How I overcame fear and stigma to win battle against breast cancer

Woman hand checking lumps on her breast for signs of breast cancer. [Courtesy/iStock) In 2020, as Emmy Angeeyo, 29, prepared to welcome her baby into the world, she noticed something unusual-a tiny bump on her nipple. It seemed insignificant, even the doctors dismissed it. But as her newborn struggled to breastfeed, her concern grew. What she initially ignored turned out to be a life-changing diagnosis. Today, Emmy stands as a survivor, holding onto the belief that she will heal completely. "I remember it as if it were yesterday, the year I was about to give birth to my first child. That's when I noticed a small, painless pimple on my nipple. Since I was pregnant, I didn't think much of it, and neither did the doctors," Emmy recalls. A week later, she gave birth via Cesarean Section. Everything seemed fine until she realized her newborn was unable to breastfeed her -nipple wouldn't protrude. "I asked the doctors about it, but they reassured me it was normal and would resolve in a few days. As a first-time mother, I trusted their advice," she says. Following their recommendations, Emmy applied warm compresses morning and evening. But after two weeks, nothing changed. The bump had grown larger -and now it was painful. For three months, she continued the prescribed remedies with no improvement. Eventually, she returned to the hospital, insisting on further examination. Since breastfeeding on the affected side was impossible, she relied on one breast to feed her baby, though the milk supply was insufficient. For two years, Emmy lived with the unexplained condition until 2022, when she was referred for a biopsy at a facility in Nairobi. The results confirmed her worst fears - breast cancer. "I was devastated. I had always thought cancer was a death sentence. I had lost my cousin to it within a year, so I believed I wouldn't survive," she says. Dr Lalit Varadpande, a medical oncologist at RFH Cancer Center in Ruai, Nairobi, explains that in countries with established screening programs, most breast cancer cases are diagnosed early when the patient is asymptomatic. However, in Kenya, due to the lack of robust screening, many women only seek medical attention when they notice advanced symptoms. "Common symptoms include a hard, usually painless lump in the breast. Advanced signs may involve axillary adenopathy (enlarged lymph nodes) or skin changes such as redness, thickening, or dimpling (peau d'orange), which could indicate inflammatory breast cancer," he explains. Dr Varadpande adds that metastatic breast cancer can affect various organs, with symptoms depending on the site of spread. Bone involvement causes back or leg pain, liver involvement leads to abdominal pain and jaundice, while lung involvement may result in breathing difficulties. Risk factors include increasing age, sex, family history, genetic mutations, early menstruation, late pregnancy (after 35), lack of breastfeeding, obesity, alcohol consumption, and smoking. He also notes that men, though less commonly affected, can also develop breast cancer. Although doctors reassured Emmy that her cancer was at an early stage and could be managed, she struggled to believe them. "I went home filled with doubt. Then, I started losing weight, my hair began falling out, and I became weak. My nipple had healed, but these changes made me lose hope," she says. When she reported these symptoms to the hospital, doctors explained that they were expected side effects of treatment. They advised her to eat a balanced diet, avoid heavy household chores, and stay warm. Unfortunately, as her physical condition changed, stigma followed. "Friends disappeared, and even some family members abandoned me. People gossiped, saying I had HIV, while others claimed I had been bewitched. But I remained strong," she says. Today, Emmy considers herself a survivor. "I no longer let cancer control me. I take a few medications to stabilize my hormones, and my condition is under control. I've been tested, and I'm stable. I am a survivor," she declares. Dr Varadpande emphasizes that cancer survivorship begins at diagnosis. However, timely treatment remains a challenge. "Many patients struggle with completing their treatment. Even after recovery, regular follow-ups are crucial, but access remains limited. In case of a relapse, treatment options may not always be available," he notes. He also highlights the psychological impact of a cancer diagnosis, especially for patients and caregivers. "Mastectomy can affect self-esteem and intimacy, while chemotherapy-induced hair loss can lead to mental distress. However, most side effects are temporary, and breast-conserving surgeries are now routine. The fear of relapse remains a concern even after successful treatment, ". Despite advancements in cancer care, Dr Varadpande acknowledges that treatment options remain concentrated in major cities, leaving many rural patients at a disadvantage. "About 75 per cent of women seek medical help when their cancer is already in an advanced stage. There is an urgent need to improve oncology care at county-level hospitals," he urges. Emmy is encouraging more women to seek medical attention at the first sign of abnormal changes in their bodies.

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