 So, coming back to this topic, we know again, we've mentioned any woman could be susceptible to breast cancer, or man, however, when a girl is growing up and we're talking of every woman from when they start becoming, you know, having the breast there in puberty all the way to their old age, who is susceptible, and can you just tell us also how it's caused and how it can be prevented in that case? Thank you for once, before we go to how it's caused, what is the causes, let's start with the causes. Yes. Among the causes of breast cancer, we have the modifiable factors, and those that are modifiable are the fact that those ones that you can do something about them to change. And the modifiable ones are the ones that you have no control over, they just come. So, in other words, for those who are women, they're not understanding, it's basically habits that can be changed, and habits that cannot be changed because they're patterned in simple talking, that those things, like we said, the habits that we can change, and those ones that we have no control over, we cannot change despite them. Natural. Natural. They're natural. Those that they come as a result of us, our making, and those ones that they just come naturally. Okay. Would you give an example of each? For the things that we have no control over, our genes. Sure. Yes. Our genes, we are naturally born with genes. There are some specific genes that they just run in our family. So, you have no control over, genetically, you're predisposed to cancer for the fact that maybe along your lineages. Yes. Yes. You might know, or you might not know about your shows, they had it. Yes. You never met them, but they had it. Yes. So, it might come to you with the fact that you have a link with that show show that you never saw. Yes. Yes. Okay. So, those are genes we have no control over. Yes. And maybe the environment. Yes. The ones that are like another thing that we have no control over, our hormones. Women have hormones. True. Yes. We have no control over our hormones. Whatever they do with our bodies, we have no control over them. This is something we can do about it. Yes. Even age. Even age. Yes. You have no control over your age. Yes. Yes. We can say, I can say I'm 20, but I'm 50. It doesn't matter if I feel 20. True. I'm 50, so. Age is what you feel, not where you are. Yes. I have no control over my age. Yes. As much as I want to still stay young and say I'm 20. Yes. My age is moving and I'm getting predisposed to. Yes. And the body changes are there. Yes. And they're happening to my breast. Yes. So, those are not things that you have control over. Okay. Yes. Then there's another one that you have control over like weight. Mm-hmm. You can choose to have the kind of weight that you have with. Diet, maybe. Diet? Yes. Yes. Now diet comes in with the weight. Okay. Yes. Basically. Mm-hmm. Yeah. Diet, too. Like, you know, where most of us like this in the dietary lifestyle, just want to eat a certain type of food that is predisposed. Yes. Yes. Could you just draw into that a bit here? Because I know that one thing, no matter what you do, it will happen every single day if I decide to eat particular foods that could, cancer-causing, that's something. And that's what everyone at home is doing. Could you maybe give us examples of foods, you know, in the way they are processed, that could be a factor, a contributory factor towards cancer? I wouldn't say I really have facts on the foods. Yes. But most of the time, you know, the kind of foods we feed on. Those are the kind foods that mix with a lot of chemicals that maybe are the ones that cause problems to our bodies. Okay. So, most of the time, people who like a lot of fats, the meat, they say there are those, do I say, carcinogens, something like that, in such things that predispose us to developing some kind of cancer, like maybe breast. True. Diet-wise, they say there's a diet called Mediterranean diet, like, okay, it tends to prevent cancer, not really 100%, but mostly it includes things that most of us don't like eating. True. Legumes, vegetables, fruits, such things. Yes. They are healthy diets, but when you maintain yourself on them, the chances of you lowering higher. Yes. It's feeding on a junk, a lot of junk. Right, right. Plus, when you're feeding on a lot of junk, you know, you're getting fat. Yes, yes, yes. Okay, fat is big. Well, yeah, unhealthy. Yeah, unhealthy. You're getting unhealthy. Yes, yes, yes. You're not able to control your weight. Exactly. But somebody who's feeding on these natural legumes and stuff kind of, you really get people who just grow. True. True. True. And also, habits, you know, like smoking. Yes, smoking is another predisposing factor. Yes. The fact that I'm a woman predisposes me to getting breast cancer. It's automatic. It's automatic. Yes, predisposes you to getting cancer. Yes. And some breast cancer conditions also predispose you to getting cancer. Yes. For example, the women who naturally have some swellings in their breasts. Yes. Or some kind of, we call it type of leisure. I don't know how it's called the simple way yet. Okay. But those are things that will predispose you to getting breast cancer. Okay. Sometimes you just bone with them. They just come. True. Yes. So those are things that