The brave smilers: Life with cancer

When she was diagnosed with breast cancer 11 years ago, Oda Nsabimana, 52, says it seemed like the worst thing that would ever happen to her in life. “Before, the only killer disease my head would ever imagine was HIV/Aids. Then, one time I watched a doctor on TV educating women about how to examine breast cancer through massaging their breasts and feeling if there is a lump, it’s effects and how it can be dangerous and a quick under taker and I quickly thought I should go for a check-up,” she narrated. It’s then that Nsabimana tried to practice what she had just learned and to her dismay, she felt the lump in her left breast. Nsabimana had always been someone that was cautious about her health and took it very seriously. “I went to Rwandex for check-up and they found me positive. It was like the world had fallen on me at that moment. Everything stood still and all I could do was go to Zion Temple and pray asking God why he had choosen me of all people,” she said. Nsabimana was an entrepreneur and the breadwinner of her family as her husband had no job at the time and she had to stand up to this hard test. “I told my husband that we had to sell some of the little we had for me to go for further treatment in Agha Khan Hospital in Nairobi where I would get the kind of treatment that wasn’t available in Rwanda during those days,” she says. This was an easy decision for her husband and children to make but not the same story for their extended family, that called her selfish and wanting to leave behind beggars particularly her husband’s relatives. Her treatment included chemotherapy, surgery and radiation. Toward the end of her first round of chemo, she felt very tired. “They gave me another chemo drug that made me feel like I had flue. I kept strong and tried so hard to move through all this but the one incident that made me almost feel like giving up was when I lost my hair,” she said melancholically. Nsabimana also discovered that the Government of Rwanda had set up an organisation to give support to cancer patients. “They where very supportive and helped us with a lot of things that we couldn’t afford and they helped everyone. They gave up hair-loss products and different products to women dealing with cancer,” she says. Among all this, Nsabimana had a young child of two and an older one aged 12. Young as they were, they got so frightened seeing their mother weak and sickly. “I had to stay strong and look strong for them. They were my family and they depended on how strong I was so I didn’t want to let them down. Sometime they thought I wasn’t going to make it to the following day. Later they accepted it and their strength and trust in me has made me strong to,” she says. But the biggest support she received,was from the government, her family, community and church. Friends cooked meals for her family, asked her out to lunch and celebrated milestones. “I continued to make trips to Nairobi for treatment and never at one moment did I think I should give up, not when I still have a family that still needs me and more days to smile at,” she narrated with hope. Nsabimana has also gone to Belgium and China for routine checkups and treatment. Part of her treatment fees was paid by the government. She says the experience has helped her realise that people can’t keep being sad in life, especially about things they can’t change. “Much as cancer doesn’t catch everyone, I do strongly advise young women to always try their best to always check for signs of cancer, visit the doctor in case they feel anything awkward and never wait a day. Most women wait until it’s too late and then it’s more dangerous,” she says. Last year was Nsabimana’s tenth anniversary and she is very optimistic of many more to come in future with good health and shape. Yesterday, June 1, 2014, cancer survivors across the globe united to show the world what life after cancer looks like. This unique celebration marked the 27th annual National Cancer Survivors Day. Thousands of people in hundreds of communities across the globe hold celebrations on this day to honor cancer survivors and to show that there is life after a cancer diagnosis – and it’s something to celebrate. National Cancer Survivors Day is an annual worldwide Celebration of Life. It is the one day each year that we come together to honor everyone who is living with a history of cancer – including the millions cancer survivors. “A ‘survivor’ is anyone living with a history of cancer – from the moment of diagnosis through the remainder of life,” according to the National Cancer Survivors Day Foundation, administrator for the celebration. NCSD provides an opportunity for cancer survivors to connect with other survivors, celebrate milestones, and recognise the healthcare providers, family, and friends who have supported them along the way. It is a day for cancer survivors to stand together and show the world what life after cancer looks like. Rwanda and the cancer burden The burden of cancer in low-income countries is staggering. More than two-thirds of all cancer deaths occur in low- and middle-income countries, according to the World Health Organisation. Last year, government opened Butaro Ambulatory Cancer Centre, which augments existing oncology services offered at Butaro Hospital. Cancer is an emerging public health concern in Africa, with the International Agency for Research on Cancer figures showing that about 542,000 cancer deaths occurred in 2008 on the continent. The figure is projected to nearly double (970,000 cancer deaths) by 2030, as many people adopt behaviour and lifestyles associated with economic development, such as smoking, unhealthy diets, and physical inactivity. “Analysis of facility-based cancer registries in Rwanda from 2007 to 2013 revealed a total of 5,430 cancer cases registered in the country, among which 360 were in children ages 15 and younger,” Dr Leonard Kayonde, director of cancer diseases at the Rwanda Biomedical Centre, told The Rwanda Focus in March. With improved provider knowledge of treatment options and referral rates, the number of identified cancer cases is expected to increase. Currently, 68.5 per cent of cancer cases are confirmed microscopically, and cancer related mortality is estimated around 9.6 per cent in Rwanda. Breast and cervical cancers are the most invasive in Rwandan women, affecting 32 per cent of all women diagnosed with cancer. “Cancer is a major public health concern in Rwanda due to its prevalence, morbidity, and mortality. The national cancer epidemic is huge and set to rise to more than 100 cases per month,” Dr Kayonde saidt. Dr Fidel Rubagumya, in an opinion published in The New Times in March, said the reality of cancer presents a significant threat to everyone regardless of age. At the 6th Annual Scienfitic Conference organised by the Rwanda Surgical Society to discuss progress and findings from researches done in different hospitals in November, last year, Dr Emile Rwamasirabo, the head of surgeons in Rwanda, said non-communicable diseases are increasingly becoming a major cause of morbidity and mortality in the country, adding that the major problem in management of cancer is lack of surgeons in different specialties of surgery. Dr Pacifique Mugenzi, an oncologist at Rwanda Military Hospital, Kanombe, said cancer treatment modalities revolve around surgery. “Cancer surgery is an operation to repair or remove part of your body to diagnose or treat cancer. This, in most cases, is accompanied by other treatments such as radiation, chemotherapy, hormone therapy and biological therapy,” Dr Mugenzi said. He said there is currently limited number of oncologists in the country but a good number are undergoing training.

Insight

The brave smilers: Life with cancer