Oncologist Dr. Catherine Nyongesa, Founder and CEO, Texas Cancer Centre narrates to DERRICK VIKIRU her experiences on treating cancer patients, giving hope to survivors, and her journey; hurdles, milestones and achievements, in running a Cancer Centre.
BY DERRICK VIKIRU
Texas Cancer Centre was started in June 2010 in response to a gap in Kenya and the region where patients were unable to promptly access specialised cancer treatment services. Generally, there was a waiting period of around 2 years before a cancer patient could get onto radiotherapy. My younger sister was a victim of this delayed treatment. She was diagonised with cancer way back during my years in medical school and I had to take care of her. I also have had close family members from my husband’s side like sister-in-law and father-in-law who succumb to cancer. I thank God, my sister is a survivor.
This prompted me to devote my time, energy and expertise in fighting this disease, hence TCC was born. We put up a business proposal to one of the banks to finance the project. I also sold my mortgaged house to fund the project. The Centre was first put up in Kibera on a rented property, later moved to Hurlingham before phase 1 of the Mbagathi road branch construction was completed.
Starting out was not just a smooth ride, I must say. There were many hurdles I had to cope with. For Instance, the venture is capital intensive with huge costs for acquiring land, purchasing equipment and construction works. Over 8 years we have only constructed and equipped ground and first floors out of the anticipated 4 story building. Other challenges are such as huge wage bill and also dealing with stress at work as majority of cancer cases come late when nothing much can be done.
Some of the notable success and achievements that I wouldn’t fail to mention is that the facility is now boasting of a complete 53 bed capacity nursing home out of anticipated 150 and having treated over 13,000 cancer patients, from different countries, at our facility over the past 8 years. We also support research and provide youth employment.
Prevalence of cancer
Cancer statistics in Kenya are shocking. Cancer has been ranked the third leading killer after pneumonia and malaria. Last year the KNBS recorded 16,953 deaths caused by cancer while MoH estimates 40,000 new cancer cases and 27,000 cancer deaths every year. We see these high numbers because there is widespread lack of awareness. Cancer has been with us for decades now. Many Kenyans still do not have a word for cancer even now. Especially in the rural areas, people are dying, and they absolutely have no idea what is killing them.
Now with more awareness, we are seeing more cases coming forward. People are becoming conscious of their health and moving with speed to get screened, hence the shocking statistic.
Texas cancer Center has seen consistent increase in number of people visiting the facility to be screened. Additionally, more people in Kenya are now reaching middle age, a time when cancer becomes more prevalent. Kenya’s population is growing and getting older.
It is usually not possible to know exactly why one person develops cancer and the other doesn’t. But research has shown that certain risk factors such as; exposure to chemicals or other substances, age, alcohol, diet, hormones, obesity, radiation, sunlight, tobacco, family history among others, may increase a person’s chances of developing cancer.
Several cancers in Kenya are caused by infections, such as the hepatitis viruses (B and C), which cause liver cancer, or the human papillomavirus (HPV), which causes 98 per cent of cervical cancers. Our lifestyle is also a contributor to new cancer cases (smoking tobacco and over indulgence in alcohol); some could be genetic while others could be environmental.
High treatment success rate
It is sad to note that cancer is also common in children such as; blood cancer (Leukemia), brain tumors, Neuroblastoma (arises from immature nerve cells in infants and in children younger than 5), Wilms Tumor (Kidney tumors), Lymphoma, and retinoblastoma (eye cancer). Parents should look out for things like weight loss, headaches, vision hearing and speech problems, dizziness etcetera. Generally, look out for symptoms that when treated for other illnesses, the symptoms do not go away. It is important to bring your child in for cancer screening. Success rate for cancer treatment is very high in children and the kid will have normal growth.
Cancer is a wasting disease. The cost of diagnosing, treating and caring for cancer patients is too high in Kenya. As a player in the industry, I understand that treating chronic illnesses, especially cancer, can be an expensive affair; the personnel, medicines, physical structures/buildings, and machinery are very expensive. Personnel, such as doctors and nurses must be appropriately trained and compensated for the many years of training. They also bare the weight of life-or-death responsibility they shoulder for their patients.
The cost of cancer drugs is also exorbitant. Certain cancer drugs, especially newer, high-tech and cutting-edge treatments can be very pricy. Some of these treatments can cost thousands of shillings per dose. Health insurance like NHIF usually picks up some of the cost, but there are other charges and some are unexpected, even the best health insurance won’t cover these costs.
The pharmaceutical companies also invest millions of dollars in researching and developing an effective cancer treatment. These companies do have more failures than successes, and these research and development costs are factored into the cost of the drug. There are also other expenses such as the drug testing for safety and efficacy. This process can take years and millions of shillings to complete. However, while the treatment is expensive, they extend life for many patients in meaningful ways. There are incredible advances in treating virtually every cancer.
We also can’t underestimate the government’s goodwill to subsidise the cost of treating cancer in Kenya. With the building of the proposed regional cancer centre of excellence, putting health among the big 4 agenda, NHIF offering some relieve to cancer cost burden is all government’s good will.
At TCC we are working to drive awareness campaign to people to take up early screening. In 2018 we have taken the drive to Kisumu, Kakamega, Taita Taveta, Eldoret, Machakos just to name a few to encourage people to come out and get screened. We have also opened a small clinic in Bungoma that offers consultation services and answer queries about cancer that the public may have. All these are efforts to build capacity locally to combat this menace. We believe the country is on the right path, but a lot needs to be done. One is to reduce draining our economy by unnecessary referrals of patients overseas for ailments that can be treated locally, so that these funds can build capacity locally.
Another aspect of cancer treatment is palliative care. Palliative care (or supportive care) focuses on relieving symptoms caused by cancer and cancer treatment. It can be given at any point during a person’s illness to help them feel more comfortable. It helps patients cope with the side effects of cancer and cancer treatment. When many different treatments have been tried and are no longer controlling the cancer, it could be time to focus on palliative care and end of life care. We offer this service through our palliative care unit. We also extend the service to our patients’ homes where we assign nurses to assist in caring for our patients.
A global fight
Cancer can and does recur after treatment. This can happen weeks, months, or even many years after the primary or original cancer was treated. It is impossible for your oncologist to know for sure if the cancer will recur. One may experience many of the same feelings they did when first diagnosed with cancer; shock, disbelief, anxiety, fear, anger, grief, and a sense of loss of control. Again, through palliative care, we help patients and their families understand and accept the situation and help them re-embark treatment. Understandably, a patient may worry about having the strength to cope with another round of tests and treatments. However, many patients find that their previous experience better prepares them to face the challenges.
The fight against cancer is for all of us to undertake. It is not a one-man fight, not even a one country fight. It is a global fight. I therefore welcome other investors, stakeholders, governments, well-wishers, and all of us to join hands to build capacity locally to allow more patients access to timely cancer treatment. Every time a life is saved, we move closer to saving the world from this cancer menace.
Finally, I want to speak to cancer patients. Cancer is an ugly disease, but the beauty of life after cancer is worth fighting for. No matter what happens now, always remember that you are a survivor, not a victim. Fill your heart with love, fill your mind with determination and fill your soul with hope so that cancer has no place to stay in your life. Your strength to suffer pain today will be the pen that writes a new destiny. Just one month of being cancer-free will wipe away the pain of many years of chemotherapy. Cancer is not a death sentence, there is always light at the end of the tunnel. HOPE is the bridge that connects cancer and recovery.”
Derrick Vikiru is the Sub-Editor, Management Magazine. Email: dvikiru@kim.ac.ke
