Josephine Tabu, 38, was barely a teenager when her father died of colon cancer.
“My father was in his early 40s when he died in 1996,” Ms Tabu says.
However, little did she know that the disease would tag along with her family for a long time.
The family had no knowledge of its early signs and symptoms that when never-ending stomach pains, diarrhoea, traces of blood in the stool and weight-loss kicked in; they were not prepared so they failed to act fast.
“It started with my sister, then my brother and I,” says the mother of four.
In 2012, her sister who had just been diagnosed with colon cancer, found out that it had spread to the liver. She died aged 32, after chemotherapy treatment failed to quell the disease.
“My sister thought the prolonged stomach upset and blood in her stool were side effects of a previous fibroid surgery. In her last days in a hospital bed, she asked us to go for genetic testing because it looked like we had a high chance of carrying a mutation that had riddled her and my father. She insisted, but I told her, ‘I can never be sick,” Ms Tabu says.
Her elder brother also refused to go for a screening test although he already had started experiencing recurring stomach pains.
“The doctors kept misdiagnosing him with ulcers and recurring H Pylori. He was finally told he had colon cancer and he died in 2018 aged 30,” she says.
Never in her wildest dreams did Ms Tabu think she was next in line.
“I cannot really pinpoint when mine started but I guess it was when I was pregnant with my last born child in 2012. I saw bloody particles, meaty-like, in my stool. But I did not think much about it because it was a one-off occurrence.
“I had a normal pregnancy and child birth. I actually gave birth at home, because at that time the doctors were on strike.”
By the time the doctor found out that she had cancer, she was weighing 38 kilogrammes.
“I had lost so much weight and my stomach was always aching. There was a time when pain was consistent for three months. I went to the doctor and he did tests and told me I had ulcers. He gave me ulcer drugs, which I took for two months but the pain persisted,” she says.
“I went back to the same doctor and he asked me to do a CT scan. I did more than eight different tests until a final one showed that I had a tumour in the stomach.”
Ms Tabu felt tired most of the time.
“Between 12am and 1pm every day, my knees and feet could grow weak. Then one day I fainted. It did not occur once. To avoid falling down in public places or spaces that I could get hurt, I started sitting down every time I felt dizzy. I realised that I could lose consciousness while seated and wake up minutes later without recollecting much,” she says.
In 2015, she did another test, a colonoscopy. “I was diagnosed with Stage 4 colorectal cancer. The good thing is that it had not spread to any other part of the body. Now, I’m okay. I’m waiting to do PET Scan to check if the chemotherapy worked to clear the cancer,” she says.
In a family of six, four got unlucky, inheriting a cancer-causing genetic mutation, leaving out her mother and last born brother.
“To my mother, it is like a dark cloud hanging over her. She wonders why she is losing her children to colon cancer. I asked my last born brother to go for testing but he refused. He says he has no money and the little he has is for his young family,” Ms Tabu says.
When colon cancer runs in a family, it increases a person’s risk of developing pre-cancerous polyps, meaning that genetic tests and colonoscopy should be done regularly.
A majority of colorectal cancers arise from polyps, which are small tumours that grow in the colon. In early stages, the polyps can be surgically removed, preventing a person from getting cancer.
Colonoscopy is a procedure where a small camera is inserted through the colon to check for abnormalities.
The test costs between Sh8,500 in public hospitals where patients may wait for up to a year before it is done to Sh40,000 in private hospitals. Mission hospitals charge Sh25,000.
Additionally, one can do a fecal immunochemical test, which is a screening test for colon cancer. It detects hidden blood in the stool, which can be an early sign. The test costs Sh2,749 in private laboratories and it should be done annually.
The Ministry of Health, in its National Cancer Screening Guidelines, says people who have an inherited risk should do colonoscopies 10 years earlier than when the affected relative got the disease.
To ease the burden, the Ministry of Health recommends 45 years as the age to begin screening for colon cancer for Kenyans with no known risk.
In Kenya, colon cancer is among the top cancers affecting both men and women, with the number of new cases estimated at 2,316 and deaths at 1,466, according World Health Organisation’s International Agency for Research on Cancer.
Besides colonoscopy and fecal immunochemical test, families can do a blood test to show if they inherited a gene mutation. The blood test costing Sh100,000 can detect cancers at a go, some at stage zero when there are no symptoms, said Robbin Noreh of Massive Genomics Kenya, a clinic in Nairobi, in an earlier interview.