When Ruth Kathini learned that she was HIV-positive eight years ago, she
was convinced that nothing worse could happen to her. And then she was
diagnosed with breast cancer in 2012. PHOTO | JENIFFER MUIRURI
When Ruth Kathini learned that she was HIV-positive eight years
ago, she was convinced that nothing worse could happen to her. And then
she was diagnosed with breast cancer in 2012.
“I
had noticed a swelling in my right breast while taking a shower, and
even though the first thought that flashed in my mind was breast cancer,
I decided to ignore it out of fear, hoping that the swelling would go
away,” she says.
It did not. A few days later, she shared her fears with her friends, who advised her to see a doctor right away.
She
decided to go to Nairobi West Hospital, since it was near her home, and
to her immense relief, a mammogram and breast scan revealed nothing
unusual. However, the doctor was not satisfied and advised her to have a
biopsy.
This entailed removing a
sample from the swollen mass for examination. The biopsy, done at St
Mary’s Hospital in Lang’ata, turned out to be negative too.
AGGRESSIVE CANCER
However, this doctor too was dissatisfied with the results and recommended surgical removal of the growth for further analysis.
Tests
conducted at the Aga Khan University Hospital’s Heart and Cancer Centre
were positive for what the doctors called invasive ductal carcinoma.
This
aggressive type of cancer, and which is the most common, spreads from
the mammary glands and goes on to affect the lymph nodes and possibly
other body organs.
“I tried to
listen, but my mind had gone blank. There is no history of cancer in my
family and all the people I knew who had cancer had died. I broke down,
wondering at the unfairness of life — I already had HIV, why get cancer
as well?”
Though the doctors pointed
out that the disease was in its first stage, making chances of full
recovery high, Ruth was inconsolable.
She
went back home feeling beaten, especially after learning that a
mastectomy, (surgical removal of the entire breast) was the only way to
stop the cancer from spreading.
Just
as she had done eight years ago when she was diagnosed with HIV, she
confided in her husband, who has been her “rock” throughout their
10-year marriage.
Ruth and her
husband are a discordant couple. When she was diagnosed with HIV,
besides wondering how to break the news to her husband, she also
wondered how she could have acquired the virus.
“I
had been faithful to my husband and I trusted that he had been faithful
too. I’d had two caesarean sections, so it could be that was when I got
the virus,” she explains.
When she
broke the news to her husband, his initial reaction was to go quiet for a
while, but when he spoke next, it was to reassure her that he would
support and stand by her. The following day, they did the test together,
but his was negative.
“For the past eight years, he has supported me and ensures that I take my medication as I should,” Ruth says.
Her
husband was as supportive as he had always been when she broke the news
about the cancer and what needed to be done to stop it.
Ruth had a mastectomy of her right breast in June 2013.
“The
surgery went well and I have since gone through chemotherapy. The side
effects are nothing to laugh about, but the treatment was necessary, so I
took it my stride,” she says.
Due to
vomiting, a common side effect of chemotherapy, she had to miss taking
her antiretroviral treatment (ART) medication on each first day of
treatment. This, she says, affected her CD4 count, (number of white
blood cells) which dropped from 1,040 to 460.
Looking at her, though, you would never guess that her health is compromised — she is cheerful, positive, and quick to laugh.
ACTIVIST FOR A CAUSE
“It is important to have a positive attitude when you’re going through a rough time. Self-pity can kill you,” she points out.
Since
the cancer diagnosis, Ruth has put on a couple of kilos, which she
intends to lose. To achieve her goal, she exercises at least three times
a week. Maintaining healthy weight and eating a balanced diet, she
says, are important for those with HIV as well as those who have had
cancer.
Ruth, a caterer, is a board member at the Network of People Living with HIV and Aids in Kenya (Nephak).
She
has also taken the anti-cancer and anti-HIV war to her church, St
Catherine of Alexandria Catholic Church in South C, where she is the
group leader of the HIV and cancer support group, Action in Mukuru
Positive Living (Amupoli), a group she co-founded with two friends.
“I
chose the name Amupoli because my target was the vulnerable people of
Mukuru slums, who might not have the kind of support, care, and
encouragement I got when I was diagnosed with HIV and cancer.”
Ruth
also uses her networks within Nephak to partner with health
organisations to organise free breast cancer and HIV screening at the
church at least twice a year.
“Mid
this year, we spotted about 10 suspicious cases of breast cancer, which
we referred for further testing in various hospitals. Six of them were
diagnosed with breast cancer and are undergoing treatment,” she says.
She
intends to have more such initiatives in future once she gets more
organisations to partner with. Should this be possible, she also plans
to include free screening for diabetes and tuberculosis, which she
considers to be serious health concerns.
Whenever she gets the chance, Ruth preaches about the importance of early testing for both cancer and HIV.
