My name is Mary Wanja Njenga. I am aged 51, am a mother of two, and, most importantly, a breast cancer survivor. This is a story of hope, faith and acceptance. Above all, it is a story of human triumph against adversity.
I tell it now because the time is opportune. Usually, I don’t like dwelling on the past, not because I find it painful, but because I have learnt that living in the present is more joyful.
I revisit the past in the hope that it will inspire you to take charge of your health, and also to show you that the body can repair itself from just about anything, if given what it needs.
I was born in 1966 in Kitale in Cherengany, Trans-Nzoia District, to a family of nine siblings. I was the seventh, but my father, Godfrey Njenga, died when I was a young child, and so I was brought up by my mother, Edith Wangari.
I attended Makutano Primary School in Kitale up to Standard Four and then, in 1978, we moved to Kahawa West, Nairobi, where we settled at a small, dusty place called Kamae.
I enrolled at Mahiga Primary School where I sat my national examination in Standard Seven and joined Gathungururu Girls’ School in Nyeri.
Due to financial difficulties, I was transferred to Kamiti Secondary School while in Form Three, but dropped out altogether shortly afterwards as Mum could not afford to keep me in class.
One thing led to another, and in 1986 I gave birth to my firstborn, a baby girl, got married later, in 1989, and landed a temporary job at Kahawa Sukari, where I worked until 1993.
After marriage, I miscarried twice before I was eventually blessed with a baby boy in 1996. I miscarried twice again after my son was born. And then, as fate would have it, my husband and I separated in 2001 and I went back home.
Mum could shelter me, but I had to do casual jobs to support my two children. When my husband and I separated, my firstborn was in Form One at St George’s School in the city. She went on to join the University of Nairobi and graduated in 2009. My son joined Njumbi High School and sat his exams in 2015.
But two years before he sat his exams, I had noticed something was not well with me. I had, for some time, been suffering from chest problems and coughing, but a small lump in my breast ushered in new worries. At the time I did not know anything about cancer, so I did not take the swelling seriously.
Unknown to me, that small, seemingly harmless lump would change my life forever.
Nudged by friends and a desire to know what was growing inside my breast, one day I made my way to Kenyatta National Hospital, but for six months I could not get a doctor to conduct a biopsy because of a long waiting list.
When my day eventually came, they said the lump was not cancerous, so I should just ignore it and go on with my life. But one day in December 2014, I felt a sharp pain in my breast and every time I tried to bend the pain recurred. My daughter, alarmed, insisted that I seek medical attention without any further delay.
Though she did not want me to worry, she told me she had read the story of a woman with similar symptoms whose lump had turned out to be cancerous. And so, in January 2015, I went to Kijabe Mission Hospital. The biopsy, again, did not turn positive for cancer.
I sought a second opinion at another hospital in Nairobi and a mammogram was inconclusive. In February, I went to back Kijabe Mission Hospital for another biopsy, and this time it revealed the presence of cancer cells in my breast.
The good news was that detection had come early, so treatment was easy, but there was one more hurdle to jump; the operation would cost Sh60,000, and I had no means of raising such a huge amount within a week.
I was introduced to a woman at the hospital who asked me to raise Sh20,000, and when I eventually reported for surgery, I learnt that the full surgical bill of Sh60,000 had been paid in advance by Dr Peter Bird, Chief of Surgery at the hospital.
I cried in disbelief. Since it was too late for admission, we spent the night outside the hospital and my operation was carried out the next day. It was a mastectomy, meaning removal of the entire breast. The operation was successful and, seven days later, I was discharged.
After the wound healed, I visited several medical facilities in search of affordable chemotherapy, a cancer treatment that uses chemical substances, and which is usually very expensive.
After an extensive search in both public and public hospitals, I ended
up at St Mary’s Hospital in Lang’ata, Nairobi. The rates were affordable and with the help of my cousins, friends and my children, we managed to raise the money required for six sessions as recommended before commencing radiotherapy.
