"United by Unique Needs: A New Approach to Cancer Care for African Patients"

  

As the world marks another World Cancer Day with the theme "United in Our Goals, Unique in Our Needs," cancer care professionals emphasize the importance of recognizing the individual journeys of each patient. Dr. Miriam Mutebi, a Consultant Breast Surgical Oncologist at Aga Khan University Hospital in Nairobi, sheds light on the evolving approach to managing cancer patients, particularly in Africa, where unique cultural, financial, and psychological concerns come into play.

In a conversation about the significance of this year’s theme, Dr. Mutebi explains that while cancer patients may undergo similar treatments, each one faces a distinctly personal path. "Everybody's journey is unique, and it's really about understanding the intricacies of that unique journey and supporting them throughout their care," she says.

Over the years, the treatment of cancer has evolved as our understanding of tumor biology and disease processes deepens. But perhaps the most notable change has been a shift in how doctors engage with patients. Moving away from a paternalistic approach, the medical community now embraces shared decision-making, giving patients a voice in their treatment options. “It’s about empowering patients, discussing the risks and benefits, and arriving at a treatment strategy together,” Dr. Mutebi explains.

However, many challenges persist, especially in African settings. Financial concerns are among the most significant. For many patients, the costs of treatment, which are often out-of-pocket, can create financial toxicity, adding stress to an already difficult situation. Additionally, Dr. Mutebi highlights that young patients, particularly those diagnosed with reproductive cancers, face worries about future fertility and sexuality, which can be affected by treatments. These concerns require thoughtful consideration when creating personalized treatment plans.

Cultural stigma also looms large, especially the belief that cancer is always fatal, leading to cancer fatalism. Many patients wrestle with fears about how they will be perceived by their communities, which may impact their ability to work or lead a normal life. “In our setting, we still see patients losing their jobs just because they were diagnosed with cancer," Dr. Mutebi notes.

Clinicians, however, understand the importance of considering these individual factors. "It’s integral to include the patient's perspective in treatment planning," she says. "Unless we can understand their worldview, their interpretation of disease, we might not be able to offer the best care." She stresses that these considerations, if ignored, can result in patients not completing their treatment journeys.

One of the most delicate aspects of cancer care is the question of disclosure, particularly among young breast cancer survivors. Dr. Mutebi acknowledges that, in some cultures, survivors may hesitate to reveal their diagnosis to new partners due to fear of discrimination or stigma. “In our setting, discrimination based on cancer history is still prevalent," she observes. "Patients may lose their jobs or be denied opportunities simply because they were diagnosed with cancer.” Despite the difficulties, Dr. Mutebi supports the need for patients to disclose their past to trusted individuals but advocates for a nuanced, case-by-case approach.

Mental health also plays a crucial role in cancer care, yet it is often overlooked. Many cancer patients are hesitant to seek counseling due to societal stigma and the financial burden of such services. Dr. Mutebi acknowledges the challenge, explaining that while some patients may be reluctant to address their mental health concerns, "mental and physical healing go hand in hand." The solution, she believes, lies in normalizing conversations around mental health and integrating psychological support as part of the standard care for all cancer patients.

As cancer treatment continues to evolve, Dr. Mutebi and her team at Aga Khan University Hospital are committed to improving the quality of life for African cancer patients by addressing not just their physical health, but their mental, emotional, and social well-being. “It’s about creating sustainable models of care that consider the full scope of the patient’s journey,” she concludes.

In this new era of cancer care, where shared decision-making and individualized treatment plans are at the forefront, the unique needs of each patient are no longer overlooked. Through a holistic, patient-centered approach, clinicians hope to ensure that no one’s cancer journey is left unheard.

February 13, 2025