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Saturday, March 25, 2017

Pathologist who started Kenya’s cancer registry

Former chief government pathologist Dr Geoffrey Mutuma and director of Zambezi Hospital.JPG
Former chief government pathologist Dr Geoffrey Mutuma and director of Zambezi Hospital.JPG

No one wants to hear their doctor say “you have cancer” at any point in life. But apparently, two in every ten Kenyans will get a cancer diagnosis before they are 75, according to the ministry of health.

The good news is, there are several things you can do to lower your chances.

Former chief government pathologist Dr Geoffrey Mutuma says it was difficult to recommend proper preventive steps ten years ago because Kenya did not have any cancer statistics.

Such records can help estimate your risk of being diagnosed with the disease based on individual aspects that are similar to the groups at risk.

That information would prompt you to get vaccines, appropriate screening tests and staying away from things like tobacco and alcohol.

Dr Mutuma was at the Kenya Medical Research Institute (Kemri) in 2000 when the US National Cancer Institute sponsored him to train in cancer control and prevention. This might have been the turning point for Kenya.

He returned home and founded the Nairobi Cancer Registry at Kemri in 2001. “We know the burden of cancer in Kenya because we have the registry. Without these statistics and research, a country cannot do anything,” he says.

He also trained medical records officers to collect data on all newly-diagnosed cancer cases from the year 2000 in their respective hospitals, laboratories and radiotherapy units. Without these statistics, the government could not even create a proper national control strategy. The country was basically throwing fists in the dark.

The registry paid them some allowances as per cases abstracted on monthly basis. The data were submitted to Dr Mutuma at Kemri for verification and subsequent entry.

A staffer tests a vial at the Zambezi Hospital.

Dr Mutuma was the head of oncology and pathology research unit at Kemri. He later served as the chairman of the national non-communicable diseases research programme.

“We established other registries in Eldoret, Nyeri and Mombasa, but the Nairobi registry remains the most active because we did not have funds to run all other registries,” Dr Mutuma says.

“The ideal situation now is to have cancer registries in all counties and a national registry in Nairobi.”

The registry and other records have unearthed important trends. Now we know that the annual incidence of cancer is about 28,000 cases and the annual mortality is more than 22,000.

More than 60 per cent of those affected are below the age of 70 years. In Kenya, the risk of getting cancer before the age of 75 years is 14 per cent and rising while the risk of dying of cancer is estimated at 12 per cent.

Cancer now ranks third as a cause of death after infectious diseases and cardiovascular

diseases. It causes seven per cent of total national deaths every year.

“Most cancers are now being diagnosed because of increased awareness,” Dr Mutuma says. “With good screening we should have very few people dying of cervical cancer.”

This is the second most common cancer among women, accounting for 24 per cent of all diagnosis, according to the Nairobi cancer registry.

The government has since developed cancer control strategies for Kenya the latest being the 2011-2016 one.

Dr Mutuma says the high incidence of cancer should not cause alarm. “It is time we became pro-active in cancer control, prevention, registration and surveillance,” he says. “This is a matter of urgency considering the impact of cancer on the economy and particularly on companies and families.”

Wards at the Zambezi Hospital in South C.

He says the disease has taken a huge financial toll on the economy. “The fact is that billions of shillings are being directed to battle the disease. At the family level the situation is unbearable with some being left bankrupt to the disease.”

Cancer management costs vary wildly, depending on where one finds treatment. At Kenyatta National Hospital, patients pay Sh500 to Sh1000 per session of radiotherapy while Chemo begins at Sh6,000. In private hospitals in Nairobi it costs about Sh50,000 a week for radiotherapy and chemo starts from Sh12,000 to Sh600,000 per treatment depending on the drug used.

Dr Ahmed Kalebi, an honorary lecturer in the University of Nairobi, says awareness is the most important because about 40 per cent of cancers are preventable through interventions such as tobacco control, promotion of healthy diets, physical activity and protection against exposure to environmental substances that are believed to cause cancer. "Prevention of cancer is the most cost-effective long-term strategy of controlling cancer by avoiding the risk factors. This should be adopted robustly to minimise incidences of cancer in the country," he said recently.

Dr Mutuma adds that the best way Kenya can beat cancer is prevention and early detection.

In 2014 he established the Zambezi Hospital, which is angling to become Kenya's leading private cancer information and treatment centre.

“We do a lot of testing because early detection helps in controlling the disease.” He says the common perception that cancer is incurable is wrong because it can be cured if detected early. “Cancer is curable but the problem is that people know about it when its too late. The disease just needs early detection and screening.”

The South C-based hospital conducts probably the highest number of cancer walks in Nairobi. Dr Mutuma says they raise funds to conduct free screening and also offset treatment costs for some patients.

“Last year we screened 10,000 people and 500 had cancer. Some were early and others were in late stages,” he says. “The main reason for awareness is to raised survival rates. Only less than 50 per cent of people diagnosed in stage four survive five years. But 90 per cent of those in diagnosed at stage one are successfully treated.”

Zambezi Hospital in Nairobi South C Estate.

WHERE TO GET HELP (In a box)

Different non-governmental organisations also provide help to people who have been diagnosed with cancer.

1. Africa Cancer Foundation

Contact person: Dorothy Nyong’o, director

Provides awareness programs, screening and educational materials about all cancers. Regions of Kenya served: nationwide. Email: info@africacancerfoundation.org, africf@gmail.com.

2. Cancer Awareness Centre of Kenya

Contact: Boniface Mbuki, Director

Provides awareness programmes, screening and education about all cancers. Regions of Kenya served: Nationwide. Email: info@cackenya.org, bmbuki@gmail.com,

3. Childhood Cancer Initiative

Contact person: Joseph Omach, Administrator

Provides childhood cancer patient-care support through events, psycho-social support, and training workshops for primary health-care workers. Email: childhoodcancerinitiative@yahoo.com; omachjoseph@yahoo.com

4. Eddah’s Hope Cancer Foundation

Contact: Issaji Moussah, Founder

Provides awareness programs, screening and education about all cancers, targeting youth education (age 15-40). Regions of Kenya served: Eldoret, Kisumu, Mombasa, Nairobi, Nakuru. info@eddahs-hope.org,

5. Faraja Cancer Support Trust

Contact: Philip Odiyo, Patient Support Manager

Provides complementary therapies, support groups and education on all cancers for cancer patients. Regions of Kenya served: Nairobi.info@farajacancersupport.org

6. HENZO Kenya

Contact: Lucy Mwangi, Executive Secretary

Provides support to patients with chronic myelogenous leukemia and gastrointestinal stoma tumor cancers. Regions of Kenya served: nationwide. info@henzokenya.or.ke

7. Hope for Cancer Kids

Contact: Wanja Mwangi, Project Coordinator

Provides support to childhood cancer patients and their families. Regions of Kenya served: Eldoret, Kisii, Machakos, Muranga, Nairobi, Nyeri, Webuye. info@hope4cancerkids.org

8. Kenya Cancer Association

Contact: Ann Korir, Chair

Provides awareness programs, screening, advocacy and education about all cancers. Regions of Kenya served: nationwide.info@kenyacancer.org

9. Kenya Hospices and Palliative Care Association

Contact: Dr. Zipporah Ali, Executive Director

Promotes increased access to, training in, and awareness of palliative care for all Kenyans. Regions of Kenya served: nationwide. zippy@kehpca.org


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