Financially exhausted and with no other option, I went back to Kijabe to share the predicament with Dr Bird. He gave me a letter addressed to Aga Khan Hospital in Nairobi, where I was offered treatment at subsidised rates. My daughter took out a bank loan of more Sh100,000 to finance the treatment. My family, at this point, was at its lowest, but we kept our hopes high.
But, just when all seemed well, I suffered another setback during radiotherapy after I developed a wound on the affected breast.
Since the wound was very painful, doctors decided to suspend therapy to allow it to heal.
I was helpless and in despair, and for the first time since my diagnosis, I thought I was not going to make it.
My son was my caregiver at the time, diligently cleaning the wound every day. Eventually, I resumed radiotherapy and finished the sessions.
Weakened by my physical and medical condition, out of work for prolonged periods of time and with limited finances, life became almost unbearable.
My daughter was servicing the loan she had taken to finance my treatment and my son was in school. Life was hard and I lost many friends during this period because most assumed I was going to die.
HELP WAS SCARCE
Help was scarce, but I am deeply indebted to my children Caroline Wangari and Ian Gachui for the help they gave me, my cousins, especially Njoroge Njihia and Ngige Kang’ethe, and members of St Peters & Paul Catholic Church Kiwanja, Marengeta.
My bosses at Kenyatta University, where I work as a casual labourer, were also very supportive and followed my health progress with keen interest. My employer allowed me to resume work after recovery, and now I work in the university kitchen, mainly cooking chapatis and doing other light duties.
And I am cancer-free!
What have I learnt from all this? That without God and support from those close to you, it is difficult to fight the disease. Accepting that you have it is the first step to healing, and then seek professional medical advice. Follow up on your physician’s appointments and instructions, and be careful with advice that may derail you from this.
Do not hide your condition from people as those with information that may be helpful cannot share it if they do not know you need it.
And do not worry about those who distance themselves from you. Instead, open up to those who care to listen to, and walk with, you.
Guide to breast self-examination
By Prof Ronald Wasike
Consultant Breast Surgeon
Aga Khan University Hospital
Breast cancer constitutes 20 per cent of all cancers affecting women in Kenya, with 4,465 new cases and 1,969 deaths reported every year, according to Globocan statistics 2012-2014.
The disease, though found in both sexes, affects women more, with less than 10 per cent of patients being men.
However, these numbers can be reduced with increased awareness, including simple interventions like performing self breast examinations to identify unusual signs in the breast at the early stages and seek treatment in good time.
At what age should one perform self breast examination, and why? If you are a woman aged 20 and above, it is important to take just a few minutes each month to examine your breasts and ensure they are healthy.
Regular examination will enable you identify any alarming changes in the breast early. If treatment is needed, it can be started as soon as possible to ensure better outcomes.
In most cases the problem may be a cyst or a small growth that can be dealt with easily. If it is cancer, then early detection gives a greater chance of effective treatment and cure.
When should I examine my breasts? You need to examine your breasts at the same time each month as they will change in shape and feel different during your monthly cycle. One to two weeks following your monthly period is the best time.
If you have reached menopause, the examination could be done on the first day of each calendar month.
During the first examination, you should note the normal size and shape of each breast, its feel (one being larger or higher than the other is normal) and the position of the nipples. Knowing your body well makes it easier to spot any changes.
How should my breasts feel? Many women who have not reached menopause have rather lumpy breasts just before their periods and for some women, this may persist for the whole month. In such cases, it becomes easier to detect any unusual lumps during examination.
Lie down comfortably on a flat surface with your head on a pillow and slightly raise the side that you are examining. Use your right hand to examine your left breast and vice versa. Examine one breast at a time.
With your left shoulder raised, feel your left breast using the three middle fingers of your right hand. Keep your fingers flat and close together; start from the collar bone above your breast, pressing the breast gently but firmly towards the body, tracing a continual spiral.
