WHAT YOU NEED TO KNOW ABOUT CANCER

Transcription

1 REPUBLIC OF KENYA MINISTRY OF HEALTH WHAT YOU NEED TO KNOW ABOUT CANCER A GUIDE FOR PATIENTS AND CAREGIVERS KENCO Keya Network of Cacer Orgaisatios

2 ACKNOWLEDGEMENT This booklet was prepared by the Keya Miistry of Health with techical support from The Joh Hopkis Ceter for Commuicatio Programs ad the America Cacer Society. Represetatives from the Keya Miistry of Health, Keyatta Natioal Hospital, Moi Teachig ad Referral Hospital, Aga Kha Hospital ad the Keya Network of Cacer Orgaizatios (KENCO) provided techical guidace ad helped desig the booklet cotet based o qualitative research amog cacer patiets ad their caregivers. The cotet i the booklet was adapted from materials prepared by The America Cacer Society. Some cotet about lifestyle ad utritio was adapted from MacMilla Cacer Support, ad The U.S. Natioal Cacer Istitute. Avocado Desig Studio was resposible for graphic desig ad illustratios. To dowload a prit-ready copy of this material, visit Cacer-Materials. America Cacer Society, 2016.

3 FOREWORD Cacer is oe of the major ocommuicable diseases (NCDs), ad together with cardiovascular diseases, diabetes ad chroic respiratory diseases they cause over 60% of total global mortality every year. It is estimated that cacer kills over 7.9 millio people globally every year costitutig close to 13% of total deaths worldwide. While commuicable diseases still remai the leadig killers i may developig coutries, the icidece ad mortality from ocommuicable diseases is risig rapidly. This has resulted i a double burde of diseases which is imposig strai o existig health systems. I Keya, cacer raks third as a cause of death after ifectious diseases ad cardiovascular diseases. It causes 7% of total atioal mortality every year. It is estimated that the aual icidece of cacer is about 28,000 cases ad the aual mortality to be over 22,000. Over 60% of those affected are below the age of 70 years. The Keya Miistry of Health (MOH), i collaboratio with the America Cacer Society (ACS), the Joh Hopkis Ceter for Commuicatio Programs (JHC-CCP), Keya cacer professioals ad civil society orgaizatios, have partered to icrease the availability, quality ad effectiveess of iformatio, educatio ad commuicatio (IEC) materials for cacer i Keya. Withi that cotext, the Miistry supported a study to provide iformatio about the state of cacer kowledge, attitudes ad practices i Keya, kow as the Cacer KAP survey. The fidigs of this survey are iteded to help iform the plaig, implemetatio ad evaluatio of health educatio itervetios i Keya. The Miistry ad its parters are also usig the fidigs of the KAP survey to iform the adaptatio of existig IEC materials for use amog cacer patiets, caregivers ad health care workers i Keya. Dr Kioko Jackso K., OGW Director Of Medical Services 3

4 INTRODUCTION I this booklet, we aswer may questios about cacer ad cacer treatmet. Please keep i mid that this is ot meat to replace the advice of your doctor or urse. Talkig with them is the best way to uderstad what s goig o with your body ad how treatmet will work. 4

5 CONTENTS INTRODUCTION...4 WHAT IS CANCER?...6 SIGNS AND SYMPTOMS...14 TREATMENT...21 PALLIATIVE CARE AND PAIN MANAGEMENT...27 DIET AND LIFESTYLE MANAGEMENT...29 BEING A CAREGIVER...44 FURTHER RESOURCES

6 1 WHAT IS CANCER? Cacer happes whe the cells i our body start to grow ad divide out of cotrol. This makes it hard for the body to work the way it should. WHAT ARE CELLS? Cells are the smallest uit of the huma body. They carry out all the fuctios ecessary for life. Cells are usually too small to be see with the aked eye. There are may types of cacer. Some cacers grow ad spread fast. Others grow more slowly. They also respod to treatmet i differet ways. 6 WHAT IS CANCER?