will predispose you to getting cancer. Okay. Then plus maybe you have history. I've talked about the history. The history is more genetic. Yes. Genetic? Yes, yes. Then you have something like, what do you call it? History of previous cancer treatment. Yes. History of other cancers. Okay. You had other cancers. They would predispose you, like they metastasize and move and move and move. True, true, true. Yes. Because it's the aspect of radiation as well. Yeah. Is that now, because I've heard you mentioned cancer treatment. So is it the radiation that will... No. Yes. It's not the radiation. Being like a risk factor is like maybe you had cancer of another place. Okay. Let me say I'll inform you. Then you go to the radiation which was exposed to the upper part of the body. Yes. You know how I have so many cells. Yes, yes. So that's one of the factors that come. Yes. It's a predisposing factor. Uh-huh. But the other radiation is meant for treatment. Absolutely. Yeah. Okay. And finally, the age factor. Yes. Yes, maybe you can break that down. Yes. The age factor. Yes. The 50 years plus. But currently, there are records that even the younger generation are getting breast cancer. But before we used to say like at least 50 plus. But I don't know if it's the kind of the exposure we get. Yes. As actually there's a scenario ever so a girl as young as 14 years with breast cancer. Yes. So age factor. Yes. It's like before we used to say at least 50 plus because of those changes in hormones and stuff like that. Yes. But as early as a 14 year old. Yes. I've seen a 14 year old with breast cancer. Yes. So it's very important. Yes. You as early as you get. Yes. Your mammary glands. Yes. You really have to take action in the exam. Yes. Anything you see. Yes. Don't say I'm too young to have cancer. Yes. I'm not too young to have cancer. Yes. You're not too young to have cancer. I have seen some 20 something year olds with breast cancer. Yes. Yes. In addition to the risk factor aspect. Yes. They usually say that having a risk factor doesn't mean that maybe some of them maybe somebody already has a breast. Yes. Yes. It doesn't mean that those risk factors once you have them you will have cancer. Yes. You can still get cancer without the risk factors. Yes. That's why we say there's no hormone or specific cause for cancer. And that's very important to note but it doesn't hurt to live a healthy life. It is very important. It's healthy, organic foods, exercise, drink your water, do not smoke. I think it's quite obvious because the minute you lead a healthy life most likely you will prevent all these illnesses. Sure. And again it's so obvious anybody could get it despite the people who are susceptible to these cancers and again it's the same as prostate cancer for men who are after a certain age and it's actually becoming more and more common. Right. So I must say the patient is here. The patient has been diagnosed and the doctor has to take now the lead to the next stages. How does it work? Now before treatment is begun first of all you talk that's why it's important to stage the disease. Absolutely. Because once you stage the disease you will know now how do you approach it. So there are main goals which doctors use to treat a patient or a client who has cancer. So one of the main goals that everyone wishes and we all wish for a patient is cure. That's the very first and foremost goal for treatment. Yes. So after that there is another goal depending on the state of the disease which is controlled. Maybe the way the disease has spread to me is on the third stage. It has moved to several organs that you cannot really eliminate it. You can't do surgery. Maybe it's a risk even to the patient to do surgery. So you aim at controlling the disease. Controlling. You will give chemotherapy, radiotherapy, even hormonal treatment to ensure that the disease is under control. It doesn't multiply anymore. The tumors remain shrinked so that the patient can continue living a normal life. Then the last and foremost goal of treatment is to palliate. To palliate it means to ensure that the patient is comfortable despite having cancer because even if somebody gets cancer which can be you or me, you deserve to live a comfortable life and a dignified life. So palliation basically it means just ensuring that the patient is comfortable, free of pain, able to meet other activities of life. Some can even go to work but they're still on palliative treatment. So those are the main three goals of treatment of cancer. Wow, it's actually quite deep to think that when a person is diagnosed with cancer it doesn't mean death sentence as many other bigger diseases are. Maybe you can just explain to us the elephant in the room. How do the numbers look like in terms of diagnosis in your place of work? Do you cure more patients or do you lose more patients in general from observation? Yeah, I know. Generally it's a heavy question. Well, this is just a personal opinion. Yes, yes, yes. Like generally what our place of work, what I usually see, I think majority of us we don't go for screenings most of the time. So the most cases that we are seeing are advanced cancers. Advanced cancers and advanced cancers, what we've seen, survival rate, just a few years then they are gone. The numbers