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In children and teenagers, leukaemia accounts for roughly one out of every 3 cancer cases. Acute lymphocytic leukaemia (ALL) is the most common kind of leukaemia in kids. Acute myeloid leukaemia (AML) makes up the majority of the remaining cases. In children, chronic leukaemias are uncommon.

A few factors are known to increase the risk of childhood leukaemia.

Genetic Risk Factors

Our DNA, which makes up our genes, contains risk factors that are genetic in nature. They are frequently passed on from our parents. While some genetic predispositions raise the incidence of paediatric leukaemia, the majority of leukaemias have no known genetic basis.

Genetic Syndromes

Some genetic disorders increase a child’s risk of developing leukemia:

Down syndrome (trisomy 21): Children with Down syndrome have an extra copy of chromosome 21. They are many times more likely to develop either acute lymphocytic leukemia (ALL) or acute myeloid leukemia (AML) than are other children, with an overall risk of about 2% to 3%. Down syndrome has also been linked with transient leukemia (also known as transient myeloproliferative disorder) – a leukemia-like condition within the first month of life, which often resolves on its own without treatment.

Li-Fraumeni syndrome: This is a rare inherited condition caused by a change in the TP53 gene. People with this change have a higher risk of developing several kinds of cancer, including leukemia, bone or soft tissue sarcomas, breast cancer, adrenal gland cancer, and brain tumors.

Leukaemia risk is also elevated in other genetic illnesses (including neurofibromatosis and Fanconi anaemia), as well as in several other malignancies.

Inherited Immune System Problems

Certain inherited conditions cause children to be born with immune system problems. These include:

• Ataxia-telangiectasia
• Wiskott-Aldrich syndrome
• Bloom syndrome
• Shwachman-Diamond syndrome

Along with an increased risk of getting serious infections from reduced immune defenses, these children might also have an increased risk of leukemia.

Lifestyle-Related Risk Factors

Smoking, being overweight, consuming excessive amounts of alcohol, and being exposed to the sun too much are all lifestyle-related risk factors for several adult malignancies. However, they are unlikely to have an impact on the majority of children malignancies. These types of characteristics are significant in many adult cancers.

Although not all studies have established a correlation, some have suggested that a pregnant woman who drinks a lot of alcohol may put her unborn child at risk for leukaemia.

Environmental Risk Factors

Environmental risk factors are influences in our surroundings, such as radiation and certain chemicals that increase the risk of getting diseases such as leukemias.

Radiation Exposure

Exposure to high levels of radiation is a risk factor for childhood leukemia. Japanese atomic bomb survivors had a greatly increased risk of developing AML. If a fetus is exposed to radiation within the first months of development, there may also be an increased risk of childhood leukemia, but the extent of the risk is not clear.

The possible risks from fetal or childhood exposure to lower levels of radiation, such as from x-ray tests or CT scans, are not known for sure. Some studies have found a slight increase in risk, while others have found no increased risk. Any risk increase is likely to be small, but to be safe, most doctors recommend that pregnant women and children not get these tests unless they are absolutely needed.

Exposure to Chemotherapy and Certain other Chemicals

Children and adults treated for other cancers with certain chemotherapy drugs have a higher risk of getting a second cancers, usually AML, later in life. Drugs such as cyclophosphamide, doxorubicin, etoposide, and teniposide have been linked to a higher risk of leukemia. These leukemias usually develop within 5 to 10 years of treatment, and they tend to be hard to treat.

Exposure to chemicals such as benzene (a solvent used in the cleaning industry and to manufacture some drugs, plastics, and dyes) may cause acute leukemia in adults and, rarely, in children. Chemical exposure is more strongly linked to an increased risk of AML than to ALL.

A number of studies have discovered a potential connection between pesticide exposure in the home during pregnancy or the early years of life and childhood leukaemia. There may be a higher probability among moms who are exposed to pesticides at work before giving birth, according to some research.

Immune System Suppression

Children who are getting intensive treatment to suppress their immune system (mainly children who have had organ transplants) have an increased risk of certain cancers, such as lymphoma and ALL.

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.

Many lifestyle-related factors have been linked to colorectal cancer. In fact, more than half of all colorectal cancers are linked to risk factors that can be changed. These include:

• Being overweight or obese
• Diabetes mellitus, Type 2
• Certain types of diets – A long-term diet that’s high in red meats (such as beef, pork, lamb, or liver) and processed meats (like hot dogs and some lunch meats) raises your colorectal cancer risk.
• Having a low blood level of vitamin D may also increase your risk.
• Smoking
• Alcohol use

If you are overweight or obese (very overweight), your risk of developing and dying from colorectal cancer is higher. Being overweight raises the risk of colorectal cancer in people, but the link seems to be stronger in men. Getting to and staying at a healthy weight may help lower your risk.

People with type 2 diabetes mellitus are more likely than people who don’t to develop colorectal cancer. Researchers suspect that this higher risk may be due to high levels of insulin in people with diabetes mellitus. Both type 2 diabetes and colorectal cancer share some of the same risk factors (such as being overweight and physical inactivity). But even after taking these factors into account, people with type 2 diabetes still have an increased risk. They also tend to have a less favorable prognosis (outlook) after diagnosis.

