National Cancer Institute Kenya

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  • UTERINE CANCER CARE AND CHALLENGES DURING THE TREATMENT PHASE

    UTERINE CANCER CARE AND CHALLENGES DURING THE TREATMENT PHASE

    Uterine cancer is one of the most common gynecologic cancers among women. Early detection plays a significant role in successful treatment outcomes, but once diagnosed, patients often embark on a physically and emotionally challenging journey. Understanding the care and treatment process, as well as the hurdles patients face during this phase, is essential to supporting those affected.

    Care and Treatment Process

    The care and treatment of uterine cancer often begins with a multidisciplinary approach involving gynecologic oncologists, radiologists, pathologists, and support teams. The most common treatment option is surgery, commonly a hysterectomy, which may include removal of the uterus, fallopian tubes, ovaries, and sometimes surrounding lymph nodes. This mainly depends on the stage and aggressiveness of the cancer.

    Post-surgery, adjuvant therapies may be required:

    • Radiation Therapy: Helps eliminate remaining cancer cells and reduces the risk of recurrence.
    • Chemotherapy: Used in more advanced or aggressive cases to target cancer cells throughout the body.
    • Hormone Therapy: Applied for hormone-sensitive cancers to block hormones that fuel cancer growth.

    Regular monitoring, including blood tests, scans, and pelvic exams, is essential throughout the treatment process to track progress and adjust the care plan as needed.

    Challenges Faced During Treatment

    While effective treatment options exist, patients often face a range of physical, emotional, and financial challenges during the treatment phase:

    • Physical Side Effects: These may include fatigue, nausea, pain, surgical complications, hormonal imbalances, and early menopause.
    • Emotional Strain: Many women experience anxiety, fear of recurrence, depression, and body image issues. For younger patients, infertility can be especially distressing.
    • Financial Barriers: In many regions, treatment costs, travel expenses, and time away from work or family can create overwhelming financial stress.
    • Limited Access in Low-Resource Settings: late diagnosis due to lack of screening, inadequate health infrastructure, and scarcity of specialists pose serious barriers to timely and quality care.

    Beyond medical treatment, uterine cancer care must include psychosocial support, patient education, and community outreach. Support groups, counseling, and financial assistance programs can significantly improve a patient’s ability to cope. Additionally, strengthening health systems to ensure earlier diagnosis, equitable access to care, and ongoing survivorship support is critical.

    Uterine cancer treatment involves more than just managing the disease. It is about supporting the whole patient. Addressing the physical, emotional, and social challenges faced during treatment can lead to better outcomes and a higher quality of life for women living with this disease.

  • ADDRESSING UTERINE CANCER IN KENYA

    ADDRESSING UTERINE CANCER IN KENYA

                                                           

    Uterine cancer originates in the lining of the uterus.  In Kenya, the disease is increasingly becoming an emerging public health concern due to rising incidence rates and late-stage diagnoses. While traditionally less highlighted than cervical or breast cancer, uterine cancer is becoming more common, driven by rising life expectancy, changes in reproductive health trends, and shifting lifestyles.

    According to the National Cancer Registry data estimates, Kenya records approximately 829 new cases annually of uterine cancer and 257 deaths annually. These numbers place uterine cancer among the top twenty cancers affecting women in the country. Data from Kenyatta National Hospital (KNH), supports these findings, showing a steady increase in gynecologic cancer referrals, with uterine cancer accounting for a growing share.

    Clinicians report that most uterine cancer patients are diagnosed between the ages of 50 and 65, often postmenopausal, and commonly present with abnormal uterine bleeding. A retrospective review of cases between 2015 and 2022 showed that more than 60% of patients presented with advanced-stage disease (Stage III or IV), reducing the effectiveness of treatment and worsening prognosis. Studies at Moi Teaching and Referral Hospital (MTRH) and Aga Khan University Hospital echo findings at KNH, indicating a demographic shift toward younger women presenting with early symptoms.

