Free Breast Cancer Screening in Kenya: Should you bank on it?

Tags: #Breastcancerscreening #Breastcancerinkenya #stage4breastcancer #selfbreastexam #cancerfreewomen

According to Daily Nation newspaper published on October 23, 2013, Mary Namata, a Ugandan lady stayed with breast lesion for 4 years before she could seek medical help. The wounds became too painful for her to live like that and it was until that point she went to seek medical help. By the time she went to the hospital, Mary was diagnosed with stage 4 breast cancer. To be exact, Mary had stage 4 fungating breast cancer where the cancer wounds had penetrated the skin and had opened outside the breast.

In Kenya, hundreds of thousands of women tune on the news and hit on google searching for free breast cancer screening in their areas. This is a very good sign because it implies that the number of women recognizing October as breast cancer month in Kenya is increasing. It is at “creating” awareness level that we must start to control this African women slayer overshadowed by HIV/AIDS & Malaria.

But, is it wise to risk your life waiting for free breast cancer screening, mammograms? Kenya has less than 15 mammogram machines primarily in private settings, meaning, chances of actually getting a free mammogram without a sponsor are very low. Notice that Kenya has far more mammogram machines than all other East African states combined.

Here is the good news, you can start the fight against breast cancer early by doing Breast self Exam (BSE) starting age 20. To carry an effective self breast exam, this is what you should know: –

Learn how your normal breast feel and look:

The key to early detection of breast cancer is the key to survival. Success in Self Breast Exam (BSE) is dependent on knowing more about your normal and your risk factors. That way, if you detect anything abnormal, you would be able to notice it and take the necessary action…Mammogram!

To learn your normal breast, it is recommended you check your breast at least once a month in front of a mirror. You should expect to see

  • Breasts that are in usual shape, size and color. In most women, breast that are equal in size. Should you doubt any of these, get a clinician to take a look.
  • Breast that are evenly shaped without any disfigurement or distortion. No dimpling, puckering or bulging of the skin.
  • Nipples that are even, well contoured without swelling, redness or inwardly inverted. Any unexpected discharge from the nipples must be reported immediately to a doctor for further evaluation.

Know the warning signs of breast cancer: Memorize them!

  • A lump, hard knot or thickening inside the breast or armpit(s).
  • Any wound, pimple, boil or blister occurring on your breast or underarm area
  • Swelling, warmth, redness or darkening of the breast
  • Change in the size or shape of your breast
  • Dimpling or puckering of the skin
  • Itchy, scaly sore or rash on the nipple or anywhere on the breast. Do not ignore Itchiness!!
  • Pulling in of your nipple or other parts of the breast
  • Nipple discharge of any colour (not milk for expectant or breast feeding mothers) that starts suddenly.  High alert if the discharge is from one breast, comes out without squeezing, is clear or bloody.
  • New pain in one spot that doesn’t go away, or pain that cannot be related to any traumatic event.

Know your risk factors:

  • Family history of breast cancer: If anyone in your family (father or mother’s side) has breast cancer or died of breast cancer, consider yourself a high risk. This is because family lineage in Africa is poorly defined
  • Overweight or obese. Being overweight in Africa is seen as a sign of wellbeing but in actual sense, this increases breast cancer risk
  • Being female: Meaning, every woman should consider themselves as breast cancer risk factor.
  • Increase in age. The more you age, the higher the risk
  • Beginning of menstrual cycles too early, before age 12
  • Giving birth to a first child after age 35. This increases your breast cancer risk factor
  • Having never been pregnant: Women that have never been pregnant have a much higher risk of breast cancer
  • Drinking alcohol: Women that drink alcohol are at higher risk of breast cancer than those who doesn’t

Do not wait until you can get a free breast cancer screening in Africa. It may never happen and waiting could put your life and your family in danger. Remember without women in Africa, our societies would collapse. A woman is the single most important figure in our society. You are important and worth everything in the world. Be safe!

Kenyan Government Need to Work With Diaspora to Control Breast Cancer

Kenyans in Diaspora may hold the most important role in fighting breast cancer in Kenya today. More than 50% of Kenya educated doctors are practicing medicine abroad. Another more than 5,000 doctors left Kenya and later became doctors and dentist abroad and have never returned.

