For most Kenyan patients and families, the death clock starts ticking after a stage 4 cancer diagnosis. “When will I die?”, many ask themselves. Families start rehearsing the funeral, emotionally at least, while others rush to ensure their wills are in order.
But Dr Andrew Odhiambo, a medical oncologist at Nairobi Radiotherapy and Cancer Centre, says stage 4 (cancer that has spread to lymph nodes or to other organs) is not as bad as it sounds and a patient can survive even up to 30 years.
“Many people with cancer don’t die from cancer. They die from complications. Stage 4 cancers are not a death notice.
“The disease may have spread to the bones but if all the other organs are okay, you can live with cancer for years as long as doctors control the disease,” he says.
If the disease has found its way into the lungs, but a tumour is small, doctors may opt to radiate it or watch-and-wait and this patient may continue living on for many years.
However, another patient with stage 4 may have a tumour that has burrowed into distant organs and has fluid surrounding the heart, brain and the lungs. This person’s chance of survival drops.
“I met a lady with stage 4 breast cancer and she stayed 11 years without dying. That is almost like a functional cure. But others die within three months,” Dr Odhiambo, who is also a consultant oncologist at Kenyatta National Hospital, adds.
What worries doctors are patients with stage 4 cancer who have additional diseases such as arthritis, diabetes, heart malfunction or high blood pressure hence they become “untreatable because their bodies have other underlying conditions”.
A cancer patient with kidney failure, for instance, is unlikely to take some chemotherapy drugs even if they work well because they may cause more damage.
These chemotherapy drugs may also cause second ailments such as liver, lung or kidney disease and mental illness, which according to Jenna Sinclair, an oncology nurse who has worked in the US, leave cancer patients in dire situations.
“The immunity reduces and the chemo kills the good and bad cells exposing patients to new diseases,” she says, adding that if your eyes turn yellow, you become too weak during chemo — talk to the doctor to delay the treatment or end it.
For instance, she says, some ovarian cancer drugs may damage the heart muscle.
For a HIV positive patient suffering from cancer, there is also a high risk of getting infections during chemo treatment.
Ms Sinclair says for patients on raw foods and vegetables diet, wash them very well and cook them lightly.
Also, depression, anxiety, bipolar disorder are linked to early deaths in cancer patients.
“Depressed patients are not likely to eat well, keep the spirits up. So learn to stop going to a negative place mentally, stay active, focus on your faith, write about your journey and your fears in a journal, listen to good music,” says the oncology nurse whose mother and grandmother survived breast cancer many years after the diagnosis.
“These things kept them alive for years.”