Nyong’o: My battle with prostate cancer

When were you diagnosed with prostate cancer and what was your reaction?
I was diagnosed in July 2010. My first reaction was shock of course, but then I had been following the rise of my (Prostate-specific Antigen) PSA for some time.

I was also rather angry because I thought I should have done the biopsy much earlier to reduce the risk of the cancer going to its secondary stage.

My doctor immediately put me on hormone therapy to stop the spread while awaiting further treatment.

Fortunately, further examinations in the US showed that the cancer was still confined to the prostate capsule so I could go through intensity modulated radiation therapy (a type of external beam radiation therapy) successfully and be cured.

Would it be timely for Members of Parliament to discuss the Cancer Control Bill ahead of the UN non-communicable diseases summit in September this year?

I think it is very important that Parliament should pass the Cancer Control Bill very soon, and I hope the House committee on Health will press for this since the Bill is ready.

What is your message to Kenyans as they mark World Cancer Day today (Thursday)?

Kenyans should remember their many compatriots who have cancer and are unable to get treatment because of poverty, lack of facilities or simply not knowing what to do.

Technology and knowledge exist globally to save the lives of our people if only we can resolve as a nation to ensure that all of us have access to quality and affordable health care.

What is the progress of your treatment?

I feel confident that I am conquering the beast. Eighty per cent of the radiation sessions, which I do for 20 minutes every day from Monday to Friday as an outpatient, are already behind me, and with minimal side effects. I will be home soon by the grace of God.

What gaps exist in Kenya in diagnosing, treatment and management of prostate cancer?

First, prevention requires awareness at the personal, societal and government level.

Individual men and their families should be aware that men over the age of 45 are likely to get prostate cancer depending on their family history, diet and lifestyle.

As such men, and families for that matter, should have healthy diets, avoiding red meat and fatty foods, and depending more on vegetables, fruits, fish and tubers. Smoking is also dangerous.

As a whole people should lead a balanced life, with plenty of exercise and leisure time.

But where poverty is rampant, all this becomes problematic.

The Government should make it a mandatory health requirement for men over 45 to have their PSA levels tested regularly so that the disease can be caught early.

Second, we require nurses, clinical officers and urologists who can diagnose prostate cancer and advise on proper treatment. Proper diagnostic equipment is also a must.

At the moment, these are extremely few, and very often diagnosing prostate cancer is done mainly at our national referral facilities, provincial government hospitals and private hospitals.

As we move towards decentralising health care in line with the Constitution and devolved government, such services should be available at the district and sub-district levels.

Third, treatment of prostate cancer is the most vexing problem. Public hospitals are extremely short of the specialists and equipment needed.

How is prostate cancer treated?
Before starting treating prostate cancer, an oncologist will need to know if its in the primary, secondary or very advanced level. This is done by assessing the extent of the presence of cancer cells using Gleason Scores (GS), which range from 2 to 10.

A GS of 3 would mean very primary cancer still confined to the prostate capsule; one of 4 to 7 would mean a secondary growth requiring attention, and anything above that could have grown beyond the prostate gland and into the rest of the body.

The four main ways of treating prostate cancer are: radical prostatectomy (surgery); external beam radiation therapy; brachytherapy, or radioactive seed implants; and hormone ablation therapy (HAT) where one or more hormones are used to shut down the production of male hormones, such as testosterone, that feed the cancerous cells.

When starved, the cells shrink and eventually die. Depending on the stage of the cancer, the doctor could decide to use one or a combination of these treatments.

We have not invested enough in the purchase of equipment and the training of enough specialists to undertake these treatments in Kenya. Treatment abroad is very expensive.