7 HOW TUMOURS DEVELOP NORMAL CELL CANCER CELL DOUBLING MALIGNANT TUMOUR WHAT IS CANCER? 7

8 Cacer ca start i almost ay part of the body. The most commo cacers i Keya are: MEN: Prostate, Oesophagus, Kaposi sarcoma, Stomach, Colorectum WOMEN: Cervix, Breast, Oesophagus, Stomach, Kaposi sarcoma MOST COMMON CANCERS IN MEN PROSTATE CANCER OESOPHAGUS CANCER CANCER URETER OESOPHAGUS BLADDER PROSTATE CANCER URETHRA COLORECTUM CANCER KAPOSI SARCOMA CANCER APPENDIX COLON RECTUM MULTIPLE LESIONS AND NODULES ON AND UNDER THE SKIN 8 WHAT IS CANCER?

9 MOST COMMON CANCERS IN WOMEN STOMACH CANCER BREAST CANCER CANCER MUSCLE ADIPOSE TISSUE (FAT) DUCTS LOBULES STOMACH CANCER CERVIX CANCER UTERUS CANCER CERVIX VAGINA Cacer is ot a death setece. Cacer is a serious disease but it ca be treated well for may people. WHAT IS CANCER? 9

10 Cacer cells ca spread to other parts of the body. For istace, cacer cells i the lug ca travel to the boes ad grow there. Whe cacer cells spread from the origial site, it is called metastasis. Whe lug cacer spreads to the boes, it s still called lug cacer. It s ot called boe cacer uless it started i the boes. TIP FOR CAREGIVERS: Make sure the patiet uderstads what cacer is, ad is ot. Talk about it opely, ad ask questios. ORIGINAL TUMOUR SPREAD TO DIFFERENT ORGANS 10 WHAT IS CANCER?

11 Causes of cacer We do t kow what causes all cacers, but we kow that certai thigs called risk factors affect your chace of gettig some cacers. Some risk factors for cacer ca be chaged ad others ca t. Risk factors that ca t be chaged iclude your age, sex, ad family history. Thigs that ca be chaged are thigs you do, such as whether you use tobacco or drik alcohol, what you eat, how much you exercise, ad how much su you get. Other risk factors are liked to thigs i the eviromet that cause cacer. But havig a risk factor, or eve may risk factors, does t mea that you ll get cacer. Ad some people who get cacer may have few or o kow risk factors. Cacer is NOT caused by witchcraft or ay form of superatural force. WHAT IS CANCER? 11

12 MODIFIABLE RISK FACTORS TOBACCO ALCOHOL SODA Soda WHAT FOODS YOU EAT AMOUNT OF EXERCISE EXPOSURE TO POLLUTANTS 12 WHAT IS CANCER?

13 Ca cacer be iherited? Cacer is usually ot iherited. It is ot passed from paret to child the same way that height ad HIV are. Cacer is caused by chages i the way cells divide. With some cacers, abormal cells ca be iherited from oe s parets. I such families, more tha oe perso may get the same cacer. Is cacer cotagious? Cacer is NOT cotagious. You CANNOT catch cacer from someoe who has it through thigs like kissig, touchig, sharig meals, or breathig the same air. However, some ifectios that ca icrease your risk of developig cacer ca be spread from perso to perso. Ifectios ad cervical cacer Some ifectios such as Huma Papilloma Virus (HPV) ca also icrease your risk of cacer. Cervical cacer is liked to HPV, which ca be spread through sex. HPV is a very commo ifectio ad i most cases it goes away without treatmet. Havig HPV does ot mea you will get cacer, but it ca icrease your risk of developig it. However, cervical cacer itself is ot cotagious, ad ca be easily preveted if caught early through regular screeig. A vaccie is also available to prevet certai types of HPV, ad it is recommeded for pretee girls aged 9 to 12 i Keya. WHAT IS CANCER? 13

14 2 SIGNS AND SYMPTOMS Sometimes, it is possible to fid cacer early through screeig before havig symptoms. The Miistry of Health recommeds regular check-ups ad certai tests for cervical ad breast cacer for wome ad prostate cacer for me eve though they have o symptoms. Differet people experiece differet sigs ad symptoms, ad these ofte deped o the type ad stage of cacer. Below are some commo sigs ad symptoms of cacer. No symptom should be igored or overlooked, especially if it has lasted a log time or is gettig worse. Although experiecig these sigs ad symptoms does ot mea you have cacer, it is always better to visit the health facility if you have ay cocers about your health. 14 SIGNS & SYMPTOMS

