Cancer Specialists Call For Effective Implementation of Guidelines in Fight Against Breast Cancer

Cancer experts including (from right), Dr Alfred Karagu, CEO, National Cancer Institute - Kenya, Dr Mary Nyangasi, Head, National Cancer Control Programme in the Ministry of Health, Dr Miriam Mutebi, Breast Surgical Oncologist, AKUHN, Prof. Ben Anderson, Chair and Director of Breast Health Global Initiative, Dr Asim Jamal, Medical Oncologist, and Dr Shahin Sayed, Cancer Pathologist at AKUHN discussing the programme of the 2nd International Breast Cancer Symposium.

Cancer experts are calling for joint effort in implementation of breast cancer guidelines to effectively manage breast cancer from screening, diagnostics to treatment especially in low-resource areas. Breast cancers accounts for an estimated one in five of all cancers in Kenya, and it’s the third leading cause of death from cancer.

Speaking at the ongoing second International Breast Cancer Symposium, Prof. Ben Anderson, the Chair and Director of Breast Health Global Initiative, said that the majority of breast cancer cases in Kenya and the region are diagnosed at Stage 3 and 4 due to limited uptake of early diagnosis initiatives to detect the cancer at earlier stages when curative cancer treatment is more practical and affordable.

“System barriers including cost of imaging and tissues sampling, appropriate diagnostics and lack of trained and specialized personnel in most sub-Saharan African countries have greatly contributed to increased cancer numbers.  There are low hanging fruits that we can improve on to streamline processes through proposed guidelines and increase uptake of the breast cancer early diagnosis. Collaborative relationships between the medical community, policy makers and civil society groups are vital to create more awareness that leads to increase in breast cancer screening at primary healthcare settings,” Prof. Anderson said.

The scientific meeting which has brought together cancer specialists from across the globe is organized jointly by the Aga Khan University and Hospital, the Ministry of Health, the National Cancer Institute, MD Anderson Cancer Center, Memorial Sloan Kettering Cancer Center, UICC Global Cancer Control, the African Society of Clinical Oncology (ASCO) and the Kenya Society of Haematology and Oncology (KESHO).

According to Dr Miriam Mutebi, Chair of the symposium and a Consultant Breast Surgical Oncologist at Aga Khan University Hospital, recent years have seen an improvement of local, regional, and continental guidelines around breast cancer especially in sub-Saharan Africa. The application of these guidelines especially in low-resource settings requires a systematic approach recognizing the diversity of the healthcare environment, making use of available resources without compromising the quality of care to breast cancer patients.

“In the sub-Saharan Africa region, breast cancer patients tend to present much younger by about 10-15 years than their western counterparts. They are also diagnosed with more advanced cancers due to a combination of health system, financial and patient related factors. They also frequently do not complete their treatment. Some of the sociocultural barriers develop because women are frequently not the primary determinants of their health seeking behavior and may have to rely on their partners and spouses for financial support in order to access care. In addition, myths and stigma around breast cancers may cause further delays in patients accessing care. Limited resources should not determine the quality of care a patient receives, and it’s within this context that doctors and policy makers endeavor to improve health systems and care delivery for patients regardless of the resource setting,” said Dr Mutebi.

The Chief Executive Officer of the National Cancer Institute Dr Alfred Karagu, highlighted a number of challenges affecting the fight against breast cancer management and cancer in general in the country including health systems inequalities which limit diagnosis and treatment opportunities, inadequate cancer research infrastructure, limited health expenditure in cancer control by governments and international stakeholders, a strong bias towards infectious diseases, poorly coordinated advocacy efforts for political and social action as well as limited uptake of screening by women due to financial constrains among others challenges.

“Across the globe, there are many cancer forums but scientists from low-resource settings hardly get the opportunity to present their experiences in such conferences. The uniqueness of this symposium is that it is happening where it’s needed the most because breast cancer is the leading cancer in Kenya.  This event, involves researchers and scientists from all continents both high and low-resource coming together to exchange scientific evidence-based findings that will help in the process of guidelines implementation and advance the breast cancer agenda in managing the disease”, said Professor Robert Armstrong, Dean, Medical College at Aga Khan University.