Cooking meats at very high temperatures (frying, broiling, or grilling) creates chemicals that might raise your cancer risk.

Following a healthy eating pattern that includes plenty of fruits, vegetables, and whole grains, and that limits or avoids red and processed meats and sugary drinks probably lowers risk.

People who have smoked tobacco for a long time are more likely to develop and die from colorectal cancer than people who don’t smoke. Smoking tobacco also increases the risk for people to develop colon polyps. Smoking is a well-known cause of lung cancer, but it’s linked to a lot of other cancers, too.

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

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

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:

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:

Emotional support and coping strategies for breast cancer patients

1. Dealing with Emotions

After learning that you have breast cancer, one can feel bad, this should not be the case, there is no right or wrong way to feel. Numerous feelings, such as fear, shock, and rage, as well as disbelief, melancholy, and numbness, are likely to pass through you.

Your feelings could fluctuate hourly or even from day to day. It is usual to experience moments of deep depression followed by upbeat moments. After receiving a diagnosis, the days and weeks that follow can be extremely emotional and difficult.

To cope with this situation, try to do the following:

• Think about how you coped with previous trauma or stress – you could try using these methods again now
• Use your breast care nurse – they can help you understand your diagnosis and treatment options and support you during your treatment and beyond
• Be kind to yourself – it may help to take time to rest, eat healthily, keep active and, when you can, do something you enjoy
• Talk to family and friends about how you’re feeling – you might like to read our tips on telling family and friends about your cancer, in section 4 of this page

• Fear and Worry

It’s scary to learn that you have cancer. You may be afraid or worried about:

• being in pain, either from the cancer or the treatment
• feeling sick or looking different as a result of your treatment
• taking care of your family
• paying your bills
• keeping your job
• dying

Some fears about cancer are based on stories, rumors, or wrong information. To cope with fears and worries, it often helps to be informed. Most people feel better when they learn the facts. They feel less afraid and know what to expect. Learn about your cancer and understand what you can do to be an active partner in your care.

Stress and Anxiety

It is normal to feel stressed about all the changes you are going through in your life both during and after treatment. Many people experience confusion or tension due to things like:

• If tests and treatments will be covered by insurance
• Where to go for emotional assistance
• How to obtain assistance with daily tasks
• How cancer may impact their employment obtaining transport to and from treatment sessions

Your body may not heal as effectively as it should due to stress. Being proactive and discussing difficulties like those mentioned above at the beginning of treatment is crucial.

Sadness and Depression

Many cancer patients experience sadness. They experience a sense of loss regarding their health as well as the life they led before to learning they had the condition. Even after the treatment is over, one can still feel depressed. This is a typical reaction to any severe sickness. Working through and accepting all of the changes that are occurring could take some time.

One can feel exhausted, have little energy, or not want to eat while depressed. These emotions may fade or weaken with time for some people. However, these feelings could intensify for certain people. The unpleasant emotions persist and interfere with day-to-day existence.

Depression can be treated. Below are common signs of depression. If you have any of the following signs for more than 2 weeks, talk to your doctor about treatment. Be aware that some of these symptoms could be due to physical problems, so it’s important to talk about them with your doctor.

Emotional signs:

• feelings of sadness that don’t go away
• feeling emotionally numb
• feeling nervous or shaky
• having a sense of guilt or feeling unworthy
• feeling helpless or hopeless, as if life has no meaning
• feeling short-tempered, moody

If your doctor thinks that you suffer from depression, they may give you medicine to help you feel less tense. Or they may refer you to other experts. Don’t feel that you should have to control these feelings on your own. Getting the help you need is important for your life and your health.

Guilty

If you feel guilty, realize that you’re not alone. Many individuals who have cancer do. Sometimes, people hold themselves responsible for:

• Disturbing the people they care about.
• Having the impression that they’re a burden.
• Missing a day of work.
• Having to pay for the price of cancer treatment.
• Being ashamed of feeling envious of other people’s wonderful health.
• Making decisions that they believe may have contributed to cancer.

Remember that having cancer is not your fault. No one knows why some people get cancer while others don’t. It may help you to share your feelings with someone. Let your doctor know if you would like to talk with a counselor or go to a support group

Cancer is the name given to a collection of related diseases. In all types of cancer, some of the body’s cells begin to divide without stopping and spread into surrounding tissues.

Cancer can start almost anywhere in the human body, which is made up of trillions of cells. Normally, human cells grow and divide to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place.

When cancer develops, however, this orderly process breaks down. As cells become more and more abnormal, old or damaged cells survive when they should die, and new cells form when they are not needed. These extra cells can divide without stopping and may form growths called tumors.

Many cancers form solid tumors, which are masses of tissue. Cancers of the blood, such as leukemias, generally do not form solid tumors.

Cancerous tumors are malignant, which means they can spread into, or invade, nearby tissues. In addition, as these tumors grow, some cancer cells can break off and travel to distant places in the body through the blood or the lymph system and form new tumors far from the original tumor.