15 Possible sigs ad symptoms of cacer Uexplaied weight loss: Most people with cacer will lose weight for o kow reaso. Uexplaied pai: Pai may be a early symptom with some cacers. This icludes a headache that does ot go away or get better with treatmet, or severe back pai. Ski chages: Some other cacers ca cause ski chages that ca be see, such as chages i color ad toe. SIGNS & SYMPTOMS 15

16 Fever: Fever is very commo with cacer, but it more ofte happes after cacer has spread from where it started. I Keya, fever might also be a sig of ifectio or malaria, ad you should visit a health facility withi 24 hours of the oset of a high ad prologed fever. Fatigue: Fatigue is extreme tiredess that does t get better with rest. 16 SIGNS & SYMPTOMS

17 Uusual bleedig: Uusual bleedig ca happe i early or advaced cacer. This icludes coughig up blood, blood i the stool, abormal vagial bleedig, blood i the urie, or a bloody discharge from the ipple. Lump or swellig: Most cacers form a lump or swellig called a tumour or a growth. But ot all lumps are cacer. Lumps that are ot cacer are called beig. Lumps that are cacer are called maligat. There are other sigs ad symptoms that are ot listed here. If you otice ay major chages i the way your body works or the way you feel, visit the health facility for a check up. SIGNS & SYMPTOMS 17

18 Cacer diagosis If your doctor suspects you have cacer, you will eed more tests. I most cases a biopsy is the oly way to be sure whether cacer is preset. A biopsy does ot make the cacer grow more quickly or spread. To do a biopsy a very small piece of the lump or abormal area is removed ad examied uder a microscope to see if cacer cells are preset. Most biopsies are doe usig a small eedle. Further tests ca also be doe, icludig scas ad blood tests. 18 SIGNS & SYMPTOMS

19 Why did this happe to me? Some people thik they re beig puished for somethig they did or did t do i the past. Most people woder if they did somethig to cause the cacer. If you re havig these feeligs, you re ot aloe. You eed to kow that cacer is ot a puishmet for your past actios. Cacer is ot your fault. Istead, focus o takig good care of yourself ow. Am I goig to die? It s ormal to thik about dyig if you ve just bee told you have cacer. May people still believe that cacer = death. But the fact is that most cacers ca be treated. Talk with your health care worker if you have questios about your ow chaces of a cure, or how log you might survive your cacer. They kow your situatio best. May people fid comfort ad meaig through religio durig cacer diagosis, treatmet, ad recovery. Do t hesitate to speak to your spiritual leader. SIGNS & SYMPTOMS 19

20 Stages of Cacer The stage of cacer tells us if ad how far the cacer has spread from where it started. Kowig the stage of the cacer helps the doctor decide what type of treatmet is best ad how well it will work. As a rule, a lower stage (such as a stage 1 or 2) meas that the cacer has ot spread very much. A higher umber (such as a stage 3 or 4) meas it has spread more. Stage 4 is the highest stage. Ask your doctor to explai the stage of your cacer ad what that meas for you. BLOOD VESSEL LYMPH NODE LYMPH NODE WITH CANCEROUS CELLS SPREAD TO OTHER ORGANS STAGE 0 Carcioma i situ - early form. STAGE 1 Cacer is oly located i oe orga. STAGE 2 The tumour is growig i size, but localized. STAGE 3 The cacer has spread to lymph odes ad possibly eighbourig tissues. STAGE 4 Cacer has spread to other parts of the body. It is the most advaced stage. 20 SIGNS & SYMPTOMS

21 3 TREATMENT Treatmet works best whe cacer is foud early, whe it is less likely to have spread to other parts of the body. The umber ad kids of treatmet choices you have will deped o all of these factors: The type of cacer The stage of the cacer Your age, overall health, ad persoal eeds Do t be afraid to ask questios as may as you eed. Make sure you uderstad the treatmet optios. The most commo treatmets for cacer are surgery, chemotherapy, ad radiotherapy. Ofte two or more treatmets are used to get the best results. TREATMENT 21