of people dying from breast cancer are higher from where I work because they come late. We rarely get stage 1's and 2's. Usually most of our admissions are stage 3, stage 4. Yes, yes. Advanced, they are gone, gone, gone, gone. Yes, yes. So, yeah, they are very good. So you are explaining to this mama, like no, we are at this stage. They are like, but it's just a small thing here. It's similar to last month. Similar to last month. The new, you know, comes harder. Yes. Most of us, Kenyans, I think, not really Kenyans, most of us are habits, we are not the health seekers. Yes. We wait for us to, at least I have to have a headache before I go for, you know, like I have a headache. Yes. And when I have a headache, let me go buy some paracetamol. Yes. Swallow, then my headache is gone and I'm fine. Yes. So by the time I'm going, like, hey, this headache is not going away. Yes. So let me go to the hospital. Yes. Like, a year ago, I felt this something, then I was like, people say it, I mean, it's just nothing. Oh my. And again, I think another thing we would say maybe, is it, I wouldn't really call it ignorance. It's just maybe lack of information. I think it's a culture of fear. And our fear. And our fear. Yes. Yes. Yes. Because even medics, you tell them, have you gone for your screening? My goodness. Actually, it's true. What if they get it's cancer? What if it's cancer? What if it's cancer? Not even that. You know, ideally every human being should have a yearly body screening. Yes. I can tell you the numbers are so low. They're so low. Yes. And that's the only way you can catch some of these diseases. Yes. Right? And you can, other than the eating well and all that, it doesn't hurt to just once a year go to your doctor, take some samples. In fact, you take samples and you walk away. Yes. Other than the physical exam, which could include that, and it can be curable. Like we said, it's very curable. Any cancer in that case. Other than the unfortunate biggest monster, which is blood cancer. Yes. And I think, again, this people at home, what can we tell them in terms of also the factors we've mentioned? And then there's the finances. Yes. Yes. Because you can never tell when you'll miss it. Yes. It's always good just to invest. I think it's 500 shillings per month to ensure you have at least a medical cover. Yes. And the cheapest I think is NHIF cover. Yes. So my advice to people at home would be that please, please just ensure that you have an NHIF cover. Yes. Just save a coin each day. Yes. So by the end of the month, you can raise 500 shillings. Yes. You pay for the NHIF. Yes. Which will be of great help actually. Yes. Of great help especially not even cancer or any other disease. Yes. Because most hospitals nowadays they use a cover. Yes. If you have NHIF, it can be, the treatment can be catered for. Yes. And for cancer if you, it's just for money, money using, money cash. Yes. It can be quite expensive. Yes. And training. Yes. Yes. Because we see so many, I think every day somewhere in the, in social media there are medical appeals and it's always the same thing. Cancer, cancer, cancer. Yes. So I think it's good for every person to do what they can. Yes. Other than prevent, check, get screening and also just have something little on the side to, you know, cater for even the basic treatment. Yes. You know, even those tests because I know they're not cheap. They're not cheap. At the same time, there's this other option. Yes. Observing 20 shillings a day for your health. And they say health is wealth. Yeah, health is wealth. Sure. You cannot work when you're ill. You cannot be a mother when you're dying at 40 years. What else could have done something about it in that case? Yes. What are you trying to tell people? Yes. You see, you might be so concentrating so much on going to work and working and working. Yes. Forgetting. Yes. All that money is like gold. Gold. You die and leave that money there. Yes. So you really have to invest in your health. Yes. Or even depleted. You really have to be healthy in your medical cover. Yes. In HIF. Yes. People should just make sure they have an HIF. Absolutely. Yes. Yes. Especially the young ones will tell you, when will I fall sick to use it? Yeah. To them is a waste of money. Yeah. Because they've had four months. Four months. When am I going to use it? Yes. Yes. When will I ever use it? So they see no need. Okay. At least take a small one where you can just make your five people fall. Then you just have to be there because then people don't apply to get sick. No, they do not. Nobody applies to fall sick. And we cannot. You can just be walking and fall down and become sick. And you become sick. So this HIF will come in and suit you out. Absolutely. Because cancer treatment is a burden. It's a burden. It's a burden. Yes. It's a burden to cover. It's a burden to you. Yes. Psychologically. Yes. Everything physically. It's a burden to you. It's a burden to your family. Yes. Most people sell things. Yes. And eventually you die. Yes. Somebody dies. True. You're dead, but you've left your family. Yes. Yes. Yes. It's true. Yes. Yes. It's true. Yes. Yes. Yes. Yes. Yes. Yes. Go ahead. Go fight with your family. Yes, go on. Yes. I imagine those who don't listen to you can tell me about what