Why Kenyans miss cancer diagnosis in the early stages
Some diseases like cancer are harder to diagnose than others.
It is hard to catch a whiff of death when there is hope that life will somehow always be there. Even when one surety we have is death.
Once it knocks, it snatches without a warning. It could be a close relative, a friend, or a celebrity with whom you have a parasocial relationship. When the news is broken, especially for people you know, questions about the cause of death start arising.
Different diseases manifest differently, but some are harder to diagnose than others. Cancer is one of those. After pneumonia, data from the Kenya National Bureau of Statistics show that the second leading cause of death in Kenya last year was cancer. It was the leading cause of death in females in 2024.
What really is cancer? You may ask.
Dr Victor Oria, the chief scientist at the Integrated Cancer Research Foundation of Kenya (ICRF), explained to the Nation, giving the analogy of a manual car.
“When you look at a car, you have an accelerator and a brake. Your body could act the same way,” he says.
He explains that in our bodies, there are certain genes that are accelerators, so their work is to tell our cells to divide. Other genes, just like brakes, will tell your body that they have divided enough cells, so they need to stop. There is always a balance.
When someone gets cancer, Dr Oria explains that one of the two things fails, and, most of the time, it is the brake that fails.
When it fails, the cells keep dividing without control. That could also flip. The accelerator sometimes could go on and on, and no matter how much a person brakes, nothing really matters.
“Cancer is a condition where your cell keeps dividing. Other people would call it a wound that does not heal,” he says.
Too much alcohol
Unlike a car, where a mechanic can fix such an anomaly, Dr Oria says that it is hard to tell the root cause of cancer. There exist risk factors such as drinking too much alcohol, use of tobacco products, (eating fast foods, lack of physical activity or exercising but it remains a paradox. He explains that some people could live the healthiest lives but still get a cancer diagnosis.
He explains that there's a lot of research going on out there trying to unravel the cause of cancer, and one of the leading theories is genetic mutations.
“Genetic mutations can be linked to cancer up to a certain point. Some happen in very early stages, in what I would call pre-cancerous lesions. This means that before that cancer becomes a cancer, you have certain mutations that precede it,” he explains.
He explains that when the risk factors link with existing mutations, they may accelerate cancer growth.
“What we have are just theories and hypotheses that say one plus one is equal to two,” he says.
Few cancers have known causes, like cervical cancer, where scientists know that 90 per cent of the Human Papillomavirus causes it. In cancers like leukaemia (blood cancer) or Neuroblastoma, scientists know that if someone has a specific type of mutation, then they are likely to develop the type of cancer.
In Kenya, however, most people you know find out about their cancer when it is in the late stages. In those late stages, Dr Oria says that most cancers are managed because it has spread to different parts of the body.
“If you have lived in this country, then you know that we have a fractured referral system,” he says.
“Anybody can wake up today and start a hospital as long as they get a license. While this is good because it improves access, what it really does, and I say this with a lot of humility, is that some of these hospitals are in the business of making money, and they don't have the right personnel, especially in the oncology space,” he says.
He faults the lack of an integrated medical system that can help doctors know a patient’s history regardless of the hospital they have gone to.
“Maybe we need a policy change,” he says.
He advises people to screen early to avoid getting late late-stage diagnosis. He asks the government to set up screening services at the ward level backed by a proper referral system.
“We should stop being so busy that we cannot go to the hospital,” he adds
There are three stages to diagnosing cancer, he explains that they are: Tumour (size of the cancer), Nodes (from the lymph nodes, which are in charge of the lymphatic system, which caters for our immunity, and Metastasis (it colonises a secondary organ). The staging is abbreviated as TNM.
Dr Oria says that while research, medicine development and new diagnostic innovations are key, the main goal is to help a patient.
“We don’t need to reinvent the wheel. We have done this for HIV, we are doing it for Tuberculosis and malaria…we just need to use those lessons and integrate them in the healthcare system,” he says.
Dr Oria says that the research field in the country mostly focuses on the epidemiology of disease, like how many breast cancer cases we have, and suggests that we should also do more molecular studies, which focus on knowing how our breast cancer is different from those in America or China.
“Just like each one has a unique fingerprint, cancer is also a very precise disease. Our genetics as Africans are so diverse. And because cancer is a genetic disease, it means how it manifests itself is also diverse. But if we don't have an understanding of that, we are never going to help the patients that really need help because we'll be using drugs that cannot help them,” he explains.
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