22 SURGERY ca be used to remove lumps caused by some cacers. The doctor might also take out some or all of the body part the cacer affects. Surgery is ot used for all types of cacer. CHEMO (short for chemotherapy) is the drug(s) used to kill cacer cells or slow their growth. Some chemo is give ito a blood vei through a eedle, ad others are pills you swallow. You may get chemo oce a day, oce a week, or eve oce a moth. Chemo is usually give with breaks betwee treatmet cycles. How log you get chemo depeds o the type of cacer, your treatmet goals, ad how your body respods to the drugs. 22 TREATMENT

23 RADIOTHERAPY is also used to kill or slow the growth of cacer cells. It ca be used aloe or with surgery or chemo. Radiotherapy ca be give i two ways from a machie outside the body or from objects put iside the body. Some people get both. Radiatio that comes from outside your body is like gettig a x-ray (a photograph of your orgas or boes). For most people, treatmets are give 5 days a week for 1 to 10 weeks. Sometimes, the doctor will eed to put a radiatio source iside you. Whe that happes its called a implat. This implat is put very ear or right iside the tumour. Radiatio therapy is t paiful, but some of the side effects it causes ca be. If you have ay pai, talk to your doctor or urse. TREATMENT 23

24 Treatmet goals Before startig treatmet, ask about the goal of treatmet. Is the purpose of the treatmet to cure the cacer, cotrol it, or treat problems it s causig? Sometimes the goal of treatmet ca chage over time. Side effects of treatmet Side effects are the udesirable effects of a drug or medical treatmet. Each type of treatmet has differet side effects. But most cacer treatmet side effects ca be relieved. CHEMO SIDE EFFECTS: These usually oly last while you are takig chemo ad ca ofte be treated. ausea ad vomitig appetite loss temporary hair loss mouth sores higher risk of ifectio bleedig or bruisig after mior cuts or ijuries aemia (low red blood cell couts), which ca cause tiredess, shortess of breath, pale ski, ad other symptoms emotioal stress Make sure to discuss ay cocers you may have about your fertility with your doctor. 24 TREATMENT

25 RADIOTHERAPY SIDE EFFECTS: Radiatio treatmets are geerally pailess, but they ca cause ski irritatio ad extreme tiredess. Tiredess ofte lasts for may weeks after treatmet eds. TREATMENT 25

26 Is cacer treatmet worse tha cacer? Cacer treatmet ofte saves lives especially whe cacer is foud ad treated early. Eve whe it ca t cure cacer, treatmet ca ofte prolog life ad reduce pai ad other symptoms. If cacer is allowed to progress without treatmet, symptoms get worse ad ew symptoms build up over time. Utreated cacer commoly causes death. What else ca I do? Complemetary therapies are those that are ot part of your medical treatmet, but that ca safely be used alog with your medical treatmet. They should ot be used istead of your medical treatmet. They ca help relieve certai symptoms of cacer or side effects of treatmet. Examples iclude prayer or meditatio to reduce stress, tea (such as giger tea) for ausea, massage therapy, ad relaxatio techiques to relieve stress ad pai durig medical procedures. However, some herbal treatmets ad witchcraft ca be dagerous to your health. Always talk to your doctor or urse before seekig such treatmets. 26 TREATMENT

27 4 PALLIATIVE CARE AND PAIN MANAGEMENT Palliative care focuses o relievig sufferig caused by cacer ad helps people live as comfortably as possible for as log as they ca. It is ot iteded to cure the illess. It ca be give at ay poit durig a perso s illess to relieve symptoms, pai, ad stress, ad should be provided alog with curative treatmet. Palliative care ofte starts at the time of diagosis. You should ever accept pai as a ormal part of havig cacer. Most pai ca be cotrolled or relieved. PALLIATIVE CARE AND PAIN MANAGEMENT 27

