Breast Cancer in Kenya: The Current Landscape

By Dr. Fatma Mahmud – Wellness Manager

Breast cancer is one of the most common cancers affecting women worldwide, including in Kenya. According to the World Health Organization (WHO), breast cancer accounts for the highest number of cancer-related deaths among women globally.

In Kenya, it has become a leading health concern, representing approximately 23% of all cancer cases in women.

Due to its high prevalence and the increasing burden on the healthcare system, raising awareness, enhancing screening programs, and improving treatment options are critical.

However, a significant number of women in Kenya face delayed diagnosis due to a variety of factors such as inadequate access to healthcare, limited awareness, stigma, and cultural barriers.

Key factors that influence the breast cancer landscape include:

• Late Diagnosis: According to the Kenya National Cancer Control Strategy, many breast cancer cases in Kenya are diagnosed at advanced stages (stage III or IV). This is attributed to limited access to screening facilities and a lack of knowledge about early symptoms.
• Healthcare Access: Despite efforts to improve healthcare infrastructure, many rural areas in Kenya still lack access to proper cancer screening and treatment services forcing patients to travel long distances to reach specialized cancer centres.
• Cultural Stigma and Misconceptions: In some communities, breast cancer is still considered a taboo subject. Many women delay seeking medical attention due to fear of stigmatization or a belief that cancer is a death sentence. Others may rely on traditional medicine or spiritual healers, further delaying proper treatment.

Common Risk Factors for Breast Cancer

Several risk factors are associated with breast cancer include:

• Age: Breast cancer risk increases with age, and while most cases occur in women over the age of 50, younger women are also increasingly being diagnosed.
• Genetic Factors: Women with a family history of breast cancer are at higher risk. BRCA1 and BRCA2 gene mutations are significant contributors to breast cancer risk, although genetic testing is not widely available in the country.
• Lifestyle Factors: Unhealthy dietary habits, physical inactivity, and alcohol consumption are emerging as risk factors for breast cancer.
• Reproductive Factors: Late childbearing, not breastfeeding, and early menarche are known risk factors for breast cancer, and these factors are relevant as societal norms around childbirth and breastfeeding evolve.

Symptoms of Breast Cancer

Recognizing the symptoms of breast cancer early is crucial for timely diagnosis and treatment. Some common symptoms include:

• A lump or mass in the breast or underarm area.
• Changes in breast size or shape.
• Nipple discharge or inversion.
• Dimpling or puckering of the breast skin.
• Redness or scaly skin on the breast or nipple.

Regular self-examinations and clinical screenings can help detect these symptoms early, increasing the chances of successful treatment.

The Role of Screening and Early Detection

Screening is one of the most effective ways to catch breast cancer early and with efforts to introduce and expand screening programs, significant gaps remain:

• Mammography Services: While mammograms are the gold standard for breast cancer screening, there are only a limited number of mammography machines across the country, primarily located in urban centres and teaching & referral hospitals.
• Mobile Screening Units: In recent years, mobile breast cancer screening units have been introduced and incorporated into corporate wellness programs that seek to promote early prevention and diagnosis.
• Clinical Breast Exams: In the absence of widespread access to mammography, clinical breast exams are a vital alternative. Healthcare workers are well qualified to perform breast exams and educate women on self-examination techniques.

Treatment Options

Treatment typically involves a combination of surgery, radiation, and chemotherapy:

• Surgery: Depending on the stage and spread of the cancer, surgery can involve either a lumpectomy (removal of the tumour) or a mastectomy (removal of the entire breast).
• Chemotherapy and Radiation: Chemotherapy is widely available in most cancer treatment centres, though it can be costly. Radiation therapy is available in a few specialized centres.
• Targeted Therapies: Newer treatments like hormonal therapy and HER2-targeted drugs (e.g., trastuzumab) are available but often expensive, limiting access for many Kenyan women.
• Palliative Care: For patients with advanced breast cancer, palliative care plays a crucial role in improving the quality of life by managing symptoms and providing emotional and psychological support.

Dietary and Lifestyle Recommendations for Breast Cancer Prevention

Diet and lifestyle play a significant role in breast cancer prevention with the following recommendations being crucial:

• Maintain a Healthy Weight: Obesity is a known risk factor for breast cancer. Women should aim to maintain a healthy weight through a balanced diet and regular physical activity.
• Consume a Plant-Based Diet: A diet rich in fruits, vegetables, and whole grains provides essential nutrients and antioxidants that may lower breast cancer risk. Traditional diets, with a focus on fresh vegetables like Sukuma wiki, Managu and Terere are beneficial.
• Limit Alcohol Intake: Excessive alcohol consumption is linked to an increased risk of breast cancer. Reducing or eliminating alcohol can help lower this risk.
• Exercise Regularly: Physical activity has been shown to reduce the risk of breast cancer. Engaging in at least 30 minutes of moderate exercise daily, such as walking or cycling, can be highly beneficial.
• Breastfeed: Breastfeeding has been associated with a reduced risk of breast cancer. Encouraging more women to breastfeed, even as societal norms change, is important for prevention.

How will My Medical Cover Support Me in Preventing and Fighting Breast Cancer?

Jubilee Health Insurance has made significant efforts to improve breast cancer care among its members by introducing more innovative products and expanding coverage through:

• Awareness Campaigns: We run and conduct multiple and vibrant breast cancer awareness campaigns, particularly around the importance of early detection and the availability of preventive services under your medical cover. This could involve but is not limited to free medical camps, partnerships with healthcare providers to subsidize the cost of screening, and health promotion on digital platforms to reach a broader audience.
• Affordable Medical Covers: Our affordable covers have expanded access to breast cancer prevention and care. You can access coverage for essential services like screenings, chemotherapy, and surgery, making treatment more affordable for a larger segment of the population
• Health and Wellness Platforms: Our Health and Wellness platform, MaishaFiti, gives you access to supportive communities that offer a space for patients, survivors, caregivers, and advocates to share experiences, exchange information, and provide emotional and practical support, serving serve a critical role in complementing traditional medical care.

Conclusion

Breast cancer is a significant public health challenge, but with increased awareness, better screening, and improved access to treatment, the outlook can be improved.

Early detection through self-exams, clinical breast exams, and mammography is essential to reducing mortality rates. Jubilee Insurance continues to invest in infrastructure, training, and public education to ensure that members and the community at large have the knowledge and resources they need to prevent and treat breast cancer effectively.

By focusing on early detection, promoting healthier lifestyles, and addressing barriers to care, we can make significant strides in the fight against breast cancer.