Aged 55 years, Nancy Wanjiku Karuga was running a modest fruit vending business, had grown-up children and a home to herself and her husband. She was all set for a relaxed retirement life. Then one morning as she was dressing up, she noticed a lump on her right breast. It was painless and she had not seen it before.
“At that time I had been experiencing tiredness and sleepiness. That prompted me to go to hospital where the doctor recommended that I get the lump checked,” says the mother of four. That was in November 2009 and in June 2010 she was diagnosed with breast cancer stage two after undergoing numerous tests.
She immediately had a mastectomy at Kenyatta National Hospital, a procedure that cost Sh24,000, followed by chemotherapy for 10 months and then 25 sessions of radiotherapy. All along, her husband stood by her, encouraging her and cheering her up when the treatment took a toll on her.
She thought the worst was over until April 2014 when she lost her husband who had been her biggest support system to throat cancer and her first-born daughter in November the same year to pregnancy-related complications. Though treatment was lifesaving it also changed her life. “My right hand was left weak due to the nerve endings and blood vessels affected during surgery. I cannot perform any tedious tasks,” she says. Initially, clothes sagged awkwardly due to the imbalance caused by the mastectomy. She had heard of mastectomy bras and breast prosthesis but did not know where to get them. Through donations, Nancy has been able to access two mastectomy bras.
Breasts are considered a big part of a woman’s sexuality. Unfortunately, for many survivors prosthetic bras are not easily accessible since they are not readily available and are costly. On average breast prosthesis costs between Sh2,000 and Sh5,000 .
According to Dr Karen Mbaabu, General Surgeon Mater Hospital, mastectomy at times involves removal of lymph nodes situated in the armpits. Removal of lymph nodes has the effect of disrupting the flow of lymphatic fluid causing swelling of the affected arm, a condition known as lymphedema. Ordinarily cancer mostly spreads through the lymphatic fluids. The surgery gets rid of the affected, lymph nodes to curb the spread of the disease,” she says.
Though not common in Kenya, the standard care for breast cancer patients involves undergoing a reconstructive surgery after the mastectomy. “For purpose of functionality and mental wellbeing, the breast reconstruction is important. But the problem is that locally the procedure is considered cosmetic; one meant to improve appearance and is not supported by insurance companies,” she says.