Breast cancer kills more women than HIV/AIDS and Malaria combined globally but the focus on breast cancer has been very minimal in Kenya and Africa in general. Over 70% cases of breast cancer diagnosed in Kenya today are stage 3&4, meaning the cancer has already spread regionally or to distance organs. Other reports have shown that 15% of newly diagnosed breast cancer cases are fungating, meaning they have exploded the skin.

But is the government of Kenya doing anything to help fight breast cancer in Kenya? I feel like breast cancer does not get the attention it deserves in Kenya and Africa in general. The government and regulating bodies should make re-entry of Kenyans in Diaspora easier and lucrative. An average doctor in Kenya earns about $2500 a month, making doctors flee abroad as “economic refugees”.

Kenyans in Diaspora could also contribute in creating breast cancer awareness. It is estimated that one in every 3 families in central province has or knows someone in Diaspora. This translates to powerful information, motivational and financial resource that can help reduce mortality of breast cancer in Kenya from 80% to 50% in 3 years. If every Kenyan in Diaspora sponsored their family to get breast cancer screening, this number could drop drastically.

If the government made technical and legal arrangement to re-import expertise back home, breast cancer and all other diseases killing Kenyans could decrease. Kenyans in Diaspora have been exposed to current treatment modalities, current research and treatment options. Many more have been involved in breast cancer awareness campaigns abroad, something that Kenyan women are missing.

Sponsor your Mom, your Aunt, your neighbor or a friend to get breast cancer screening, education and mammogram today. It could be the most important thing you have ever done for them. It cost less than a weekend night out abroad.

The conclusion is Kenyans in Diaspora hold a great knowledge and financial resource in fight against breast cancer. Unfortunately, no one family is immune to breast cancer and often, breast cancer is fatal in Kenya and rest of Africa. The government bodies needs to rethink how they can tap onto diverse knowledge, talents and financial resources from Diaspora to control diseases and improve quality of life

Sexuality and Intimacy After Breast Cancer

painful sex after breast cancerMany women undergoing breast cancer treatment or those who have gone through breast cancer treatment may get painful sexual intercourse. Lets lay it on the table and talk about another common hurdle breast cancer heroes encounter. breast cancer treatment approaches like surgery, radiation therapy, chemo-therapy and estrogen modulation therapies can greatly alter sexual experience.

While most breast cancer survivors are grateful and excited enough to be cancer free, and most of breast cancer survivors could care less about sex immediately after conquering the disease, sex is an important part of human life. Women should not be without sex especially after coping with breast cancer treatment as this could add on to body disfigurement related stress. Women should be supported and encouraged to engage in sex. It’s time the world accepted breastless and scarred breasted women as normal. Sex is a good communication tool for lovers and it should be addressed without shame or reservation. Let’s talk about the commonest causes of painful sex after cancer treatment.
  1. Vaginal dryness
  2. Muscle Spasm

Vaginal Dryness

Sex feels great and painful sex can be heartbreaking. Sex is pure friction but vagina is adapted to withstand this friction. In fact, sexual friction is what causes pleasure in sexual intercourse, not lack thereof. Vaginal walls are made up of several layers of cells naturally adapted to protect deeper layers from getting damaged by sexual friction. These protective cells also produce lubricants that reduce the amount of friction.
Over 50% of breast cancer cases are estrogen receptor positive. One of the treatment combination therapy is to block estrogen production or action on receptor cells. Vaginal wall cells are maintained by estrogen. Lubricant production is another function of estrogen hormone. When attempt to save breast cancer heroes lives involves estrogen therapy, vaginal wall dryness occurs causing painful sexual intercourse.
Most chemotherapeutic agents target fast growing/generating cells (like cancer cells) in the body. Cells naturally adapted to withstand friction and produce lubricants belong to this group, among other cells like hair follicle cells and nail germinal cells. This explains why hair and nails falls off. Vaginal walls cells and other cavity cells like oral cavity are easily damaged by chemotherapeutic agents. Most women who have undergone chemotherapy have had oral sores.
Oxytocin, also called “Love Hormone” is a very important hormone in sexual pleasure experience. While oxytocin is produced by pituitary gland, stimulation of breast nipples have shown to increase its production. This oxytocin spurt has shown to have effect on orgasmic experience and relaxation of vaginal walls.
Mastectomy and other breast surgeries usually damage areola (nipple dark part), the most sensitive breast tissue decreasing sexual pleasure. This explains why breast fondling before intercourse is not only pleasurable but also causes arousal and lubrication. With mastectomy or surgeries that may severe breast nipples, sexual intercourse may be painful due to poor lubrication (in addition to chemo damaged lubricant producing cells) and tension of vaginal floor.