needs to be discussed with you and when you arma pain the time you schmooze what and what need to be jabber on. And you know. the types of treatment the shortest period and the longest period and now the other kind of kind of maybe psychological care and all that. So to begin with the types of treatment the first one that I mentioned was surgery. Your surgery is one type whereby they will remove the tumor as a whole if it's caught early stage one stage two yeah so after that they combine it with chemotherapy you can have a mask it has been confirmed it's cancerous the first thing they'll first of all give you chemotherapy sorry chemotherapy is a type of cancer treatment whereby it acts to shrink the tumor so that it's not that big so after that chemotherapy it can also it can either be oral or through the veins yes then after that is where now they go remove it through surgery the then depending with the state if maybe it has gone to state and it can be removed a patient is now exposed to radiation radiation is a very strong stress that are directed to the tumor to ensure that they say that are dividing very fast are killed yes to ensure that you remain clean are free of the of the tumor yes then there is also another form of treatment it's called hormonal therapy okay they use hormones to treat and control the disease so in this case you know in our bodies something that I would like to mention I hope it's not complicated yes we remain mostly we have two major hormones progesterone yes and estrogen yes which is even contained in the normal pills that we take to control the hormones in our body yes so hormonal therapy mostly it prevents the cancer cells from getting attracted to the hormones that I've mentioned okay this one is these two hormones they're like you see we it came as to used to call catalysts yes yeah so they're like catalysts to the cancer cells so it's hormonal therapy blocks it blocks so that the cancer cell and the hormones in our bodies don't match they don't okay okay so in that case the tumor will be controlled okay it's not replicate and multiply yes more so that it can like spread and matter spread in the rest of the body yes yes yes wow today's the first time I'm hearing about the last one oh there's another one yeah the last one yes there's a biological therapy okay yeah now this one it is meant to mimic your immune system they've made a tablets that can be given they mimic your immune system in that it boosts your body to fight against the cancer cells okay okay and which is the most common among the four orders it depends on the cancer among those that I've mentioned yes do surgery it's common yes chemotherapy yes radiotherapy and even hormonal therapy yes in that order yeah okay and then the biology then the biological biological therapy still it's yeah wow is there any other kind of support you give to the patient and how long does it which is the shortest amount of time the longest a patient can be on treatment that one I'll say it depends with the response of course there is the mostly patients will put on a specific cycle maybe 28 days of radiation for example this radiotherapy so after the 28 days they do the the ones that she told us CT scan MRI to check the response to treatment yes now the response to treatment is what would direct the doctor to know how long the patient will be on treatment because if maybe some patients there are different types of responses yes some are like complete response so that after this schedule time of treatment you know the tumor is gone normal they only put this patient on a maintenance dose of like five years to ensure that if there's anything remaining it doesn't come again so and there's the other response the patient will come to just be stable response okay stable meaning the tumor is just like this even after irrigation after chemotherapy yes that's a stable two yes then there's a other response whereby it'll be quite partial so depending with the response is when the duration of treatment will okay we are okay depends on the patient's response right and maybe maybe maybe you could demystify because I have maybe mostly in the movies seeing cancer patients who've been diagnosed and they say I don't want to kill more because it's going to kill me what maybe demystify that for people watching at home and show them the advantage of treatment second treatment of letting the cancer take them out which I also know it's a personal choice depending on the age maybe the patient is too old and they're like there's no need for this could you demystify the death by chemo yes they are right to feel that yes I think most of the people will feel death by chemo because of the fear a little the fear of the the outcome majority of people maybe will say like if they don't have proper information about what chemotherapy does to the body of the cancer there is the time I'll feel I'll feel and say yes that chemo will kill me but there if they explained like this this might be the only option for you this chemotherapy is going to destroy that cancer cells and the possibility or probability of you living longer of beating cancer is high I think people will not be saying cancer will kill you so information information yes most of the people may lack information yes to make