Wellness & Fitness

Right time to stop cancer treatment

hospice

Nairobi Hospice takes services to patients in homes when too weak to move. FILE PHOTO | NMG

Ending chemotherapy and radiotherapy treatment for a loved one battling advanced cancer is one of the most wrenching decisions.

John Weru, a palliative care physician at Aga Khan University Hospital, says most Kenyans dread the possibility that it is time to let a loved one die without having to endure the expensive, aggressive treatment like chemotherapy, radiotherapy or surgery, which might not help much.

Many Kenyans still associate palliative or hospice care with giving up or not caring for the sick.

‘‘Palliative care improves the lives of patients and families facing life-limiting illnesses and should start immediately when distressful diagnosis of an incurable disease is made,’’ Dr Weru says, adding that a hospice is not only for those on the verge of death.

Kenya has about 75 hospices and with the rise in non-communicable diseases which are mostly diagnosed at advanced stages, the demand for palliative care is expected to grow, yet it remains underused.

Dr Weru says the biggest challenge is the stigma attached to hospices and late referrals to these facilities or to palliative care physicians.

‘‘Patients are still being referred late to see palliative doctors when there is no adequate time to communicate and support them,’’ he says. Studies show that patients who receive early palliative care are less likely to suffer from depression than those who receive standard care.

The spiritual, physical and psychological support offered at the hospice helps patients with untreatable illnesses live fully, regardless of their prognoses. Sometimes the nutritional, breathing therapies and pain-relief management help patients survive several months or years longer.

Many countries are struggling to offer quality death and as governments work to improve lives of citizens, they must also consider how to help them die well. Kenya has made progress and when it comes to availability of morphine for pain relief, most patients receive it for free.

Alice Bacia, a public relations co-ordinator at Nairobi Hospice, says nurses do home and hospital visits to reach the bedridden, offering emotional support, painkillers and other drugs.

‘‘We take the palliative care services to people who have no fare to come to the hospice or those who are too sick to come to us,’’ she says.

Besides providing painkillers, hospices give patients fortified porridge flour and some organise clinics in informal settlements to reach the low-income people.

Ken Were, a throat cancer patient is one of the beneficiaries of the hospice. The 28-year-old who has lived with cancer for 10 years says he receives free morphine from the Nairobi Hospice.

‘‘The social workers make follow-ups and sometimes bring the morphine to my house in Kayole. It helps ease the pain. But sometimes it works for about three hours and then the sharp pain in the eye and the right knee comes back. If I take the morphine twice a day it gives me constipation and nausea, so I just take it a night,’’ he said.

Alice Njeri also used to get free painkillers and fortified porridge flour at Nyahururu hospice for her son who had xeroderma pigmentosum (XP), a rare genetic disorder which had progressed to skin cancer.

‘‘The pain killers used to ease his pain for a few weeks and he gained some weight,’’ she said.

Patricia Wanjiru, a cervical cancer survivor and living with HIV also visits Nakuru hospice for free drugs to treat occasional bleeding.

In many countries, lack of access to strong painkillers leave many dying an agonising death. A Quality of Death Index report by Economist Intelligence Unit notes that only 33 of the 80 countries surveyed offer opioids painkillers freely.

Although still facing challenges, Kenya fared better than India, China and Nigeria as it ranked 63 out of the 80 countries surveyed for the quality of death research. In Africa, South Africa ranked top followed by Uganda.