Vaginal Muscle Spasm

Oxytocin production causes uterine walls to contract and vaginal walls to relax, making delivery of the baby easier. When vaginal walls/floor is deficient of lubrication (estrogen) and oxytocin, sexual experience can be very painful. Initial pain causes even more pelvic wall contraction causing even more pain.
Stress related to dealing with breast cancer treatment worsens these vagina wall spasms. Pleasurable sexual experience in women is a combination of many factors, not just one. Emotional or physical stress can completely alter sexual pleasure or even inhibit arousal.

Remedies:

Oil based lubricants may prove helpful in situations where dryness is the primary cause of painful sexual intercourse.
For women with estrogen receptor positive breast cancer, talk to your doctor about estrogen related options like estrogen ring (estring). No not use such options without asking your oncologist.
Foreplay and use of toys may help in decreasing vaginal muscle spasms before penetration. The couple should use toys that are comfortable for both of them to enhance the overall sexual experience.

Nursing a Breast Cancer Patient: Pain Kills

Breast cancer patient in both physical and emotional pain

I choose to give this story because it still bothers me 4 years down the road. My name is Linda and I am a critical care nurse in a big city in America. Breast cancer patient hurts both physically and emotionally, something we deal with everyday especially being a cancer center hospital.

Four years ago I took care of a young 35 years old lady with end stage metastatic breast cancer. This day still remains fresh as if it happened yesterday. For those of you who are in healthcare, I beg you to stand firm and advocate for your patients as if you are fighting for one of your own.

dehiscedMy 35 years old had been fighting breast cancer well over five years. This time, her best ever fighting spirit was on all time high. Her breasts were scarred, full of flaps and patches. Some of the scars show they had dehisced and repaired leaving heartbreaking scars. But that was not the toughest battle yet.

On this night, she was transferred from oncology unit to ICU after a round of Chemo.  For those familiar with inpatient healthcare protocols, a patient whose oxygen saturation drops below 90%, change in mentation, heart rate in 130’s meets the criteria of being admitted to intensive care unit (ICU). On top of that her liver profile looked really bad. Her skin color was yellow due to liver failure secondary to metastasis. Excuse me if I sound too much like a text book nurse.

Series of radiological tests were performed to make sure she didn’t have a collapsed lung or pulmonary embolism. These tests showed nothing way out of normal and the oncologist together with intensivist gave me orders to continue watching the patient. The patient vision had been taken away by chemo and the only good special sense she had was hearing. She could easily recognize me because of a foreign accent.

Supraventricular tachycardiaThe heart rate kept on going up and orders to give her fluids and Morphine were executed. My eyes could not hold tears anymore and I became a bitter empathetic nurse taking care of a near helpless patient. Few hours later, I sent a specimen for complete blood count to the lab and her white cells count was near ZERO. We put the patient on neutropenic precautions, simply meaning anyone is a danger to the patient as she had no immune defense left in her system.

My patient had no family close to her, just a few friends that came to see her, one of them, a Briton. Now in neutropenic precautions, no one was allowed to stay in that room for long and a safe distance from the patient was enforced. The heart rate kept going up and up and now it’s almost 0200 AM. This time, I am dealing with heart rate of 160-180 beats per minute. The heart cannot withstand this rhythm/rate for too long before it gives up and so I had to act and act fast.

Numerous calls had been placed to the oncologist as the patient kept complaining and crying of pain. The dose I had initially was for morphine 2 mg every hour as needed. The second call I placed, the dose was doubled to 4 mg every hour as needed for pain. This did not make a difference,

The oncologist was getting irritated because of my endless calls at late hours of the night, but I was not going to give up on this lovely lady. The oncologist argument was that the patient oxygenation was poor and may potentially have lungs related problem. He was also concerned that due to liver involvement, the metabolism of opiates may be poor and this could further compromise breathing and oxygenation.