    Risk Factors

    • Delayed childbearing and decreased fertility rates in women
    • Limited access to regular gynecological care and screening, especially in rural regions
    • Low public awareness about the symptoms of uterine cancer
    • A growing prevalence of obesity and metabolic disorders, even among younger women

    Diagnosis and Treatment Gaps

    Uterine cancer diagnosis in Kenya is hindered by limited diagnostic capacity, particularly outside major urban centers. Many public hospitals lack equipment for transvaginal ultrasound, histopathology, and advanced imaging. At KNH, diagnosis is often delayed due to long waiting times for biopsy results.

    Treatment typically involves total abdominal hysterectomy, sometimes followed by radiation or chemotherapy. However, there is a shortage of radiation therapy machines, with only a handful of public facilities offering radiotherapy. This shortage forces many patients to wait months or travel long distances for treatment, worsening their outcomes. With the operationalization of the Cancer Prevention and Control Act, 2012, by the National Cancer Institute of Kenya, these challenges are now being addressed through policy making, partnerships, and collaborations.

    The Way Forward

    Collaboration between the Kenyan government, academic institutions, and international health organizations can drive progress. Leveraging global insights while adapting strategies to Kenya’s health landscape is crucial to reducing uterine cancer mortality. This can be done through;

    • Increased public awareness campaigns tailored to Kenyan women.
    • Expand diagnostic infrastructure to counties and sub-counties.
    • Subsidize treatment through the Social Health Authority (SHA)
    • Train more gynecologic oncologists, nurses, and pathologists.
    • Integrate uterine cancer education into reproductive health services.

    Uterine cancer is a growing threat to women’s health in Kenya. With rising incidence and late diagnoses, the government of Kenya, through the National Cancer Institute of Kenya, is rolling out better screening programs, affordable treatment through the Social Health Authority (SHA), and public awareness.

    Addressing this issue requires more than medical treatment as it calls for a comprehensive, system-wide response that includes public education, investment in diagnostic capacity, equitable access to treatment, and health workforce training. With coordinated efforts from the government, healthcare institutions, and international partners, Kenya can shift the narrative from late-stage suffering to early detection and survival.

  • Decoding Uterine Cancer Symptoms: What Every Woman Should Know

    Decoding Uterine Cancer Symptoms: What Every Woman Should Know

    Uterine cancer, most commonly Endometrial cancer (which starts in the lining of the uterus), often presents with symptoms that are noticeable, allowing for earlier detection and better treatment outcomes. It’s crucial for every woman to be aware of these signs, even though they can also be caused by less serious conditions.

    Here’s what everyone should know about uterine cancer symptoms:

    The Most Important Symptom: Abnormal Vaginal Bleeding

    This is by far the most common and often the earliest symptom of uterine cancer, occurring in about 90% of cases. “Abnormal” bleeding can look different depending on whether you’ve gone through menopause or not

    While abnormal bleeding is the primary symptom, other signs can occur as the cancer grows or if it’s a less common type of uterine cancer (like uterine sarcoma):

    • Unusual vaginal discharge: This can range from watery to thick, and may be clear, white, pink, or blood-tinged. It might also have an unpleasant odor.
    • Pelvic pain or pressure: This can be a persistent ache, cramping, or a feeling of fullness or discomfort in your lower abdomen or pelvis. It might also present as pain in your lower back or legs.
    • Pain during sex (dyspareunia): This can occur if the cancer has grown and is affecting the cervix or vagina.
    • Changes in urination or bowel movements: If the tumor grows large enough, it can press on the bladder or rectum, leading to:
      • Pain or difficulty when urinating.
      • More frequent urination.
      • Blood in the urine.
      • Pain or difficulty with bowel movements.
      • Blood in the stool.
    • Unexplained weight loss: Losing weight without trying can be a symptom of many cancers, including uterine cancer, especially in later stages.
    • A lump or swelling in the tummy or pelvis.
    • Feeling of fullness or bloating.
    • Symptoms can be misleading: Many of these symptoms can be caused by benign conditions like fibroids, polyps, infections, or hormonal imbalances. However, only a doctor can determine the cause. Don’t assume it’s “just” menopause or a normal part of your cycle if you experience these changes.
    • Don’t wait: If you have any of these symptoms, especially abnormal bleeding, see your doctor right away. Don’t delay seeking medical advice.

    By being aware of these symptoms and acting quickly, women can significantly improve their chances of a positive outcome if diagnosed with uterine cancer.

