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What next after breast cancer diagnosis?

BY GRACE ESHIWANI

Joan Kariuki was only 23 years old when she accidentally discovered a lump in her left breast. She was convinced that it was only hormonal and didn’t take it seriously.

A few months down the line, Joan notes that there was dimpling and discharge from her breasts. It was at this point that she consulted a doctor, who referred her to an Oncologist. Sadly, she had breast cancer.

With help from family members, she began treatment soon after. “Chemotherapy was the hardest thing I have ever gone through in my entire life,” she says. “You hear about bouts of vomiting, fatigue and pain, but nothing prepares you for chemotherapy treatment,” she added.

Her hair started falling off, her skin became darker.  She says that it was during this period that she reconnected with God. It was the only way she could go through it.

Self-examination

The recently released statistics from World Health Organisation (WHO) indicate that Cancer is currently the second leading cause of death globally and is estimated to cause 90 deaths per day in Kenya. There are several factors that predispose one to breast cancer which include obesity, alcohol, sedentary lifestyle and genetics.

There has been a lot of awareness about breast cancer but more needs to be done. Breast cancer occurs when abnormal cells form in the breast and begin to multiply exponentially.

All females should look out for a painless lump in the breast, changes in the shape of the breast, discharge from the nipple and swelling in the armpit. The same goes for men, though the incidence of breast cancer in men is negligible.

According to WebMD there are different kinds of breast cancers, which includes inflammatory breast cancer whose symptoms include thickening of the skin, which might also turn red and pitted.

Frequent self-examination is extremely important in helping one understand their body, making it easier to understand any slight change.  Finding a lump does not necessarily mean one has cancer, it could be other things including hormonal changes or a cyst.

A breast cancer diagnosis confirmation is done through a tissue biopsy. A piece of tissue is extracted from the breast and the sample is sent to a lab for further analysis. After a positive diagnosis has been made, the doctor will then seek to find out if cancer has spread to other parts of the body in order to determine the stage of the disease.

An early diagnosis of cancer often leads to better outcomes as compared to diagnoses made after the disease has progressed.

According to Dr Lance Mayabi, a general Surgeon at The Karen Hospital, after staging of the disease, treatment will commence immediately whereby whole or part of the breast may have to be removed. Both procedures have their pros and cons, however, it is paramount that one has an intensive discussion with their doctor regarding which treatment route to follow and why.

Treatment

Radiotherapy is one of the treatment options available, whereby high-energy rays are used to ensure that any remaining cancerous cells are destroyed to curb the spread of the disease. One may experience fatigue or swelling among other side effects as a result of this treatment option.

Chemotherapy is administered intravenously and can be done before surgery to reduce the size of the cancerous mass, or after surgery. It works by eliminating any cancer cells in any part of the body. The side effects from this type of treatment include nausea and vomiting, fatigue, loss of hair and sometimes nails and lowered immunity.

The third treatment option is hormonal therapy which is used to treat fast growing cancer cells which would be responding to progesterone or oestrogen. This depends on the histological type of breast cancer that looks at the presence or absence of oestrogen or progesterone receptors on the cells of the tumour.

There have been advancements in the field of medicine and currently, there is targeted treatments that are used to attack components in cancer cells. This form of treatment can be used alongside chemotherapy and has fewer side effects.

After a mastectomy – removal of the entire breast – one can have breast reconstructive surgery. One may also use padded bras and prosthetics which will enhance a balanced look.

Speak out

There are some unfortunate incidences where by diagnosis is done when little or nothing can be done to salvage the patient’s health.  Palliative care comes in to help make the patient comfortable by alleviating pain but also prepare the patient and family mentally for any eventuality. According to WHO, “Palliative care is treatment to relieve, rather than cure, symptoms caused by cancer and improve the quality of life of patients and their families.“ In Kenya, The Kenya Palliative Care is an umbrella body which brings together palliative care givers.

While a cancer diagnosis is not easy, a patient should not isolate themselves from family and friends. Instead, they should reach out for moral and financial support. Additionally, one should stick to a treatment regime to enhance the chances of getting better.

Most individuals who have been diagnosed with cancer also often seek solace in religion, which is important as it fosters a sense of belonging and a hope for the future. There are several support groups that welcome patients and their relatives as they all share similar pains and fears.

Grace Eshiwani is the Communication Officer at Karen Hospital. Email: graceeshiwani@gmail.com

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