Globocan 2018, a report released by the WHO-affiliated International Centre for Research on Cancer, breast cancer is the most fatal in Kenya among women, claiming more than 2,500 lives in 2018 alone.
“In 2018, there were 5,985 new cases of breast cancer, equivalent to 20.9 per cent of all new cancer cases, making it the most prevalent cancer among women in Kenya,” the report says. It also adds that breast cancer is prevalent in women aged 50.
Prof Fredrick Chite, the Director of Clinical Care, Education and Training and Research for AMPATH Oncology Institute in Kenya, says it’s impossible to determine the exact number of women in Kenya with breast cancer.
“As a country, we are missing out on a lot of data. But we know for sure that about 47,000 Kenyans are diagnosed with cancer every year. Majority of the women have breast cancer. So, we can comfortably say every year we’re probably likely to see almost 10,000 breast cancer patients. In my programmes last year alone, we screened over 27,000 women for breast and cervical cancer. Through both community screenings and facility-based screening services, we diagnosed and treated over 1,000 breast and cervical cancer patients. In total I see almost 60 patients — with the majority being breast and cervical cancer patients,” he says.
Chite identifies some risk factors of breast cancer as sedentary lifestyles, family history, lack of exercise, poor nutrition excessive alcohol consumption, tobacco smoking and exposure as well as genetic mutations. Although breast cancer is a disease of the ‘old age’, he says that nowadays women as young as 30 are contracting breast cancer at an alarming rate that more research is needed. He maintains that the lifetime risk of developing cancer is one in eight, meaning that if all the women in the world live long enough into their 70s or 80s, one in every eight of them will have breast cancer.
“Being a woman is also a cancer risk because while men also experience breast cancer, the percentage is low. Out of 100 women with breast cancer, there is one man. So, we normally say that 99 per cent of breast cancer affects women—with one per cent going to men,” Chite adds.
He says not all breast lumps are cancerous “The only sure way to ascertain the possibility of breast cancer is the probable patient going for a biopsy as early as possible. After it is determined as cancerous, the patient goes for staging — during which we determine what stage the cancer is.
Staging is important to help with choice of therapies needed and prognosis. The lower the stage, the higher the chances of cure,” Chite explains.
He elaborates the earliest stage of breast cancers is stage 0. It then ranges from stage one to four. As a rule, the lower the number, the less the cancer has spread. A higher number, such as stage four, means cancer has spread to other parts of the body. Breast cancer treatment requires multi-thronged care, which may include a combination of surgery, chemotherapy, radiation therapy, hormonal therapy and/or biologic therapy. Biologic thereapy is a type of treatment that uses the body’s immune system to kill cancer cells.
Chite maintains that breast cancer is curable at stages one and two. At stage three, a patient is supported to live a normal life. Some patients have group prognosis—which means, at stage three, and after several years of treatment, they are doing so well the doctors can say the patient doesn’t have evidence of cancer.
However, for doctors to declare a patient completely cured of breast cancer, they look at how well the patient has survived after five years of treatment.
Early cancer screening is encouraged.
“We do not cure stage four, because it has already spread. However, I have breast cancer patients still alive today, with stage four cancer. About 70 per cent of the patients we see are diagnosed at stages three or four — a scenario we would like to swap with stages one and two,” he adds.
After fully recovering from breast cancer, Wangui now operates a clothes business. She is also an advocate of early diagnosis and creating awareness of the condition.
“As the secretary of Kiambu Cancer Support Group, I advocate for home visits. Most times, we find patients with no information on cancer or what to do.
“But after counselling, they tend to believe cancer is curable. We refer such patients to Kiambu Level 5 Hospital, and encourage them to join the support group,” Wangui concludes.