  • Understanding Kidney Cancer Risk Factors: Knowledge is Power

    Understanding Kidney Cancer Risk Factors: Knowledge is Power

    March is Kidney Cancer Awareness Month, a time dedicated to shedding light on this often-overlooked disease. While there’s no foolproof way to prevent kidney cancer entirely, understanding the risk factors can empower you to make informed choices and take proactive steps towards better health.

    What is Kidney Cancer?

    Kidney cancer occurs when cells in the kidneys, the organs responsible for filtering waste from your blood, begin to grow uncontrollably. The most common type is renal cell carcinoma (RCC), which originates in the lining of the small tubes within the kidneys.

    Key Risk Factors to Be Aware Of:

    Several factors can increase your risk of developing kidney cancer. Let’s delve into the most significant ones:

    • Smoking:
      • This is a major culprit. Tobacco use significantly elevates your risk. The harmful chemicals in cigarettes damage kidney cells over time. Quitting smoking is one of the most effective ways to lower your risk.
    • Obesity:
      • Excess weight, particularly abdominal obesity, is linked to an increased risk. Maintaining a healthy weight through a balanced diet and regular exercise is crucial.
    • High Blood Pressure (Hypertension):
      • Chronic high blood pressure can strain the kidneys and increase the likelihood of cancer development. Managing your blood pressure through lifestyle changes and/or medication is essential.
    • Gender:
      • Men are more likely to develop kidney cancer than women. The reasons for this disparity are not fully understood.
    • Age:
      • The risk of kidney cancer increases with age, with most cases diagnosed in people over 50.
    • Family History:
      • If you have a close relative who has had kidney cancer, your risk is higher. Certain genetic conditions, such as von Hippel-Lindau (VHL) disease, hereditary papillary renal cell carcinoma, and Birt-Hogg-Dubé syndrome, can also increase your susceptibility.
    • Chronic Kidney Disease:
      • People with chronic kidney disease, especially those on long-term dialysis, have a higher risk.
    • Exposure to Certain Chemicals:
      • Occupational exposure to certain chemicals, such as trichloroethylene, cadmium, and asbestos, has been linked to kidney cancer.
    • Long-Term Use of Certain Pain Medications:
      • Prolonged use of some pain medications, particularly phenacetin-containing drugs (which are no longer widely available), has been associated with an increased risk.
  • Can Kidney Cancer Be Prevented?

    Can Kidney Cancer Be Prevented?

    While there’s no guaranteed way to completely prevent kidney cancer, you can take steps to reduce your risk. Here’s a breakdown of key protective measures:  

    Lifestyle Changes:

    • Don’t Smoke:
      • Smoking is a significant risk factor for kidney cancer. Quitting smoking is one of the most impactful things you can do to lower your risk.  
    • Maintain a Healthy Weight:
      • Being overweight or obese increases your risk.Aim for a healthy body mass index (BMI) through a balanced diet and regular exercise.
    • Control High Blood Pressure:
      • High blood pressure is linked to an increased risk. Manage your blood pressure through lifestyle changes and, if necessary, medication.  
    • Healthy Diet:
      • A diet rich in fruits and vegetables can contribute to overall health and may help reduce cancer risk.  
    • Regular Exercise:
      • Physical activity is essential for maintaining a healthy weight and overall well-being.  

    Occupational and Environmental Factors:

    • Limit Exposure to Certain Chemicals:
      • Exposure to certain chemicals, such as trichloroethylene, cadmium, and asbestos, has been linked to kidney cancer. If you work with these substances, take proper safety precautions.  

    Medical Considerations:

    • Manage Chronic Kidney Disease:
      • People with chronic kidney disease may have an increased risk. Regular checkups and proper management of kidney health are crucial.  
    • Be Aware of Family History:
      • If you have a family history of kidney cancer or certain genetic conditions (like von Hippel-Lindau disease), discuss your risk with your doctor. Genetic counseling may be beneficial.
    • Limit Unnecessary Use of Pain Medications:
      • long term use of some pain medications can have a negative effect on kidney health. So use them as directed by your doctor.

