Mercy Muia, 28, lost her mother to breast cancer in 2015. Before being diagnosed with the disease, her mum had noticed that a lump was growing in her right breast.
“At first, she didn't think it was anything serious. In fact, a clinician at a local health dispensary said the lump resulted from hormonal imbalances and should, therefore, not worry her.”
But a year later, the lump could no longer be ignored as it was causing her so much pain.
“I brought her to Nairobi, where doctors eventually discovered that she had breast cancer. But it was in Stage Four and had spread to other parts of the body. So she died six months later,” she says.
Mercy’s mum is among the many women that have succumbed to the disease in Kenya due to delayed diagnosis as a result of care gaps in the country's healthcare.
David Makumi, the chairman of the Kenya Network of Cancer Organisations (Kenco) notes that continuous training and sensitisation of healthcare workers — in all cadres — on cancer signs or symptoms is important as it greatly contributes to early detection of the disease.
“We emphasise early diagnosis as this boosts treatment outcomes and survival chances of patients.”
According to him, enhanced public awareness on cancer symptoms is also important as it can empower people to make the right health choices.
A recent study in multiple African countries, including Kenya, provides additional insights into barriers that breast cancer patients face.
The findings of the research were presented at this year’s American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago this month.
The study indicated that despite significant strides made in detecting, managing and treating breast cancer, the disease is still one of the most frequently diagnosed cancers in Kenya.
Indeed, statistics from the 2018 GLOBOCAN report by the World Health Organisation’s International Agency for Research on Cancer revealed that the disease is the leading type of cancer diagnosed in Kenya.
Out of the approximately 6,000 (5,985) women diagnosed with breast cancer each year, about half (2,553) will die of it.
Findings from the new study Access to Care and Financial Burden for Patients with Breast Cancer in Ghana, Kenya and Nigeria indicate that a patient’s chance of survival can be impacted by delays in diagnosis and treatment, limitations in access to appropriate and quality cancer care, and financial burdens associated with receiving care.
Medical records used in the study were retrieved from six tertiary hospitals spread across the three countries.
In Kenya, the participating hospitals were Kenyatta National Hospital and Aga Khan University Hospital.
The study found that most patients travel long distances to access breast cancer medical services in Kenya.
It is estimated that the commute to a tertiary cancer centre where such services are offered is up to 398 kilometres.
This causes treatment delays or failures for patients without adequate financial resources to cater for travel expenses and accommodation.
Based on the study, patients treated in Kenyan tertiary facilities are not accessing diagnostic procedures, treatment and therapies at standard of care.
For instance, the use of common screening methods for breast cancer such as a mammogram or breast ultrasound was less than 45 percent in the country.
The research also found that despite a greater proportion of patients in Kenya receiving some financial support from the government or private institutions for their investigations and treatment, some still dug into their pockets to meet cancer care costs.
For example, between 30 to 32 percent of patients studied paid for their diagnostic tests entirely out of pocket.
On treatment, approximately eight to 20 percent relied solely on personal finances.
The government’s National Hospital Insurance Fund (NHIF) has played a significant role in enhancing cancer care in Kenya, however, it does not always meet the full diagnostic or treatment costs for all patients.
Those covered partially are thus forced to fill the financial gap on their own.
“This study is a critical first step to understanding the magnitude of the barriers that Kenyan breast cancer patients face in their fight against this disease, both to improve access to quality cancer treatment and ensure that our patients do not face financial catastrophe while fighting this disease,” said Majid Twahir, lead author of the study and medical director of Aga Khan University Hospital.
He noted that in line with the global momentum toward Universal Healthcare, there is a need for policies that improve standard of care treatment and increase insurance coverage to ultimately improve outcomes and protect breast cancer patients from financial hardship.
“This can be accomplished through stronger private-private and public-private partnerships geared towards improving access of breast cancer care, as no single player can tackle the barriers alone,” said Stephen Maina, the Medical Director of Roche in East Africa that supported the study.
"When we work together we can increase access and affordability of cancer care – and ultimately, improve outcomes for women in Kenya facing breast cancer."