Awareness and Support Activities Highlight Lung Cancer Awareness Month

The AMPATH Multinational Lung Cancer Control Program (MLCCP) supported by the Bristol Myers Squibb Foundation (BMSF) carried out a series of activities during Lung Cancer Awareness month in November.

Dr. Naftali Busakhala, the principal investigator of the program, presenting to the delegates of KESHO conference on “Opportunities and challenges of lung cancer care and treatment in Western Kenya.”

The AMPATH-BMSF MLCCP program participated in an awareness drive at the University of Eldoret (UOE) grounds for students and the community and distributed information about prevention, awareness and advocacy. Information, education and communication material about lung cancer was also shared at Moi Teaching and Referral Hospital (MTRH) Chandaria Cancer and Chronic Disease Centre (CCCDC).

Prof. Lameck Oteko Diero, a co-PI of the program, presenting to the delegates on “Strengthening Lung Cancer Management Program in Western Kenya.”

The program also participated in national advocacy activities through the Kenya Society of Haematology and Oncology (KESHO) International Cancer Conference and the Kenya Lung Health Conference (KLHC) both held in Mombasa. The AMPATH-BMSF MLCCP principal investigator, Dr. Naftali Busakhala, and the co-principal investigator Professor Lameck Diero were part of the organizing committee and the leadership of KESHO and KLHC respectively. This gave the program a higher platform and the opportunity to showcase the great milestones they had made in improving and supporting the continuum of cancer care and lung health in general. Dr. Busakhala presented to the delegates on, “Opportunities and challenges of lung cancer care and treatment in Western Kenya,” while Prof. Diero shared on “Strengthening Lung Cancer Management Program in Western Kenya.” During the presentations, delegates wanted to know what was next for the lung cancer program in relation to molecular alterations/genotyping, driver mutations and new innovations in diagnosis, care and treatment.

At the Kenya Lung Cancer Conference, the discussions were focused on the need for better global health solutions taking into account the most recent science and research. The platform provided a forum to share on recent advancement in clinical practice and research in the field of lung health and respiratory medicine. The program actively participated in the conference showcasing key findings in lung health through ongoing research work.

As a culmination to the awareness month, the program brought together lung cancer patients and their caregivers through a joint support group. Support systems and complementary services improve the quality of life for lung cancer patients by providing a platform for experience sharing and encouragement throughout the care and treatment process. Patients and their care supporters form cohort groups that discuss the treatment and care journey together. Psychological counselling, nutritional support and physiotherapy sessions are also offered during these initiatives.

Support groups for patients and caregivers provide a platform to share experiences.

One of the survivors was grateful to be part of the day. “This survivorship program enlightens and encourages me. I can share so much with people who face similar challenges and learn how to navigate the side effects of the therapies and medication,” they said.

Lung cancer poses one of the greatest challenges in the overall public health. Global statistics indicate that lung is the second most common cancer with an estimated 2.2 million cases and comes first on mortality with an estimated 1.8 million deaths (GLOBOCAN 2020). It is evident that each year more people die of lung cancer than of colon, breast, and prostate cancers combined (GLOBOCAN 2020). Incidence rate of lung cancer generally remains low in Africa, for example in Kenya, it accounts for 794 cases ranking 14th among all other cancer sites with 729 deaths and at a prevalence of 1.75 per 100,000 translating to a case fatality of 92 percent (Kenya National Cancer Control Strategy-2017-2022).

Available data indicate that of the cancers being managed at MTRH Oncology clinics, lung cancer is the 5th most common cancer but with the highest mortality of an average 40 deaths per year. This accounts for 75 percent mortality per year of all primary lung cancers diagnosed which is less than the national mortality rate of 92 percent as previously indicated.

Part of the program team that attended the KESHO & KLH Conference in Mombasa

The lack of prompt intervention in lung health care leads to late-stage presentation, late diagnosis, less effective treatment interventions and poor outcomes in management of lung cancer.

“Early diagnosis of lung cancer is often missed due to lack of high index of suspicion associated with the overlapping symptomatology of lung cancer and tuberculosis (TB). There is a close co-relation as the two conditions share some identical risk factors. Lung cancer symptoms also mirror those of TB such as chronic cough with or without blood-stained sputum, chest pains, difficulties in breathing and lymph node enlargement among others,” said Lawrence Atundo, program manager for the AMPATH Lung Cancer Program.

Mr. Lawrence Atundo, the program manager, presenting to the delegates on incidences and trends of lung cancer during a conference in Mombasa.

Additionally, socio-economic challenges facing the population, lack of awareness and poor referral systems greatly interfere with the process of seeking, reaching, and receiving interventions for chronic lung conditions including lung cancer.

The AMPATH-BMSF MLCCP works with communities and the Ministry of Health to determine and mitigate some of these barriers by providing support to ensure identified clients reach, receive and are retained in lung cancer care. This includes support such as transport reimbursements, enrollment to National Hospital Insurance Fund (NHIF), diagnostic procedures and treatment initiatives.

To ensure the referral cycle is complete, the program has established a referral system with feedback mechanism from household level to tertiary facilities. This ensures all individuals identified at the household level can reach, access and receive interventions for chronic lung condition including TB and lung cancer. At the policy and advocacy level, findings of the program have been shared with the Ministry of Health. This has led to a national policy change that recommends further evaluation of patients testing negative for TB (i.e with gene X-pert), or if positive, not improving on treatment at the TB/chest clinic to establish if they could be having other chronic lung conditions including lung cancer.