28 WHAT CAREGIVERS CAN DO Watch the patiet for sigs of pai, icludig grimacig, moaig, tesio, or reluctace to move aroud i bed. Try warm baths or warm washcloths o paiful areas, but avoid areas where radiatio was give. Getle massage or pressure might also help some types of pai. Suggest fu activities to distract the patiet. Pla activities for whe the patiet is most comfortable ad awake. Offer plety of fluids. Help the patiet track whe pai medicies are due. Talk with the doctor or urse so that you uderstad which medicies are for pai ad how each is to be used. Check with the doctor or urse before you crush or dissolve pai pills to make them easier to swallow. Keep pai medicies away from others, especially childre ad pets. Whe you are carig for someoe with pai, pla time for activities you ejoy ad take care of yourself. A support group for family members may be helpful. Caregivers are critical to a patiet s wellbeig, but must also look after themselves. Refer to sectio 6 for more iformatio o beig a caregiver. 28 PALLIATIVE CARE AND PAIN MANAGEMENT

29 5 DIET AND LIFESTYLE MANAGEMENT Beefits of good utritio durig cacer treatmet Eatig the right kids of foods before, durig, ad after treatmet ca help you feel better ad stay stroger. It ca help you maitai your body weight, deal with side effects of treatmet, lower your risk of ifectio, ad heal ad recover faster. Eatig well meas eatig a variety of foods to get the utriets your body eeds to fight cacer. Make sure to discuss your utritioal eeds with a health care worker or utritioist, especially if you have other chroic illesses. DIET AND LIFESTYLE MANAGEMENT 29

30 YOGURT SWEETS Occasioally MEAT DAIRY FATS & OILS Moderate portios, daily to weekly FISH & POULTRY Ofte, at least two times weekly BEANS & NUTS WHOLE GRAINS FRUITS VEGETABLES TUBERS Base every meal o these foods GREENS 30 DIET AND LIFESTYLE MANAGEMENT

31 Protei (Meat ad alteratives) After treatmet, extra protei is usually eeded to heal tissues ad help fight ifectio. YOGURT Good sources of protei iclude legumes (beas, pigeo peas, cow peas, gree grams, letils, ad soya beas), poultry (e.g. chicke), lea red meat (e.g. beef, goat, lamb, pork), eggs, fish (e.g. tilapia, ile perch (mbuta)), dried small fish (omea), dairy products (milk, yogurt, cheese), uts (e.g. cashews, grouduts, macadamia) ad simsim ad peaut butter. DIET AND LIFESTYLE MANAGEMENT 31

32 DEALING WITH POOR APPETITE A perso with a poor appetite may eat much less tha ormal or may ot eat at all. What to pay attetio to Little or o iterest i food Refusig to eat favorite foods Weight loss What caregivers ca do Try givig the patiet 6 to 8 small meals ad sacks each day. Offer starchy foods, such as ugali, chapatti, bread, potatoes, or pasta, with high-protei foods, such as chicke, meats, fish, eggs, cheeses, milk, uts, yogurt, peas, ad beas. Offer fruit juices, chocolate milk, or soup whe the patiet does t wat to eat. Keep cool driks ad juices withi the patiet s reach. Try plastic forks ad kives if the patiet is bothered by bitter or metallic tastes. Do t blame yourself if the patiet refuses food or ca t eat. Be ecouragig, but try ot to fight about eatig. 32 DIET AND LIFESTYLE MANAGEMENT

33 Fats ad oils Fats serve as a rich source of eergy for the body. But some fats are better for you tha others. The best sources of fats are: vegetable oils like cor, simsim, suflower, ad peaut. Speak to your doctor about how much saturated fats you should get from aimal sources (like meat ad poultry, whole milk, cheese, ad butter). Limit your itake of solid fats, such as margarie, shorteig, ad solid cookig fats. These fats are also ofte foud i sack foods ad baked goods. Carbohydrates Carbohydrates are the body s major source of eergy. DIET AND LIFESTYLE MANAGEMENT 33

34 The mai sources of carbohydrates i Keya are maize, rice, chapatti, ugali, potatoes, sorghum, cassava, wheat, sweet potatoes, millet ad gree baaas. Sugars ad sugary foods should be take i moderatio (these iclude table sugar, hoey, jam, cakes ad biscuits). Vitamis ad mierals Fruits ad vegetables cotai essetial vitamis ad you should try to cosume a miimum of five portios of vegetables ad fruits everyday. Fruits ad vegetables that you should eat iclude: sukuma wiki, spiach, pumpki leaves, cowpea leaves, carrots, cassava leaves, gree pepper, sweet potatoes, magoes, pawpaw, passio fruit, orages, pieapple, ad red watermelo. All traditioal vegetables are also good sources of vitamis ad mierals. Vitamis ad mierals are also obtaied from aimal source foods such as milk, eggs, liver, kidey, fish, boe soup, beef, mutto, pork, chicke. 34 DIET AND LIFESTYLE MANAGEMENT