Unlike malignant tumors, benign tumors do not spread into, or invade, nearby tissues. Benign tumors can sometimes be quite large, however. When removed, they usually don’t grow back, whereas malignant tumors sometimes do. Unlike most benign tumors elsewhere in the body, benign brain tumors can be life threatening.

Differences between Cancer Cells and Normal Cells

Cancer cells differ from normal cells in many ways that allow them to grow out of control and become invasive. One important difference is that cancer cells are less specialized than normal cells. That is, whereas normal cells mature into very distinct cell types with specific functions, cancer cells do not. This is one reason that, unlike normal cells, cancer cells continue to divide without stopping.

The cancer burden is rising globally, exerting significant strain on populations and health systems at all income levels. In Kenya, cancer is the 3rd leading cause of death after infectious and cardiovascular diseases. The International Agency for Research in Cancer (IARC) GLOBOCAN report for 2018 estimated 47,887 new cases of cancer annually with a mortality of 32,987.

This represents close to 45% increase in incidence compared to the previous report that estimated 37,000 new cancer cases annually with an annual mortality of 28,500 in 2012. Breast, cervix uteri, oesophagus, prostate and colorectum are the leading types of new cancer cases in both males and females across all ages, with oesophageal cancer being the leading cause of cancer deaths, followed by cervical cancer and then breast cancer.

It is sad to note that 70-80% of cancer patients in Kenya are diagnosed at an advanced disease when it is not amenable to cure. Cancer is a critical global health and human issue. Today, 9.6 million people each year will die from cancer. This number is predicted to almost double by 2030; making it the second-deadliest disease. 70% of cancer deaths occur in low-to-middle income countries. Less than 30% of low income countries have cancer treatment services available (compared to 90% in high-income countries).

Up to 3.7 million lives could be saved each year through resource appropriate strategies for prevention, early detection and timely and quality treatment. Yet, at least one third of cancers can be prevented. This is part of the justification to improve the face of health in our society by creating cancer awareness and early detection through screening and healthy lifestyles modifications towards a cancer free society.

What is Cervical Cancer?

Cervical cancer begins in the cells of the cervix. The cervix is the bottom, narrow end of the uterus (womb). The cervix joins the uterus and the vagina (birth canal). Cervical cancer typically grows slowly over time. Before cancer develops in the cervix, the cells undergo a process called as dysplasia, during which aberrant cells grow in the cervical tissue. If the abnormal cells are not killed or eliminated, they may develop into cancer cells that proliferate and spread deeper into the cervix and surrounding tissues.

KEY FACTS

• Cervical cancer is the fourth most common cancer in women globally with around 660 000 new cases and around 350 000 deaths in 2022.
• Cervical cancer is caused by persistent infection with the human papillomavirus (HPV).  Women living with HIV are 6 times more likely to develop cervical cancer compared to women without HIV.
• Prophylactic vaccination against HPV and screening and treatment of pre-cancer lesions are effective strategies to prevent cervical cancer and are very cost-effective.
• Cervical cancer can be cured if diagnosed at an early stage and treated promptly.
• In Kenya, Cervical cancer contributes approximately 12% of all cancer cases diagnosed in Kenya, and is the leading cause of cancer mortality in Kenya, with an estimated 3,200 deaths every year.

What Causes Cervical Cancer?

Human papillomavirus (HPV) is a common sexually transmitted infection that can affect the skin, genitals, and throat. Almost every sexually active person will become infected at some point in their lives, generally without symptoms. In most situations, the immune system removes HPV from the body. Persistent infection with high-risk HPV can cause abnormal cells to grow, eventually leading to cancer. Persistent HPV infection of the cervix leads to 95% of cervical malignancies if not treated. It typically takes 15-20 years.

Risk Factors for Cervical Cancer

• Multiple sexual partners
• Having sex at early age
• Sexually transmitted infections such as chlamydia, gonorrhea, syphilis and HIV/AIDS

Prevention

Increasing public knowledge and access to information and services are critical to prevention and control throughout the life cycle.

1. Vaccination between the ages of 9 and 14 is highly successful in preventing HPV infection, cervical cancer, and other HPV-related malignancies.
2. Screening begins at the age of 30 (25 years in women living with HIV) and can detect cervical illness, which, when treated, avoids cervical cancer.
3. Regular pap smear tests to detect the cancerous conditions of the cervix after 35 years
4. Safe sexual practices such as using condoms
5. Avoid smoking

HPV vaccination and other prevention steps

As of 2023, there are 6 HPV vaccines available globally. All protect against the high-risk HPV types 16 and 18, which cause most cervical cancers and have been shown to be safe and effective in preventing HPV infection and cervical cancer.

As a priority, HPV vaccines should be given to all girls aged 9–14 years, before they become sexually active. The vaccine may be given as 1 or 2 doses. People with reduced immune systems should ideally receive 2 or 3 doses. Some countries have also chosen to vaccinate boys to further reduce the prevalence of HPV in the community and to prevent cancers in men caused by HPV.