There is still hope in the fight against cancer
Anne Dembah-Aringo
With end Breast Cancer Awareness Month, World Health Organisation statistics paint a grim picture an expected 60 per cent increase in cancer cases over the next two decades if the current trends continue.
The situation has now been worsened with the pandemic and its double burden on cancer patients who are already immunosuppressed.
This has exacerbated an already strained oncology environment weighed down by barriers to patients seeking testing and/or treatment as well as to healthcare practitioners in delivering these services, ultimately creating a perception that cancer is a death sentence, but is it really?
Cancer is the third leading cause of mortality in Kenya, accounting for about seven per cent of annual deaths with breast and prostate cancer ranked as the most prevalent among women and men respectively.
A majority of breast cancer patients in Kenya display the disease at an advanced or in late stages, a clear indication that diagnosis is still a challenge, and in most cases making it impossible for them to achieve cure. This should not be the case.
Breast cancer is the most common invasive cancer among women in Kenya, with more than 5,985 new cases and 2,553 deaths in 2018. Of these, 42 per cent present in stage III and 18 per cent in stage IV (metastatic disease).
Up to 30 per cent of women diagnosed with and treated for early breast cancer will develop metastatic breast cancer, which occurs when the cancer spreads beyond the breast to other body parts.
WHO guidelines highlight a wide range of proven interventions to mitigate cancer prevalence.
These include controlling tobacco use (responsible for 25 per cent of cancer deaths), vaccinations, screening and treatment as well as implementing high-impact cancer management interventions that bring value for money and ensuring access to palliative care including pain relief.
For breast cancer patients in Kenya, an innovative and much-needed new treatment option is now available to tens of thousands of women with HR+/HER2- metastatic breast cancer.
When used in combination with recommended hormone therapy, it increases duration of tumour control and is generally well tolerated – and could delay need for patients to start chemotherapy.
Metastatic breast cancer places a heavy burden on patients and their families, financially or otherwise.
And although novel treatments and drugs may have potential to provide better quality of life and outcomes for them, there is the issue of costs and accessibility.
Stakeholders must ensure such treatments or drugs are affordable. The biggest challenge remains that of balancing various considerations such as cost, feasibility and effectiveness.
Cancer drug costs typically higher than average ones, and thus most countries fund them through public reimbursement programmes to facilitate equal access for citizens by eliminating direct costs to patients.
Even though we are on the right track in Kenya, we still have a long way to go.
Ministry of Health’s move to develop a Universal Health Care (UHC) benefit package that emphasises on early screening and detection of NCDs, including cancers is welcome.
Introduction of cancer care (including radiotherapy, chemotherapy, and surgery up to a predetermined limit) as part of the outpatient benefit package by NHIF is another step in the right direction and one that will help in bridging this gap.
In early 2019, NHIF announced plans to replace undifferentiated oncology coverage plan with a comprehensive cancer care plan, based on protocols developed by National Cancer Control Programme.
The package is expected to address gaps including additional lab tests, follow-up specialist consultations, enhanced nutrition support, psychological counseling, and palliative care.
With such packages and collaborative efforts of health sector stakeholders, there is hope for cancer treatment.
As we continue to strive towards UHC and improved access to healthcare for all, these measures can be enhanced.
For instance, introduction of subsidised premiums for those in the informal sector and implementation of evidence-based programmes to improve packages are worth looking into.
These will enable patients access more innovative research-based treatment options currently far from reach financially
Finally, public and private sector need to embrace innovative access partnerships aimed at bridging gap between accessing quality innovative treatment and financial constraints cancer patients face. — The writer is Pfizer Laboratories Country Manager Kenya and East Africa Cluster Lead