  • Can Childhood Cancer Be Prevented? Understanding Risk and Prevention Strategies

    Most common cancers found in kids 14 years and below are leukemia, lymphoma, or cancer of the brain or central nervous system. More than one in four people diagnosed with bone cancer are under 20 years of age.

    Similar to adult malignancies, the majority of childhood cancers are caused by changes or mutations in genes, which cause uncontrolled cell proliferation and eventually cancer. Germline variations, which are genetic alterations (or variants) transferred from parents to their offspring, have been linked to an elevated risk of cancer

    The types of treatment that a child with cancer receives will depend on the type of cancer and how advanced it is. Common treatments include: surgery, chemotherapy, radiation therapy, immunotherapy, and stem cell transplant.

    The types of cancers that occur most often in children are different from those seen in adults. The most common cancers of children are:

    • Leukemia
    • Brain and spinal cord tumors
    • Neuroblastoma
    • Wilms tumor
    • Lymphoma (including both Hodgkin and non-Hodgkin)
    • Rhabdomyosarcoma

    Children’s cancers are not always treated like adult cancers. Pediatric oncology is a medical specialty focused on the care of children with cancer. It’s important to know that this expertise exists and that there are effective treatments for many childhood cancers.

    What causes cancer in children?

    Cancer occurs in people of all ages and can affect any part of the body. It begins with genetic change in single cells, that then grow into a mass (or tumour), that invades other parts of the body and causes harm and death if left untreated. Unlike cancer in adults, the vast majority of childhood cancers do not have a known cause. Many studies have sought to identify the causes of childhood cancer, but very few cancers in children are caused by environmental or lifestyle factors. Cancer prevention efforts in children should focus on behaviours that will prevent the child from developing preventable cancer as an adult.

    Some chronic infections, such as HIV, Epstein-Barr virus and malaria, are risk factors for childhood cancer. They are particularly relevant in LMICs. Other infections can increase a child’s risk of developing cancer as an adult, so it is important to be vaccinated (against hepatitis B to help prevent liver cancer and against human papillomavirus to help prevent cervical cancer) and to other pursue other methods such as early detection and treatment of chronic infections that can lead to cancer.

    Current data suggest that approximately 10% of all children with cancer have a predisposition because of genetic factors [5]. Further research is needed to identify factors impacting cancer development in children.

  • Breastfeeding: A Natural Defense Against Hormone-Receptor-Negative Breast Cancer

    This being a Breastfeeding week, let’s learn something on the relationship between Cancer and Breastfeeding. Did you know that women who breastfeed have a lower risk of breast cancer especially before menopause, than women who don’t breastfeed?

    Many women are not aware that breastfeeding their babies can help lower their own risk of developing breast cancer; despite the fact that most parents are aware that breastfeeding is the best way to nurture babies and offers them vital health benefits.

    Breastfeeding may be more strongly linked to a lower risk of estrogen receptor-negative (Some breast cancer cells require progesterone and/or oestrogen. Hormone receptors are unique proteins found inside these cancer cells. When hormones attach to hormone receptors, the cancer cells with these receptors grow.

    Hormone receptor-negative tumors are estrogen receptor-negative (ER-negative) and progesterone receptor-negative (PR- negative). Hormone receptors are not expressed in these tumors. Because of this, they either have few or no hormone receptors.

    Approximately 75% to 85% of newly diagnosed breast cancers are hormone receptor-positive, these hormones cane be treated with hormone therapies; hormone theraphy drugs include aromatase inhibitors, tamoxifen, anastrozole, exemestane and letrozole. Hormone receptor-negative breast cancers are not treated with hormone therapies because they don’t have hormone receptors.

    Research suggests that breastfeeding women are less likely to develop pre and post-menopausal breast cancer symptoms. And breastfeeding longer than six months can have additional benefits. Most women ignore their breast health, which results in breast cancer, due to which the number of increased breast cancer cases worldwide.

    Breastfeeding protects children from cancer, it reduces not only the mother’s chances of cancer but also the child’s. It is therefore beneficial to both mother and child. Studies show that breastfeeding prevents the child from being overweight, that later reduces the risk of many cancers such as pancreatic, post-menopausal breast, endometrial, oesophagal, rectal, and kidney cancers. 

