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Palliative care for cancer patients

Dr John Weru, the first palliative medicine specialist in Kenya and leader of the Palliative Care Team at Aga Khan University Hospital . [PHOTO: COURTESY/STANDARD]

Starting in the 1990s when the first hospice was set up, palliative care in Kenya has grown over the years and now there are 45 hospital based palliative care facilities and hospices. This has been prompted by the Kenya Hospices and Palliative Care Association (KEHPCA) in partnership with other stakeholders.

According to the Centre to Advance Palliative Care (CAPC), the specialty is fast growing in the field of medicine worldwide and has many young doctors interested in pursuing the profession.

Through much advocacy and petition to the Ministry of Health and the Medical Practitioners and Dentists Board, palliative medicine was gazetted as a medical specialty in 2012.

And today, Kenya has the first palliative medicine specialist in the history of the nation, Dr John Weru, who is also the leader of the palliative care team at the Aga Khan University Hospital.

His interest in this field started immediately after completing his undergraduate studies and piqued as he learnt more about palliative care on his own, as there were no other doctors trained in the field to guide or teach him. He then went to Oxford Brookes University and the University of Dundee (both in the UK) for further studies. He also studied at the Institute of Palliative Medicine in San Diego, California.

“I grew more excited about palliative medicine. I came to realise it was an area I would find rewarding and enjoyable if I got good at it over time. I found more satisfaction in palliative care encounters with patients and became less comfortable with what I perceived as the occasional lack of holistic patient care,” says Dr Weru.

The doctor says palliative care is a medical specialty that focuses on comfort, relief of symptoms, and clarifying a patient’s treatment goals. It can be offered concurrently with other medical therapies for any seriously ill patient with any disease or condition, particularly when there are physical, psycho-social, or spiritual complications.

Fully informed

The main aim is to treat the patient’s symptoms, provide supportive care while understanding the patient’s aspirations and goals. It also ensures that patients and their families are fully informed of the diagnosis and the likely outcomes in a timely, sensitive and appropriate manner. It is about treating the patient’s pain, fatigue, nausea and vomiting, weight loss, loss of appetite and difficulty in breathing, among other conditions.

A patient diagnosed with cancer will suffer many of these symptoms and timely assessment and treatment reduces the distress these patients and their families suffer from.

Communicating with these patients and their families about the diagnosis, expected symptoms, the likely benefits or lack of the same of different treatments and the expected prognosis, forms a very crucial aspect of care. This is only possible if palliative medicine specialists are engaged as soon as the diagnosis is made.

Patients and families who have experienced palliative care say that it maximises quality of life and empowers patients and their families to make treatment decisions more in line with their hopes and values. Palliative care gives an emotional lift to providers, while reducing hospital expenses.

It is also considered an additional tool for enhancing care transitions, thus reducing hospital stays and readmission rates.

Weru says while palliative care is an incredibly intense service, it is richly rewarding.

“It allows us to give care to people living at the most vulnerable time of their lives.”

“At the Aga Khan University Hospital, palliative care services are fully accredited and offer both inpatient and outpatient care to patients in the hospital and those who are referred from other health facilities.”

The duty now for palliative medicine specialists, is to train other doctors and clinicians as this is a new medical specialty in the country, says Weru.