Move your fingers in small circles, working right around the outside of the breast.
Continue to work systematically over the whole surface of the breast, checking for any lumps.
Now place your arm comfortably above your head with elbow bent and carefully repeat the examination of the whole breast, paying attention to the outer part which can now be felt with more certainty.
You may find a ridge of half-moon shaped firm tissue under your breast, this is normal as this tissue helps to support the breast.
Finally, examine the tail of the left breast ensuring that you go right up into the hollow of the armpit.
Now repeat the same for the right breast. If you think you have found something wrong, or if there is a noticeable change since the last examination, consult your doctor without delay, it does not matter how uncertain you are. Take note of the change since the last examination or the location of the just identified lump, but leave it alone until you see the doctor. Most lumps are not cancerous. If the lump is cancerous, it can be treated early enough, sometimes even without requiring mastectomy, but breast conservation surgery.
What other warning signs should I look out for during examination? Unusual difference in size or shape of the breast, alteration in the position of either nipple, dimpling of the skin surface, unusual rash on the breast or nipple, unusual discharge from the nipple, unusual discrete lump or nodule in any part of either breast.
The risk factors
Every woman wants to know what she can do to lower her risk of breast cancer. Some of the factors associated with the disease — sex, age, and genetics, for example — can’t be changed, but other factors — being overweight, lack of exercise, smoking cigarettes, and eating unhealthy food — can be overcome by making personal choices. By choosing the healthiest lifestyle options possible, you can empower yourself and make sure your breast cancer risk is as low as possible.
Sex: Just being a woman is the biggest risk factor for developing breast cancer.
Age: As with many other diseases, your risk of breast cancer goes up as you get older. About two out of three invasive breast cancers are found in women 55 or older.
Family history: Women with close relatives who have been diagnosed with breast cancer have a higher risk of developing the disease. If you have had one first-degree female relative (sister, mother, daughter) diagnosed with breast cancer, your risk is doubled.
Genetics: About five per cent to 10 per cent of breast cancers are thought to be hereditary, caused by abnormal genes passed from parent to child.
Personal history: If you’ve been diagnosed with breast cancer, you are three to four times more likely to develop a new cancer in the other breast or a different part of the same breast. This risk is different from that of the original cancer coming back.
Radiation: If you had radiation to the chest to treat another cancer, such as Hodgkin’s disease or non-Hodgkin’s lymphoma, you have a higher-than-average risk of breast cancer. If you had radiation to the face at adolescence to treat acne, you are at higher risk of developing breast cancer later in life.
Breast changes: If you’ve been diagnosed with certain benign (not cancerous) breast conditions, you may have a higher risk of breast cancer.
Being overweight: Overweight and obese women have a higher risk of being diagnosed with breast cancer compared to those who maintain a healthy weight, especially after menopause. Being overweight can also increase the risk of the breast cancer coming back in women who have had the disease.
Pregnancy history: Women who have not had a full-term pregnancy or have their first child after age 30 have a higher risk of breast cancer compared to women who gave birth before age 30.
Breastfeeding history: Breastfeeding can lower breast cancer risk, especially if a woman breastfeeds for longer than one year.
Menstrual history: Women who started menstruating younger than age 12 have a higher risk of breast cancer later in life. The same is true for women who get into menopause when they are older than 55.
Drinking alcohol: Research consistently shows that drinking alcoholic beverages — beer, wine, and liquor — increases a woman’s risk of hormone-receptor-positive breast cancer.
Dense breasts: Research has shown that dense breasts can be six times more likely to develop cancer and can make it harder for mammograms to detect the disease.
Smoking: Smoking causes a number of diseases and is linked to a higher risk of breast cancer in younger, pre-menopausal women. Research has also shown that there may be a link between very heavy second-hand smoke exposure and breast cancer risk in post-menopausal women.