    A mother’s hormones are altered by breastfeeding, which may delay the onset of her menstrual cycle and minimize her lifetime exposure to oestrogen and other hormones that may increase her risk of breast cancer. Breastfeeding may also aid in preventing breast cancer-causing mutations in cells.

    Breast cancer can be detected during breastfeeding; when a woman feels a lump in the breast during breastfeeding, it could be a sign of breast cancer, and the lumps can disappear after some time but can translate to cancer as a result of mastitis, which is an infection of the breast tissue by a bacteria which blocks milk ducts. Symptoms are swelling and pain in the breast, skin warmth and redness, fever. Fibro adenomas, which are lumps that feel like marble when touched and always move beneath the skin can also be the symptoms.

    REFERENCES

    Fei, F., Siegal, G. P., & Wei, S. (2022). Characterizing clinicopathologic features of estrogen receptor-positive/progesterone receptor-negative breast cancers. Clinical Breast Cancer, 22(7), e788-e797.

    Huang, Y., Ouyang, Y. Q., & Redding, S. R. (2019). Previous breastfeeding experience and its influence on breastfeeding outcomes in subsequent births: a systematic review. Women and Birth, 32(4), 303-309.

    Kay, J. E., Cardona, B., Rudel, R. A., Vandenberg, L. N., Soto, A. M., Christiansen, S., … & Fenton, S. E. (2022). Chemical effects on breast development, function, and cancer risk: existing knowledge and new opportunities. Current Environmental Health Reports, 9(4), 535-562.

    Rozeboom, B., Dey, N., & De, P. (2019). ER+ metastatic breast cancer: Past, present, and a prescription for an apoptosis-targeted future. American journal of cancer research, 9(12), 2821.

    Skilton, M. R. (2022). Obesity and Cancer. Clinical Obesity in Adults and Children, 211-220.

    Trabert, B., Sherman, M. E., Kannan, N., & Stanczyk, F. Z. (2020). Progesterone and breast cancer. Endocrine reviews, 41(2), 320-344.

  • Improving Breast Cancer Outcomes in Kenya: Focus on Early Detection & Prevention

    This month provides an opportunity for us all to focus on breast cancer and its impact on those affected by the disease in our community.

    The total breast cancer cases notified by county of usual residence between the years 2020 and 2023 amounted to 4,824 people in Kenya, Nairobi County leading with the highest number of diagnosed people at 550 followed by Nakuru County which registered 398 people.

    Finding breast cancer early provides the best chance of surviving the disease. While mammograms can help to detect cancer before you can feel a lump, breast self-exams help to be familiar with how your breasts look and feel so you can alert your doctor if there are any changes.

    Take the time to ‘get to know’ how your breasts normally look and feel through normal regular activities such as showering, getting dressed, using body lotion or looking in the mirror.

    You don’t need to use a special technique, but ensure you look at and feel your breasts regularly. Make sure this includes all parts of your breast, your armpit and up to your collarbone.

    For women of all ages, it is recommended that you be breast aware.

    Changes to look for include:

    • a new lump or lumpiness, especially if it’s only in one breast
    • a change in the size or shape of your breast
    • a change to the nipple, such as crusting, ulcer, redness or inversion
    • a nipple discharge that occurs without squeezing
    • a change in the skin of your breast such as redness or dimpling
    • An unusual pain that doesn’t go away.

    Visit a doctor in case you notice any changes in your breast.

    Breast cancer signs

    According to doctors, it is quite difficult for breast cancer to get diagnosed for women under 40 because their breasts are denser. This means that a tumour, if present, is not likely to show up in a mammogram.

    The most common way to detect breast cancer in younger women is to keep a close check on the changes in your breasts. In fact, according to Healthline, a majority of young women diagnosed with breast cancer discover an abnormality themselves. If you notice any changes in your breast, like changes in the skin, nipple discharge, pain, tenderness, or a lump or mass in the breast or underarm area, please report it immediately to a doctor.

    Breast cancer is one of the most common cancers in women and there is a misconception among people that it only happens to older women. While it’s true that most breast cancers are found in women who are 40 years or older, it is imperative to know that it can strike any female at any age.

