Kenyan oncologist opens up on patients’ journeys with cancer

Prof Nicholas Abinya
Prof Nicholas Abinya, oncologist

Anne lived to make her husband, Gitaka, and his mother happy. To make them happy she had to deliver babies because that is what the mother-in-law wanted.

A healthy and roaring beauty even at 33, she never thought this would be a problem even after she started experiencing some pains after passing stool.

A neighbourhood doctor prescribed her some painkillers which did not work, triggering what was to become a torturous medical journey and the end of her dreams.

What had been treated as a simple case of hard stool, anal tear and even hemorrhoids eventually turned out to be a life-threatening cancer, requiring chemo, surgery, and radiotherapy.

“I did not want radiotherapy. I was hoping to have babies after recovery and radiotherapy would compromise my ovarian function. That is how I ended up here,” she had told Prof Nicholas Othieno Abinya, on her first visit to his clinic at the Nairobi Hospital Cancer Centre.

The doctor had then proceeded to examine Irvine who was accompanied by Gitaka, her partner, with results indicating need for radiotherapy and possible surgery.

I am married

“No doctor,” the couple had protested. “Kindly consider our point of view, I am just married and we have no children. Radiotherapy will mess me up completely. The way my mother in law seems to be waiting for a grandchild, no. She will be very disappointed.”

After negotiations, Prof Abinya, who is the head of medical oncology at Kenyatta National Hospital and director of cancer training at the University of Nairobi, had then proposed a compromise.

He would start her on chemotherapy and then surgery – they had agreed. Many months later, Prof Abinya in a new book that chronicles his daily experiences with cancer patients says Irvine after chemo, surgery, and a colostomy had experienced many changes.

Along the way, she lost much of her shine and with it her partner. “We are no longer together because his mother said with a colostomy I would not be able to conceive and carry a baby hence should stay out of their lives. I understood and we parted.”

Shadow in Perpetuity

A colostomy is a surgical procedure involving an opening through the skin from which a pouch is attached for the collection of feaces.

Of course in the book titled, ‘Shadow in Perpetuity,’ the real names of patients are changed for privacy. But this, Prof Abinya says, does not mask the struggles thousands of Kenyans affected by cancer are going through every day.

He tells of immense pressure local cancer doctors have to bear especially from patients and relatives who demand immediate cures, “like is being acquired from India.”

India, he says has become the Mecca for cancer cures for Kenyans. This, Prof Abinya, writes is not without some merit but most of the referrals are not necessary and are exploitative in nature.

He tells of his experience with Eric, a young boy, and his seemingly wealthy family. The boy had lost a leg to cancer which had been treated locally but had since spread to the lungs.

The family wanted  Prof Abinya to refer the boy for treatment to India. “I asked to examine the boy and his medical records  so as to make the most beneficial decision,” he writes.

But the family would not have any of this blaming the doctor for erecting unnecessary road blocks. “Just sign the forms and send us on our way,” they had insisted.

Honesty

There is a reason, the ministry of health insists on a referral letter, Prof Abinya had explained to the family.  “They trust that we can carry out an honest and impartial assessment and determine whether going to India or anywhere else will be of any value.”

In this case, the type of cancer  and  its advanced stage, he explained the boy would not benefit from more curative treatment  either in India or anywhere else.

At this point, he had explained what the boy required was palliative care and not an oncologist. But still, the family insisted they had already been guaranteed a possible cure in India but needed the letter  to allow for financing by the National Hospital Insurance Fund.

Alarmed over the growing number of Kenyans being lured abroad for treatment, in 2017 the government tightened the law on medical travel.

Patients, the law said, would only be referred abroad if there is no expertise or equipment locally to handle their condition.

Alternatively  there is evidence that the referral would be the most cost-effective option for the patient, or  that the patient opted for the referral and public resources will not be used.

Cures are rare

In the 295-page Shadow in Perpetuity, Prof Abinya says while cancer cures happen, they are rather rare, and relapses are always a possibility.

“At times it disappears for good, but more often than not it keeps its watch and then may strike again, once stricken you can never let you guard down.”

He tells of Damaris, who was first diagnosed with uterine cancer 19 years ago in 2001 resulting in the removal of the whole uterus.

Luckily by then she already had two children but in 2005 she was referred to Prof Abinya where it was found the cancer had moved to the breasts.

She underwent chemotherapy and  breast removal and is still ‘relapse-free today.” When confronted with cancer, Prof Abinya advises, “retain a good relationship with your caregiver and above all your creator.”

By Gatonye Gathura

About Gatonye Gathura 125 Articles
Science Journalist

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