For those in healthcare, especially nurses and doctors, I am sure you can follow me on this and agree it is a true prudent rationale from the oncologist. The oncologist consulted the cardiologist and he ordered adenosine push to correct supraventricular tachycardia (heart rate above 150).

Before I could even fax the order to the pharmacy, the patient called. She could barely talk. She said “Linda, I want you to get lethal injection and kill me or get a baseball butt and hit my head so I won’t have to feel this.

Angry-DoctorMy courage, empathy and bitterness rose to the threshold that I could not hold anymore. I placed another call to the already upset oncologist, this time with demands, not requests. A frustrated voice answered the phone and I started…

“I need better pain control for this patient from you right now, or else, you come in and take care of her. I need strong medications for pain and if she cannot support her airway, better be on a ventilator (life support machine) that suffer like this. I need dilaudid (hydromorphone) drip in Patient Controlled Analgesia (PCA)”.

The oncologist had never heard someone come that strong to a point of demanding which drug they want. He replied…calm down. Go ahead and start dilaudid PCA …..” Give the patient 2 mg push now before starting the drip….”. In 2 minutes, I pushed the 2 mg and the heart rate dropped quickly from 180, 150, 110, 80 and before it got to 60, the whole team was at the door with crash cart. We all thought the patient heart had given up.

At heart rate of 70, the patient stabilized. Blood pressure improved. Breathing rate lowered from 40’s to low 20’s. Her oxygen saturation went up to above 95%. We changed her from 100% non-rebreather mast to 2 liter nasal canula. She was in pain and now her pain is under control.

15 minutes later, she asked for ice water. She drank. She then requested extra blankets and off she slept. She was in pain but no one thought of pain as the reason why all her vital signs were off the limits. No adenosine for her.

Good night sunshine. You are my hero. 3 days later when her white count was starting to come back up, she passed on. She came to an end of her pain. I attended her burial and to this day, I still feel it like my own family.

Again, Good night sunshine and rest in peace.

rip

Life Without Breast. A New Tribe of Scarred Breast Cancer Heroes

mastectomy 4“Breast cancer is not a Pink Ribbon”. Please say that out loud and tell it to your friends”BREAST CANCER IS NOT A PINK RIBBON”. The diagnosis of breast cancer is a chilling experience not only to the sufferers themselves but also the families and friends around them.  The attention breast cancer get is high yet not high enough that we need to not only talk about the pink ribbons but also address what breast cancer treatment is all about. It’s time to take the bull by its horns!

Scar 1Breast is the greatest symbol of femininity in all mammals. In many mammals, the only way to tell the physical difference between a male and a female is the mammary glands AKA breast, or udder in four-legged animals.  Breast cancer specifically affects the greatest symbol of femininity tearing down and shattering many women definition of beauty. Cancer treatment, even worse takes away the most prominent feminine features of human beings like hair, eye lashes, breast, skin and nails.

Breast reconstruction after mastectomy in breast cancer treatment is not only physically painful but also emotionally and sexually destructive. Women value breast as one of their strongest attraction points for men. This explains why we spend billions of dollars every year to augment breast so as to look “HOT” and appealing to men

I was searching Google on breast cancer survival stories and I noticed that very few stories talk about the emotional pain women go through during their breast cancer fight. Very few breast cancer survival stories address the issue of mastectomy and breast reconstruction surgeries that only happen to well insured and those whose condition allows.

mastectomy 5I came across the SCAR project by David Jay, a fashion photographer who has committed his photography into re-empowering women after mastectomy. David is a true hero to me because as a man, he has taken the greatest stigma of feminine beauty and used it to show breast cancer survivors that they can be beautiful even after breast cancer surgery

mastectomy 6Breasts are normally obscured in non-pornographic photography/media but David defied the norms and used his photography to show how women look after mastectomy. Rather than demoralizing, David’s photography is empowering and creating a new tribe where the world will view breast differently.

In many situations total radical mastectomy needs to be done to save breast cancer sufferer life. In some occasions, even reconstruction may not be possible. David Jay’s scar project has proven against the normal expectations that by photographing women for the scar project is not only helping women regain the courage, confidence and positive view of their femininity and sexuality but also empowering the public to view them as beautiful again.