the right choice absolutely they should also rely on what the doctor tells you because outside there you tell the streets this this is like the the relation will ban you the patient becomes already sent to America so rely on the information from the health care provider who is taking care of you absolutely so we have so much to talk about and I'm really I'm thankful that you took your time to come and explain to our audience and also teach me along the way about cancer and put a face on it and also you know remove that aspect of ignorance in the most respectful way which is lack of information yes so for you must see any final words to anybody watching out there about this thing cancer my final word anybody watching is that cancer is treatable and it's manageable yeah that's that's very important for everybody to know especially now that today you've been talking about breast cancer it's very important that just I'll just repeat go for your routine checkup so that when the cancer is got in an early stage trust in God you will be well yes it will be treated so to avoid many problems many worries kindly just go for Ali Ali check out screening screening is therefore screening yes the disease will be caught early and don't fear because I'm for fear because this is what I get cancer you better have the correct to go it's caught early then you get treated absolutely then you live your normal life yes yeah absolutely and mainly I'll echo what she has said yes everything she has said is very correct then I would say we all know cancer takes a toll on people and family if you feel like if you're a cancer patient you do feel overwhelmed there are counselors that are there who can talk to for you to air out your worries you may not be helped financially but psychological well being produced a lot to you absolutely yes yes so if you feel overwhelmed you should talk to people go see your doctor tell your doctor how you're feeling maybe the doctor will link you to a person you can talk to yes and then you get through yes you get through your stress absolutely because cancer is a burden it is and I want to also tell the women even men if you go to see a doctor feel free to ask your doctor your oncologist nurse all the kind of questions you want to know before that if a when a diagnosis is given to you ask what are my mode of work my treatment what are my options yes yes so that you're able to decide after you've been you've been told that you are at this stage ask your doctor what are my options what is the outcome this one will help you plan your life because if you've been told maybe you're in stage four then you you're holding on that hope like I'm going okay you might get healed but peer the chances that you might not you might not make it I'm very high compared to you surviving so when you get to know as to know like what are my options what is my outcome especially what is my outcome you're able to arrange your life you know as Africans we don't like making a planning our life because you don't imagine ourselves dying today or tomorrow so you want to hold on on that hope it's good to hold on that hope yes but again it's good to plan your life so that when I'm told that the prognosis we call it the prognosis my prognosis is like this I'm able to plan my life like even have a small will for your family then you're again if you ask what stage am I you're able to choose because you might say if you we are going to sell my whole I can get cure but where we all know it the chances of you curing this stage four yes are not very high so once you get to know you're able to decide that like I'm going to spare my abcd I'm going to use abcd to push my life for this this time absolutely so when you go see your doctor ask all those kind of questions that you want to know they will really help you manage family your everything and arrange to lose visibility so that most of the time we see yes like you know now this patient this time you're asking well who do I need to call you need to talk to somebody that's so stressed depressed they're not even able to express themselves so most of them die then they leave the family they are wondering did you leave you know such kind of things it's true wow I can't put it any better and once again thank you ladies for coming on board there's no more to add but you've heard it from their specialists themselves special oncology nurses they see this every day they take care of people with cancer every day and the third bit is they maybe ask themselves I wish they knew this I wish they could come early enough for diagnosis or just a checkup so a message to you at home it doesn't matter how old how young you are even parents to young children take your kids to the hospital once a year just once just plan yourselves because without health nothing exists and this hope cancer is curable when caught early and how do you do that it's by actually taking the first step which is self-check and also checking with your doctor not your friends not google not movies but with your doctors yes thank you tomoka coffee in westland at anana center for having us thank you for this beautiful setup and thank you adorware for my outfit my crew for making this possible and until next week at the same time same place have a good night