What is the cost of cancer treatment and care in Kenya?

While we acknowledge it is very important and practical to determine the cost of cancer treatment and care for all cancer types, this is influenced by several factors.

These include the type of cancer, type of treatment modality required, stage of cancer, scope/extend of care required (inpatient/ outpatient care); service provider (public/ private), etc.

It is advisable to consult your doctor at the point of service delivery for cost information.

What is a risk factor?

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer.

Some people with several risk factors never develop cancer, while others with no known risk factors do.

Knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

What is breast Cancer?

Breast cancer is a disease in which cells in the breast grow uncontrollably, then form a malignant tumor that can invade the surrounding tissues.
They can also spread to other parts of the body, usually through the lymph system to form a secondary (metastatic) tumor.

Is breast cancer common in Kenya?

Out of all cancers in Kenya, Breast Cancer leads in incidence with 5,985 new cases annually (12.5% of all new cancer cases).
Breast cancer is the third leading cause of all cancer deaths. Five out of ten breast cancer cases in Kenya are diagnosed late (GLOBOCAN, 2018)

What causes breast cancer?

The exact cause of breast cancer is not yet well understood. Evidence exist that some factors are attributable to breast cancer, however in certain cases, some patients seemed free of the risk factors while other individual with the risk factors did not develop cancer. Some of these factors are modifiable while others are non-modifiable.
They include;

• Behavioral factors
• Genetic factors
• Hormonal factors
• Obesity
• History of breast cancer in the family
• Environmental factors
• Exposure to radiation
• Alcohol use
• Tobacco use
• Increase in age
• Late first pregnancy after age 30 years
• Early menstruation
• Late menopause

Who is at risk of breast cancer?

Breast cancer can occur in both men and women, but it is commonly found in women.

How do I know that someone has breast cancer?

Although it is not always easily noticeable in the initial stages, the following are signs and symptoms of breast cancer.

• A lump or mass in the breast
• Swelling of all or part of the breast, even if no lump is felt
• Skin irritation or dimpling
• Breast or nipple pain
• Nipple retraction (turning inward)
• The nipple or breast skin appears red, scaly, or thickened
• Nipple discharge

What can be done to prevent breast cancer?

• Lifestyle changes can prevent breast cancer, including:
• Eating a healthy diet
• Exercising regularly
• Maintaining a healthy body weight
• Breastfeeding
• Avoiding smoking
• Avoiding harmful consumption of alcohol
• Annual screening among women from 40 years to 74 years is recommended to prevent breast cancer.
• Mammography is the only screening modality shown to reduce breast cancer mortality.
• Knowledge of what is normal in your breast is important to maintain good breast health
• Discuss breast health and awareness with your healthcare provider
• Report any abnormality noted in your breast
• Breast-self-examination and clinical breast examination are complementary but do not substitute mammography as screening tool
• Asymptomatic women above 40 years should do mammography screening annually
• Clinical Breast Examination (CBE) should be considered as part of a physical examination and used as an opportunity to discuss and educate the woman on breast health.
• Ultrasound is not recommended for routine screening but may be used to complement mammography in patients with increased breast density.
• Performing monthly Breast Self-Examination (BSE) can increase breast awareness and help to detect breast changes early. Women are encouraged to be aware and to report changes in their breasts, such as nipple discharge, rash on nipples, inversion, dimpling or new mass in the breast or axilla.

Can breast cancer be cured?

When discovered early and treatment initiated promptly, many patients have survived breast cancer. The commonly available treatment options for breast cancer include Surgery, Chemotherapy, Radiation Therapy, Hormone Therapy and immunotherapy.
Breast cancer treatments are getting better all the time, and people have many more options today than ever before.

What can one do to minimize chances of getting breast cancer?

Since there is no sufficient knowledge on the cause of breast cancer, choosing a healthy lifestyle, screening (mammography) and early detection of the disease remains the cornerstone of breast cancer control.

What is a mammogram?

A mammogram is an X-ray of the breast. Mammograms are commonly used to screen for breast cancer. If an abnormality is detected on a screening mammogram, your doctor may recommend a diagnostic mammogram to further evaluate that abnormality. Breast ultrasound

Does cancer attack children?

Although rare, cancers in children before the age of 18 years do occur.

What are the most common childhood cancers?

• Leukaemia (Cancer of the blood)
• Lymphomas e.g Burkitts lymphoma
• Tumours of the central nervous system

What is the cause of cancer in children?

The cause of childhood cancer is not well understood. However, some of the childhood cancers are associated with radiation, genetic factors, viral infections e.g Epstein-Barr, Hepatitis B, Human Herpes and HIV

How can one identify a child who has cancer?

The early signs and symptoms of childhood cancers are non-specific. This increases the chances of l late detection.

Is there a cure for children with cancers?