35 Make sure you wash fruits ad vegetables very well especially if you are eatig them while gettig treatmet (chemotherapy ad/or radiatio) whe the risk of ifectio is high. Water Water ad healthy fluids are vital to health. Try to drik about eight large glasses of water each day. You may eed extra fluids if you re vomitig, have diarrhoea, or eve if you re just ot eatig much. You should avoid sugary ad artificially sweeteed liquids, ad alcohol. TIP FOR CAREGIVERS: Offer water to the patiet may times durig the day. If they have mouth sores, try offerig a straw DIET AND LIFESTYLE MANAGEMENT 35

36 Tips to get more eergy Eat several small healthy sacks throughout the day. Do t wait util you feel hugry. Eat your favourite healthy foods at ay time of the day. Eat your biggest meal whe you feel hugriest. Try to eat high-eergy, high-protei foods at each meal ad sack. Exercise lightly or take a walk before meals to icrease your appetite. Drik high-eergy, high-protei beverages like chocolate milk. Drik most of your fluids betwee meals istead of with meals. 36 DIET AND LIFESTYLE MANAGEMENT

37 Do t forget about physical activity Physical activity helps keep you strog, ad it ca help reduce depressio, stress, fatigue, ausea, ad costipatio. It ca also improve your appetite. If your doctor approves, start small (5 to 10 miutes each day). Liste to your body, ad rest whe you eed to. Talk to your doctor before you start ay type of exercise. Start slowly. Try short periods of exercise with frequet breaks. Always start with warm-up exercises for about 2 to 3 miutes. Ed your sessio with stretchig or flexibility exercises. DIET AND LIFESTYLE MANAGEMENT 37

38 Here are some ways to add physical activity to the thigs you do every day. Walk aroud your eighbourhood after dier. Play active games with kids, like jumpig rope, ad the games you played whe you were a kid. Take a fried dacig, or dace i your ow livig room. Use a exercise bike or treadmill, or do arm curls, squats, luges, ad cruches. Use the stairs istead of the elevator or escalator. Get off the matatu or bus several stops early ad walk the rest of the way to work. Make appoitmets for yourself for 10-miute walkig breaks. Form a walkig club of co-workers or eighbours. 38 DIET AND LIFESTYLE MANAGEMENT

39 How will cacer affect my sex life? Some people have little or o chage i their sexual desire ad others fid that they have less iterest i sex. It ca be caused by stress, feelig tired, ad other treatmet side effects. This is ormal. Some types of cacer, like cacer of the cervix or bladder, may cause bleedig i the geital area or uriary tract. If this bleedig is worse after sex, talk with your doctor. If you ve had surgery, how soo you ca have sex will vary. Your health worker ca give you more iformatio. If you have sex withi the first couple of days of havig chemotherapy, use a codom. Sex caot make your cacer worse or icrease the risk of it comig back. Cervical cacer is ot ifectious. Your parter caot catch it from you. Talk with your parter about their cocers ad what you feel OK with which ca chage from week to week. DIET AND LIFESTYLE MANAGEMENT 39

40 Will cacer make me ifertile? Pregacy is ot recommeded durig treatmet. Doctors ofte tell me ad wome to use family plaig throughout treatmet, ad eve for a few weeks or moths after treatmet is doe. Wome may fid that their periods become irregular or stop while gettig treatmet. This does t mea that they ca t get pregat, so family plaig is still eeded. I me, the treatmets may reduce or damage sperm cells. Eve so, me ofte become fertile agai after treatmet is doe. Whether or ot you pla to have childre, it s ormal to worry about how treatmet will affect your fertility. Talk to your doctor before treatmet starts about ay questios or cocers you have about fertility ad cacer treatmet. 40 DIET AND LIFESTYLE MANAGEMENT