    Pain in any Area of The Breast

    Check for pain and tenderness in any area of your breast. While lumps don’t usually hurt, some may cause a prickly sensation. However, pain in your breasts can also be due to numerous other benign reasons and hormonal changes. 

    Unusual Nipple Discharge

    An unusual nipple discharge that’s clear, red, brown, or yellow (other than breast milk) can be an early sign of breast cancer. If you notice this, consult a doctor for an evaluation.

    Breast Changes

    Look for changes in shape, swelling, and difference in size, texture, or temperature of either one or both breasts.

    Unexplained Redness/Rash

    Early warning signs of breast cancer can include unexplained redness, swelling, itchiness, or rash on one or both breasts.

    Swelling around the Collarbone or Armpit

    Consult your doctor if you notice swelling around your collarbone or under the arm. It could be a sign that the breast cancer has spread to the lymph nodes in that area.

    While these are some of the early signs of breast cancer, it is important to remember that these can also be caused by benign conditions. It’s always best to consult a doctor so that they can evaluate and help you determine whether it is cause for concern.

    Apart from this, it’s also important to keep in mind that often, women with breast cancer have no symptoms. This is why regular breast screening is important to detect it. The main tool to diagnose breast cancer is a mammogram, which basically shows normal and abnormal breast tissue.

    It is recommended that women should start getting mammograms when they cross the age of 40 and should continue getting one every 1 or 2 years. Meanwhile, for women above the age of 20, monthly breast self-examination is recommended.

  • Breast Cancer Status in Kenya – National Cancer Registry of Kenya (NaCaRe-KE)

    The National Cancer Registry of Kenya (NaCaRe-KE) was established in 2021 and launched in the same year.  The first report on the status of cancer in Kenya, utilized 6,778 records for the period July 2021 to June 2022, notified from 42 facilities across 21 counties.  From the report, it is established that three most common cancers are breast (15.1%), cervix (13.3%) and oesophagus (11.8%). 

    The total breast cancer cases notified by county of usual residence between the years 2020 and 2023 amounted to 4,824 people, Nairobi County leading with the highest number of diagnosed people at 550 followed by Nakuru County which registered 398 people. Counties that diagnosed the least number of breast cancer as notified to NaCaRe-KE included Turkana, Tana River and Wajir that registered 3, 2 and 1 cases respectively as shown in table 1 below.

    Table 1: Distribution by County of Usual Residence per Year – Filtered by Date of diagnosis

    County of Usual Residence2020202120222023TOTAL
     Nairobi County            1          51         354         144         550
     Nakuru County          96        105         130           67         398
     Nyeri County           96         179           94         369
     Kiambu County           14         199           70         283
     Machakos County           30         112           77         219
     Mombasa County            4          20           23         143         190
     Meru County          61          27           65           24         177
     Makueni County             8           96           49         153
     Kirinyaga County            1          33           69           49         152
     Muranga County             6         111           35         152
     Embu County            2          36           75           27         140
     Kitui County          22          19           59           32         132
     Kakamega County           23           65           40         128
     Kajiado County             9           47           36           92
     Laikipia County          10          13           36           33           92
     Nyandarua County          10          17           39           15           81
     Kisumu County           15           37           28           80
     Kilifi County            4            9            7           59           79
     Kisii County            1            7           37           30           75
     Siaya County           10           26           22           58
     Uasin Gishu County            1          29           21            7           58
     Taita Taveta County           13           21           19           53
     Bungoma County           16           16           14           46
     Busia County           15           17           11           43
     Vihiga County             8           15           20           43
     Nandi County             5           13           24           42
     Kwale County            1            3            4           26           34
     Baringo County            6          12            4            5           27
     Homa Bay County            1            5            9           12           27
     Migori County             3           15            9           27
     Tharaka Nithi County             6           15            5           26
     Trans Nzoia County             9            8            9           26
     Kericho County            1            8           10            5           24
     Nyamira County             4            6           14           24
     Bomet County           10           10            2           22
     Narok County             6            5            9           20
     Garissa County             4            8            1           13
     Lamu County            1            2            1            6           10
     Isiolo County              5            2            7
     Marsabit County             2            1            3            6
     West Pokot County             2            2            2            6
     Elgeyo Marakwet County             2            2            1            5
     Mandera County              5             5
     Samburu County            1             2            1            4
     Turkana County             1            1            1            3
     Tana River County              1            1            2
     Wajir County              1             1
     Non-resident             16            4           20
     Missing        357        207           33            3         600
     TOTAL        581        920     2,033     1,290     4,824

    Distribution by County of Notification per Year – Filtered by Date of Diagnosis

    Distribution by County of notification means the county in which the cancer case was diagnosed. From table 2 below, it is noted that Nairobi County leads by 2150 of cases notified; meaning therefore that most people seek cancer medication at the capital city.