Generally, about 80% of children diagnosed with cancer survive for at least five years

What is cervical cancer?

Cervical cancer is cancer starting from (cervix) - the opening of the uterus. In women the cervix is located between the vagina and the womb.

Who can get cervical cancer?

Any woman can get cervical cancer. However, presence of some risk factors exposes some women more than others

What is the cause of cervical cancer?

The cause of cervical cancer is currently not very clear. However, it is highly liked to Human Papillomavirus Virus (HPV) which is sexually transmitted viral infection. This virus may cause cancer in some women but not all women as some spontaneously recover from the infections. If detected early, precancerous lesions caused by HPV can be treated successful before they transform to cancerous cells, It is important to for all women over 30 years to get screened for cervical cancer.

Other risk factors for cervical cancer include:

• Aging: The peak age for cervical cancer is 35-45 years but a decade earlier in women with HIV/AIDS
• Multiple sexual partners
• Early sexual activity
• Sexually Transmitted Infectionss
• HIV/AIDS
• Smoking /any other form of tobacco use

How can one know if they have cervical cancer?

It is not always for possible for a woman to know if they have cervical cancer initially since there are no obvious signs or symptoms experienced.

Nevertheless, as the disease progresses, a woman with cervical cancer presents with one or several with the following signs and symptoms;

• Vaginal discharge (sometimes foul smelling)
• Irregular vaginal bleeding
• Post-menopausal bleeding
• Bleeding after sex, between periods or after a pelvic exam
• Heavy vaginal bleeding or discharge (more than usual)
• Urinary frequency & urgency
• Back ache
• Lower abdominal pain
• Pain during sex or urination
• Weight loss
• Inability to pass urine due to obstruction of the ureters
• Inability to control flow of urine or fecal matter (Urinary and fecal incontinence)
• Swelling of the lower limbs
• Difficulty in breathing due to cancer spread to the lungs

Investigations by a doctor will confirm if one presenting with the above signs has cancer of the cervix. Promptly seek medical assistance if those signs are there. Some of these signs appear in the later stage of the disease.

How can cervical cancer be prevented?

There is no definite prevention approach to cervical cancer. This is because some risk factors are not within an individual ability to control/modify e.g age. Some ways of lowering the chances that one gets cervical cancer are;

• HPV vaccine
In Kenya all girls age 10-14 years should be vaccinated against the HPV infection routinely. The vaccine is available in all the public facilities in Kenya
• Cervical cancer Screening
The screening tests available in Kenya are; Pap test (or Pap Smear), VIA/VILI test as well as High Risk (HR) HPV test. Consult with your doctor. Get screened. Prompt treatment for the precancerous lesions saves lives
• Behavior modification to control the other predisposing factors

What is prostate cancer?

Currently the cause of prostate cancer is unknown but it has been associated with some factors

Who can get prostate cancer?

Prostate cancer is affects Men. It is common among men 40 years and above

What increases an individual’s probability of getting prostate cancer?

Since the exact cause of prostate cancer is not well understood currently,

Some of the risk factors for developing prostate cancer are;

• Age is the most important factor
• Race: It is more common in blacks
• Diet: Inadequate intake of micronutrients e.g. zinc, selenium, vitamin E
• Hormonal: High testosterone levels.
• Infections e.g. chronic prostatitis (inflammation of the prostate) and frequent STIs
• Family history- Genetic factors

What are the signs of prostate cancer?

• In early state, prostate cancer does not show an signs or symptoms because it is confined to the prostate
• When locally advanced, patients may present with urination obstruction symptoms such as;
• Hesitancy to start urine flow
• Intermittent urinary stream,
• Decreased force of stream
• Examination shows growth into the urethra or bladder neck
• Blood in urine (Hematuria)
• In advanced state when it has spread to the regional pelvic lymph nodes, patients may present with;
• Edema of the lower extremities/swelling of the feet
• Pelvic and perineal discomfort

Can prostate cancer be prevented?

Prevention of prostate cancer may not be guaranteed because not all the predisposing factors are controllable, however chances of developing prostate cancer can be minimized through;

• Control of some of the risk factors within an individual’s ability through lifestyle changes
• Screening: Although PSA population screening not recommended, it is important men consult with their doctors about the PSA test.
• Early detection of prostate cancer and prompt treatment improves chances of cure. The Standard Laboratory Diagnosis for Prostate Cancer is histological examination of biopsies obtained through TruCut biopsy procedure
• The doctor will recommend PSA for follow up or in consideration to other factors
• The following additional investigations are done as part of staging:
• X-rays
• Cystoscopy
• Magnetic Resonance Imaging and CT scan

What are the currently available treatment modalities for prostate cancer?

The treatment modalities that the doctor may chose for depending on other clinical consideration include:

• Surgery
• Radiotherapy
• Hormonal therapy
• Chemotherapy