41 Some questios you may wat to ask your doctor What kid of cacer do I have? What stage is it ad has it spread to other parts of my body? What are the treatmet optios for this type of cacer? What are the risks ad possible side effects of the treatmet optios? How successful is the treatmet for my type ad stage of cacer? Is the aim of treatmet to cure or to cotrol the cacer? What if I choose ot to have treatmet? What if I would like a secod opiio? DIET AND LIFESTYLE MANAGEMENT 41

42 How to talk to your loved oes about cacer It ca be hard to talk about cacer, eve with the people you love. Your loved oes may also have a hard time talkig about cacer. Here are some tips to help you: Tell your family ad frieds about your cacer as soo as you feel up to it. They might feel hurt or left out if they have t heard about it from you. Explai what kid of cacer you have ad how it will be treated. Let them kow that o oe ca catch it from you. Explai that you are gettig treatmet to get better. Allow frieds ad family to help you, ad tell them what kid of help you eed. 42 DIET AND LIFESTYLE MANAGEMENT

43 Let frieds ad family kow that eve if they ca t support you fiacially, their support is still welcome i other ways. Tell the people who are closest to you how you feel. This may ot be easy, but it ca be a very importat way to get the support you eed whe you eed it most. If some people are ot OK with talkig about your feeligs, do t be upset. Try talkig to others who might liste. TIP FOR CAREGIVERS: Help the patiet explai the diagosis ad treatmet to their family members. Be supportive ad be there to aswer questios. You may ot be able to do thigs you were doig before you got cacer. If that s true, let your family ad frieds kow. If you re feelig sad or depressed, talk to your doctor, urse, or religious leader. DIET AND LIFESTYLE MANAGEMENT 43

44 6 BEING A CAREGIVER How to be a good caregiver A good caregiver is ofte the oe perso who kows everythig that s goig o with the patiet. Do t be afraid to ask questios ad take otes durig doctor visits. Keep the patiet ivolved i plaig their care. Disclose to the patiet what you kow. 44 BEING A CAREGIVER

45 Ask questios. Let the perso with cacer make decisios, but if the patiet is makig questioable choices (like ot takig medicies), talk to them about their choices. Ecourage the patiet ad give them positive words. Sometimes you might eed to set limits with the patiet. For example, have the patiet care for themselves as much as they ca, ad ecourage them to talk about thigs other tha cacer ad illess. It s ormal to feel frustrated, upset, ad stressed whe carig for someoe with cacer. Ask for help whe you eed it. Take care of your ow eeds. Be sure to get eough sleep, exercise, eat healthy foods, ad keep your ormal routie as much as you ca. Do t try to do it all yourself! Reach out to others. May people fid comfort ad meaig through religio. Speak to your spiritual leader if you eed support. BEING A CAREGIVER 45

46 Whe others wat to help Askig for help or lettig others help ca take some of the pressure off ad allow you time to take care of yourself. Look for areas where you eed help. Make a list. Hold regular family meetigs to keep everyoe up to date. Iclude the patiet. Ask family ad frieds whe they ca help ad what jobs they thik they ca do. Be very clear about what you eed. 46 BEING A CAREGIVER

47 Eve though you do the best you ca, there may be times you ll feel that you could have doe better. Try ot to blame yourself. Fid a way to forgive yourself ad move o. Focus o those thigs that you do well. It s ot easy to be a caregiver, but it ca be rewardig. BEING A CAREGIVER 47

48 7 FURTHER RESOURCES Hospitals with cacer treatmet services KENYATTA NATIONAL HOSPITAL, Hospital Road, Nairobi, +254 (0) MOI TEACHING AND REFERRAL HOSPITAL, AMPATH Ocology Cetre, P.O Box 4606, Code: 30100, Eldoret, plus satellite cliics i: Kitale, Webuye, Busia, Chulaimbo (Kisumu), Mosoriot, Turbo, Ite, , Provides cacer educatio, screeig, diagosis, surgery, chemotherapy, ad palliative care. JARAMOGI OGINGA ODINGA TEACHING AND REFERRAL HOSPITAL, Kisumu, Keya (0) AGA KHAN UNIVERSITY HOSPITAL, Limuru Road, Parklads, Nairobi, +254 (0) /2644, +254 (0) BEACON HEALTH SERVICES CANCER TREATMENT CENTER, 5 th Ngog Aveue, 5th Aveue Buildig, 3 rd Floor, Nairobi, +254 (0) , +254 (0) COAST PROVINCE GENERAL HOSPITAL, Kisaua Road, Mombasa, +254 (0) , +254 (0) , chiefadmi@cpgh.co.ke. 48 FURTHER RESOURCES