 

scar2To me, these SCAR project pictures show a new shift in society’s acceptance of a tribe of scarred, breastless and one breasted women. It is a high time we start accepting SCARRED women are just as beautiful since 1 in 8 women will be diagnosed with breast cancer at some point in their lives. This new tribe inspired by David is growing and will at some point in future became the norm, just the same way we no longer see pregnant women as unattractive. This exposure will help women to accept what we might not be able to change. Perhaps fashion designers will soon start making bras for women with one breast and accept them as “normal.” What if not having breasts or having one breast became acceptable? What if mastectomies and scarred breast are seen as a symbol of honor and strength? What if the society could tone down the breast obsession with breasts just a little bit and appreciate David work on SCAR project for pioneering the new “normal” for breast cancer fighters and survivors?

Share this article on Facebook to appreciate David Jay’s Work.

Please check out the SCAR Project at http://thescarproject.org/ for more photos and information.

Breast Cancer Symptoms

Breast cancer is one of the biggest killer of women today. The increase of mammogram screening has revealed more breast cancers than ever before. Still, mammograms are not 100% perfect and can miss some breast cancers. Sometimes unfortunately, many women only learn they have cancer when noticeable symptoms appear. The most common symptoms include:

  • A new painless hard and irregular breast lump or mass may appear 
  • A new painful, tender soft and round breast lump or mass may appear 
  • Generalized swelling  for part or all of the breast, with or without a lump
  • Painful or painless swelling in an underarm lymph nodes without any breast lump/mass
  • Skin indentions or dimpling
  • New breast skin irritation or inflammation
  • Breast skin redness, thickening, or scaliness
  • Breast nipple retraction or change in shape
  • Breast nipple thickening or change in color and/or shape
  • Non-milk nipple discharge that could be pus-like but particularly blood
  • Generalized breast pain or nipple pain
  • Breast tenderness or soreness
  • Change in the size or shape of the breast

How Kenyan Women Can Stay Ahead of Breast Cancer

  1. Women with a family history of breast cancer can lower their risk by breastfeeding their babies according to the Archives of Internal Medicine. In their study, it was revealed that Women with a family history of breast cancer were 59% less likely to develop pre-menopausal breast cancer if they had ever breastfed. In the past, majority of Kenyan women breastfed their kids but industrialization and urban life is decreasing the breastfeeding. This may have contributed in the current increase in breast cancer incidences in Kenya.
  2. Reducing dietary fat may reduce the risk of breast cancer according to the Women’s Intervention Nutrition Study in America. In the wake of economic growth and urbanization in Kenya, fatty foods intake like KFC chicken and red meats is on the rise. Our traditional low-fat high fibre foods like beans and vegetables offers the best breast cancer protection.
  3. The link between obesity and breast cancer have been very clear for many decades. Obese women are at higher risk of breast cancer than lean women. Eating small food portions of well-balanced diet low in fat and red meats is a good way to protect yourself from breast cancer.
  4. Mammography is the best way to detect breast cancer in its earliest, most treatable stage. If it’s time to schedule your mammogram, make the appointment now. Most Kenyan women over age 50 has never had a mammogram according to a simple questionnaire conducted my Cancer Free Women in two local churches in Nairobi. Over 70% did not even know what a mammogram is. Among the 200 participants, 21% has had a close family member dies of breast cancer. Cancer Free Women has created a platform/website where you can sponsor a family, friend or a random person to get a free Mammogram in Kenya.
  5. Avoid Excess alcohol intake and smoking.

Free Breast Cancer Screening in Kenya

Free Breast Cancer Screening in Kenya

Every year on October, the world join hands for a whole month to fight breast cancer through breast cancer awareness month. Third world countries like Kenya have been observing breast cancer month and a number of non-governmental organizations (NGO) have started offering free breast cancer screening and awareness. The breast cancer awareness month campaign originated in the United States in 1985 through a partnership between American Cancer Society and AstraZeneca Pharmaceutical Company.

Cancer Free Women® is planning to offer free breast cancer screening to thousands of Kenyans every year during breast cancer awareness month.  Our goal is to educate thousands of women how to do Self Breast Exams (BSE) and how to detect early signs of abnormal breast changes.

We encourage as many women to participate in this event as possible. All updates regarding the venues and schedules will be posted on our website momentarily.

We would also like to solicit corporate, private and religious donors to help us make breast cancer awareness campaigns possible. We hope to be holding free screening campaigns every month across Kenya and East Africa.

May God help us and may your prayers be answered.