“If
cancer is detected and treated early, it can save many lives. The same
applies for HIV. Knowing your status early enough means timely access to
life-prolonging treatment,” she explains.
COPING MECHANISMS
When Ruth Kathini learned that she was
HIV-positive eight years ago, she was convinced that nothing worse could
happen to her. And then she was diagnosed with breast cancer in 2012.
PHOTO | JENIFFER MUIRURI
So, how does Ruth cope, besides wearing a positive attitude?
“A
supportive family, being in a network of supportive friends, and my
belief in God. I am a prayerful person,” says Ruth, a staunch Catholic.
She advises those fighting breast cancer and people living with HIV to accept their condition and follow their doctor’s advice.
“It is the only way you will get the strength and motivation to fight and live life to the full,” she says.
In September this year, Ruth took a step of faith and went for cervical cancer screening.
The
results were negative. Due to their compromised immunity, people living
with HIV are at a higher risk for certain cancers compared to HIV-free
individuals. The “HIV-defining” ones include cervical cancer and
Kaposi’s sarcoma, a type of skin cancer.
At
KNH, a radiotherapy session costs Sh500, though the patient also has to
pay for other tests, such as blood tests. In private hospitals, the
treatment costs between 8,000 and ****effectively cut out a majority of
Kenyans in need of this treatment.
“I
have been on the waiting list since November last year. I had been
scheduled to start treatment in August this year, but when I went, I was
told I will have to wait longer,” she explains.
Radiotherapy is necessary because ductal invasive carcinoma is a very sensitive type of cancer.
“Even though I am cancer-free, some of the cells might just be buying time for an attack,” Ruth says.
Kenya
is faced by inadequate and outdated equipment to mitigate cancer. There
are only two functioning radiotherapy machines for breast cancer
treatment at KNH. Besides, these old Cobalt 60 machines are being phased
out globally due to their limited capability to treat complex cases.
Some leading private hospitals in the country have newer technology,
called Linear Ac
Ruth was scheduled
for radiotherapy, in November last year, but is yet to have it due to
the long waiting list at Kenyatta National Hospital (KNH). She says she
cannot afford to have it done in a private hospital.
At
KNH, a radiotherapy session costs Sh500, although the patient also has
to pay for other tests, such as blood tests. In private hospitals, a
radiotherapy session costs between Sh8,000 and Sh11,000.
“I
have been on the waiting list since November last year. I had been
scheduled to start treatment in August this year, but when I went, I was
told I will have to wait longer,” she explains.
Radiotherapy
is necessary because ductal invasive carcinoma is a sensitive type of
cancer, and it might just be a matter of time before the cancer strikes
Ruth again.
The long waiting list at
KNH could be due to the fact that there are only two functioning
radiotherapy machines for breast cancer treatment. Besides, these old
Cobalt 60 machines are being phased out globally due to their limited
capability to treat complex cases. Some leading private hospitals in the
country have newer technology, called Linear Acceleration, which is
more accurate, but costly due to high maintenance demands.
COSTLY TREATMENT
Like
many cancer patients who cannot afford the hefty cost of radiotherapy
in private hospitals, Ruth has no idea how much longer she will have to
wait before she can get this necessary treatment.
She
thinks that many lives could be saved if such vital diagnostic
equipment were available, and if such tests were offered free of charge
or subsidised at public hospitals.
Another
setback is the fact that there are only 10 oncologists in Kenya and
only five of them have specialised in radiography oncology. This
increases the amount of time that a cancer patient has to wait for
treatment. This poses a challenge to the war against cancer, and in
particular, the most common, which is breast cancer, its research, and
documentation.
Chemotherapy treatment
costs between Sh5,000 and Sh10,000 at KNH. This does not include the
cost of the drugs administered with the chemotherapy as well as several
blood tests.
It is worth noting that
before initiating treatment, a breast cancer patient has to go through
screening, which costs a minimum of Sh10,000. The cost is much higher in
private hospitals.
The patient is
also required to pay more than Sh4,000 to buy first-line cancer drugs at
KNH, excluding other costs, such as antibiotics and nutritional
supplements.
The patient may spend as much as Sh4,000 on supplements that help them regain their appetite when on chemotherapy.
In
total, a patient with breast cancer requires a minimum of Sh25,000 to
start treatment at the referral hospital, an amount that is out of the
reach of most cancer patients.
Ruth,
who had six sessions of chemotherapy spread over five months, spent
Sh42000 — each session cost Sh7000. She feels that it would be a big win
for cancer patients if access to medication could be widened, as is the
case for ART.
“This would restore
hope that having cancer is not a death sentence. The pain and suffering
that cancer patients go through is immeasurable. Why make it more
difficult by denying them affordable care?” she asks.
No comments :
Post a Comment