49 KIJABE MISSION HOSPITAL, P.O. Box 20, Kijabe 00220, +254 (0) , +254 (0) , MATER HOSPITAL, alog Mukeia & Duga Road, South B, Nairobi, +254 (0) , +254 (0) , M.P. SHAH HOSPITAL/CANCER CARE KENYA, Shivachi Road, Parklads, Nairobi, +254 (0) (MP Shah), +254 (0) (Cacer Care Keya), (MP Shah), (Cacer Care Keya). NAIROBI HOSPICE, Keyatta Natioal Hospital Complex, Hospital Road, Nairobi, +254 (0) , NAIROBI HOSPITAL, Argwigs Khodek Road, Nairobi, +254 (0) , NAIROBI WOMEN S HOSPITAL, Hurligham, Nairobi, +254 (0) , ifo@wch.co.ke. TEXAS CANCER CENTRE, Argwigs Khodek Grove, Hurligham, Nairobi, +254 (0) , +254 (0) TENWEK MISSION HOSPITAL, P.O Box , Bomet, +254 (0) , +254 (0) , tewek@tewek.com. FURTHER RESOURCES 49

50 Health isurace The Natioal Health Isurace Fud (NHIF) is Keya s largest medical isurace provider, with over 2,000 accredited health care providers coutrywide. Cotact NHIF to fid out how to eroll. customercare@hif.or.ke, +254 (0) /56, +254 (0) /94,+254 (0) Support Groups ALL CANCERS SUPPORT GROUP, Aga Kha Uiversity Hospital, 1 st Thursday of the moth, 2pm to 3.30pm, Cacer.care@aku.edu BREAST, CERVICAL AND PROSTATE CANCER SUPPORT GROUP, Faraja Cacer Support Trust, Nairobi Place, Mokoyeti West Road (off Lagata Road), 10:00am to 12:00pm, arwa@farajacacersupport.org. ALL CANCERS SUPPORT GROUP, Keyatta Natioal Hospital, Radiotherapy Departmet, twice a moth o Fridays 11:00am. ALL CANCERS/HOSPICE SUPPORT GROUP, Nairobi Hospice, every Thursday, 12pm, ifo@airobihospice.or.ke. ALL CANCERS SUPPORT GROUP, Nairobi Hospital Couselig Departmet, Short Stay Auditorium, 2 d Tuesday of the moth, 2:15pm 4:15pm, +254 (0) , +254 (0) Ope to patiets, survivors, family members, Nairobi Hospital staff. BREAST CANCER SUPPORT GROUP, Faraja Cacer Support Trust, 4 th Tuesday of the moth, ifo@farajacacersupport.org. 50 FURTHER RESOURCES

51 CERVICAL CANCER SUPPORT GROUP, Faraja Cacer Support Trust, 3 rd Tuesday of the moth, ifo@farajacacersupport.org. CERVICAL CANCER NAVIGATORS GROUP, Wome 4 Cacer Early Detectio ad Treatmet, Biblica Cetre, every 2 d Saturday of the moth, Phoe: +254 (0) , Mobile: +254 (0) , P.O. Box , Nairobi Keya; ifo@wome4cacer.org; Website: COLORECTAL CANCER SUPPORT GROUP, Aga Kha Uiversity Hospital, 2 d Saturday of the moth, 10am to 11.30am, Cacer.care@aku.edu. PROSTATE CANCER SUPPORT GROUP, Faraja Cacer Support Trust, 2 d Wedesday of the moth, ifo@farajacacersupport.org. Olie Resources AMERICAN CANCER SOCIETY: FARAJA CANCER SUPPORT: KENYA NETWORK OF CANCER ORGANIZATIONS: keyacaceretwork.wordpress.com/ MACMILLAN CANCER SUPPORT: NATIONAL CANCER INSTITUTE (USA): FURTHER RESOURCES 51

52 KENCO Keya Network of Cacer Orgaisatios 52 WHAT IS CANCER?