    Table 2: Distribution by County of Notification per Year – Filtered by Date of Diagnosis

    County of Usual Res 2020 2021 2022 2023 TOTAL
     Nairobi County        218        215      1,288         429      2,150
     Nakuru County        128        126         124           82         460
     Nyeri County         117         143         125         385
     Machakos County        101          73           78           65         317
     Mombasa County          18          31            7         242         298
     Uasin Gishu County         116           79           36         231
     Kakamega County           89           49           42         180
     Kisumu County           34           42           71         147
     Meru County          61          32           25           23         141
     Embu County            3          47           65           24         139
     Makueni County             56           19           75
     Kitui County          22          13           17           14           66
     Bomet County          20          11           13            4           48
     Taita Taveta County           13           15           13           41
     Kiambu County              4           31           35
     Kisii County              2           28           30
     Nandi County              3           24           27
     Garissa County          10            3            8            2           23
     Laikipia County              5            5           10
     Muranga County             10            10
     Kirinyaga County               8            8
     Vihiga County               3            3
     TOTAL        581        920      2,033      1,290      4,824

    In terms of distribution of cancer type in the breast (primary site), Breast NOS (excludes Skin of breast C44.5) accounts for 94.44% of the all cancers of the breast; 4556 of the total 4824 as notified between 2020 and 2023. Breast NOS in simple terms is the Invasive Ductal Carcinoma of Breast, Not Otherwise Specified (NOS), they are invasive breast cancers, which have a tendency to be aggressive and spread. This subset comprises the largest group and also the most common type of breast cancers as seen in table 2 below.

    Table 3: Distribution of Cancer Type by /year – Filtered by Date of Diagnosis:

    Primary Site 2020 2021 2022 2023 TOTAL
     Breast NOS (excludes Skin of breast C44.5)        542        893     1,957     1,164     4,556
     Upper outer quadrant of breast          10          12           20           27           69
     Central portion of breast            2            1           20           28           51
     Upper inner quadrant of breast            3            5            7           19           34
     Overlapping lesion of breast          19            6            6            3           34
     Axillary tail of breast             11           17           28
     Lower inner quadrant of breast            4             9            8           21
     Nipple             3            1           15           19
     Lower outer quadrant of breast            1             2            9           12
     TOTAL        581        920     2,033     1,290     4,824

    In Kenya, the majority of breast cancer cases discovered are at stage IV, accounting for 37.2% of all cases as seen in table 4 below. This is the leading factor towards mortalities as late discoveries reduces the likelihood of survival. Early screening of breast cancer increases the chances of managing the disease through prompt treatment and care, therefore increasing the chances of survival.

    Table 4: Distribution by Stage at Diagnosis per Year – Filtered by Date of Diagnosis:

    Stage at Diagnosis2020202120222023TOTALPercentage
    In situ 22036582.6%
    Stage I121856291155.1%
    Stage II256723521053723.8%
    Stage III4414425626470831.4%
    Stage IV5617137224184037.2%
    TOTAL1374029397802258100.0%

  • Understanding Brain Tumors: A Guide for Patients

    A brain tumor is a growth of cells in the brain or near it. Brain tumors can happen in the brain tissue. Brain tumors also can happen near the brain tissue. Nearby locations include nerves, the pituitary gland, the pineal gland, and the membranes that cover the surface of the brain.

    Brain tumors can begin in the brain. These are called primary brain tumors. Sometimes, cancer spreads to the brain from other parts of the body. These tumors are secondary brain tumors, also called metastatic brain tumors.

