A casual doctor's appointment yields unexpected results. She is diagnosed with breast cancer. She slumps into her seat in shock and sadness. Her heart sinks into her abdomen with a thud! Her first instict is denial. 'No.. This cannot be. I eat healthy and exercise regularly.. How can this be? I cannot have cancer.'
"Don't worry, we caught it in its early stages," the doctor tries to reassure her, 'you'll be fine." The treatment takes a toll on her health. Suddenly she must go under the knife.. what she dreads most. The cancer has spread and her left breast must be cut off if she must survive. She tries to come to terms with what she's been told. Its hard. How can she? Her full chest is a symbol of her womanhood, her femininity. What will people say? How will society treat her?She hasn't much time to think through it. She must make a decision, and quickly at that. An injection to the arm for local anaesthesia. She blacks out.Her eyes lazily open to lights as she hazily tries to focus on her surroundings. She's in the post-op ward and is doing well the nurse informs her.The bandages are out. Scar tissue is all that's left and a mound on the right reminding her of what once was. Tears well in her eyes. She tries to stop them but like a river running its course they flow down the cheeks, past her nose to the corners of her mouth before she quickly wipes them away. 'I must be strong,' she keeps telling herself.'I must be strong.' His heart fills with sorrow when he sees her suffer. He is saddened that his presence and kind words are not enough to comfort the woman he loves. He wants to hold her and assure her that they will be fine, she will be fine. To whisper his love to her scar from his heart. To kiss the pain away.Tell her I say. Tell her you still love her with her scar and mean it. Tell her she's the only one you see. Tell her that her breast still satisfies you even in your old age. Say that you want to help in any way you can. Assure her you will always be true to her and mean it. Tell him you want to feel his breath as he whispers to your scar. Tell him you feel empty and inadequate as a woman. Tell him you cannot handle the pain. Tell him you want him to hold you as you mourn your loss. Tell him you're insecure and unsure he'll remain true. Tell him you wish things were different. Tell him you still love him and want things to work. Tell him what you feel. Don't bottle it up inside. ------------------------------------------------------ Editor's Note: Read here a research paper by Alice M. Musibi on breast cancer treatment in Kenya. She argues that while breast cancer treatment has been successful in many parts of the world, inlcuding other parts of the developing world, Kenya still has a long way to go: Cancer treatment is improving in the developed world. Metastatic testicular cancer—virtually lethal a few decades ago—can now be cured. Similar though less dramatic advances have also been made in the treatment of various hematologic malignancies, and the therapeutic promise of specific small molecule inhibitors and antibodies is becoming realized in the clinic. In Kenya, unfortunately, these advances are yet to be realized, owing to an underlying deficiency of resources, infrastructure, and trained personnel; the entire lack or prohibitive cost of chemotherapy drugs; and the advanced stage of the majority of cancers at the time of presentation. Unfortunately, as Musibi reports, the data on cancer on Kenya is very limiting as it is mostly from Kenyatta National Hospital and private hospitals in Nairobi. Further, oncology specialists are mostly located at the capital making it difficult, mostly impossible, for proper diagnosis and treatment of cancer of Kenyans outside Nairobi and its environs. And for those with access to Nairobi, she says the cost of chemotherapy is exorbitant and out of reach for many Kenyans. Although chemotherapy drugs are available, high cost prevents the majority of patients from even beginning treatment. Others are unable to afford the most current regimes. Chemotherapy is administered by general physicians and surgeons as much as 80% of the time, often exposing patients with cancer to preventable risks, side effects, and resistances from use of substandard regimens, and eventually leading to poor response rates. Awareness and availability of palliative services in the country are increasing. These exist mainly as joint services with HIV/AIDS management programs and in private hospices across the country. Because Kenya's medical research mostly focuses on malaria, HIV/AIDS and tuberculosis, Musosi further shows that cancer treatment and research in Kenya is not treated as a priority. However, there is some good news: KEMRI now has a department dedicated to non-communicable diseases, including cancer, and the Kenyan government is in the process of developing National Cancer Control guidelines. We are hopeful that these will lead to the development of policies that address cancer as an entity in the health budget and enable many patients to afford cancer management services as early as possible. The formation of the East African Community, with the associated infrastructure for common bargaining in health issues, will push the implementation of the relevant policies on cancer control, prevention, and also training. Over the weekend, we learned that Mater Hospital 's breast clinic in Nairobi will offer discounts on mammograms and breast ultrasounds in October for its breast cancer awareness campaign. Visit their Web site to learn more about self breast exams. Remember that breast cancer is not exclusive to women, thousands of men continue to be diagnosed with breast cancer. This Web site here (Mayo Clinic) also has comprehensive information on breast cancer. Are you a breast cancer survivor, or have you recently been diagnosed with cancer? What was your experience in Kenyan hospitals? Are you an oncologist with research and anecdotes to share? We'd like to hear from you:
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