    Many different types of primary brain tumors exist. Some brain tumors aren’t cancerous. These are called noncancerous brain tumors or benign brain tumors. Noncancerous brain tumors may grow over time and press on the brain tissue. Other brain tumors are brain cancers, also called malignant brain tumors. Brain cancers may grow quickly. The cancer cells can invade and destroy the brain tissue.

    Brain tumors range in size from very small to very large. Some brain tumors are found when they are very small because they cause symptoms that you notice right away. Other brain tumors grow very large before they’re found. Some parts of the brain are less active than others. If a brain tumor starts in a part of the brain that’s less active, it might not cause symptoms right away. The brain tumor size could become quite large before the tumor is detected.

    Brain tumor treatment options depend on the type of brain tumor you have, as well as its size and location. Common treatments include surgery and radiation therapy.

    Types

    There are many types of brain tumors. The type of brain tumor is based on the kind of cells that make up the tumor. Special lab tests on the tumor cells can give information about the cells. Your health care team uses this information to figure out the type of brain tumor.

    Some types of brain tumors usually aren’t cancerous. These are called noncancerous brain tumors or benign brain tumors. Some types of brain tumors usually are cancerous. These types are called brain cancers or malignant brain tumors. Some brain tumor types can be benign or malignant.

    Benign brain tumors tend to be slow-growing brain tumors. Malignant brain tumors tend to be fast-growing brain tumors.

    Types of brain tumors include:

    • Gliomas and related brain tumors. Gliomas are growths of cells that look like glial cells. The glial cells surround and support nerve cells in the brain tissue. Types of gliomas and related brain tumors include astrocytoma, glioblastoma, oligodendroglioma and ependymoma. Gliomas can be benign, but most are malignant. Glioblastoma is the most common type of malignant brain tumor.
    • Choroid plexus tumors. Choroid plexus tumors start in cells that make the fluid that surrounds the brain and spinal cord. This fluid is called cerebrospinal fluid. Choroid plexus tumors are located in the fluid-filled cavities in the brain, called the ventricles. Choroid plexus tumors can be benign or malignant. Choroid plexus carcinoma is the malignant form of this type of brain tumor. It’s more common in children.
    • Embryonal tumors. Embryonal tumors begin in cells that are left over from fetal development. The cells, called embryonal cells, stay in the brain after birth. Embryonal tumors are malignant brain tumors that happen most often in babies and young children. The most common type of embryonal tumor is medulloblastoma. It’s usually located in the lower back part of the brain, called the cerebellum.
    • Germ cell tumors. Germ cell tumors start in reproductive cells, called germ cells, that go on to become the sperm and egg cells. Germ cells are mostly in the ovaries and testicles. But sometimes they’re in other parts of the body, including the brain. When germ cell tumors happen in the brain, they’re often located near the pineal gland or the pituitary gland. Germ cell tumors are mostly benign. They’re more common in children.
    • Pineal tumors. Pineal tumors start in and around the brain’s pineal gland. The pineal gland is located in the center of the brain. It makes a hormone called melatonin that helps with sleep. Pineal tumors can be benign or malignant. Pineoblastoma is a malignant type of pineal tumor that’s most common in children.
    • Meningiomas. Meningiomas are brain tumors that start in the membranes around the brain and spinal cord. Meningiomas are usually benign, but sometimes they can be malignant. Meningiomas are the most common type of benign brain tumor.
    • Nerve tumors. Nerve tumors are growths that happen in and around nerves. The most common type that happens in the head is acoustic neuroma, also called schwannoma. This benign tumor is located on the main nerve that connects the inner ear to the brain.
    • Pituitary tumors. Brain tumors can begin in and around the pituitary gland. This small gland is located near the base of the brain. Most tumors that happen in and around the pituitary gland are benign. Pituitary tumors happen in the pituitary gland itself. Craniopharyngioma is a type of brain tumor that happens near the pituitary gland.
    • Other brain tumors. Many other types of rare tumors can happen in and around the brain. Tumors can start in the muscles, blood vessels and connective tissue around the brain. Tumors can form in the bones of the skull. Malignant brain tumors can start from the germ-fighting immune system cells in the brain. This type of brain cancer is called primary central nervous system lymphoma.