 Good morning to you. Thank you so much for being part of this morning's show. This is why in the morning, my name is Ram Agukko. If at all you're just joining us, you're just in time for the next conversation of the day and it's all about matters concerning your health, cancer awareness. Let's talk about breast cancer awareness. What are the signs and symptoms of breast cancer awareness? How can you be able to fight breast cancer? Is it possible for you to detect it early? What about stigmatization? How do you fight it? Today, let's talk about this particular issue. I am joined in studio by Dr. Mora Bosiri. She is a general practitioner who shall be able to help us in understanding this particular issue. Thank you so much Ram. Thank you for having me. It's always a pleasure to do something with the youth. You're welcome. Yes, I am on top of the universe as usual by God's grace. I love the energy. It's difficult not to have energy around you too so I'm mirroring now. Thank you. Thank you so much. Keep the conversation going. The hashtag is one in the morning at Ram Magukko and that's why 254 channel is where you can engage with us. Head over to Facebook and drop in your questions and your comments and tell us where you're watching us from. I shall sample your feedback as we continue with this morning conversation. It's all about breast cancer symptoms. How can you be able to understand this particular issue? But before we head over and touch on the niti grittis of this particular issue here, I want us to just start from the general outlook. Yes, sir. When you talk about breast cancer, what is the current state of cancer especially in the country and are people aware about it? Do people talk about it as they ought to? One of the things is first if we talk about the incidence, we talk about 8% of population. Although these studies are rising for obvious reasons lack of awareness, 8% of the cancers we have in Kenya are breast cancer. But it's a second to cervical cancer. Wow. Yes, and you see both of these cancers require awareness, a lot of awareness. But people don't know about this particular issue. Even if people know, they don't have the detailed approach from a medical practitioner who will tell you these are the things you need to look out for. Google is not necessarily always your friend. That's why we go to school to help people understand some of these things. So it's not just copy paste. Yes. Sometimes you can google something smaller then you get a different thing, thereby misleading yourself. Exactly. And some of the protocols you see people doing based on what can present as a cancer of any region tends to make the cancer worse. Other than going to the people who are interested in oncology and want to help and create awareness in the ecological issues in our country. So for some Kenyans this conversation may be difficult or uncomfortable. And we need you to really be comfortable with having this particular conversation. Because the doctor here is here to help you understand what you need to do. The things you need to start believing in. We want to dispense of every myth and misconception about breast cancer. We put them aside and we give you the facts. Absolutely. Is breast cancer, when you talk about breast cancer, are we just talking about women only? So breast cancer as it says, it's breast tissue. So men also have breast tissue. So it's both men and women. So they can both get breast cancer. Yes, although the risk in itself is being a woman. But men do get breast cancer. So even men need to be able to get screening. Yes, we need to. In these times where things are changing for reasons like environmental or other reasons things are changing. Men also need to be alert into getting themselves checked. In your experience you've managed to get to understand how breast cancer moves from the early stages to the late ones. We know that there are different types of breast cancer. Yes. Just to mention but a few. What are we looking into? So we have a large variety of types of breast cancer which comes into the niti griti details of how we specify the type of cells that affect. But the common one is the lobula one or the ductile type. The most common being the ductile type. So the duct is the pipe that will bring breast milk into the nipples. And the lobula one is where the glands that produce the breast milk. So those are the two common, top common types. Of course we have a variety of other types which is based on when we do the histology checks and let you know. And does it matter age is it all about for mothers? Where do we have most prevalence? So the risks first is number one a woman being the risk. And a woman who had her periods early or became an opposite or a woman with no children. Because women with many children are covered from that. And breastfeeding has shown to reduce the percentage by at least six percent. And one year breastfeeding. So not two months. One year breastfeeding reduces that. So breastfeeding reduces chances of getting breast cancer. Yes sir. Wow. Yes sir. So this thing of bottle feeding our kids you should put it aside. You know what? I am as trendy as they come and I did it for one year and I was pleased to do so. So encourage mothers to do so. It has no effect. Infact if when they come to the clinic, where I am based, I will teach the mothers how to make sure their breasts don't sag because that's their concern. We can work on that too. Yes. It's possible. It's possible. So let's just breastfeed. Because we want to look young. Yes. We don't want people to insult us. So the society can be so toxic. It's true. It's true. If you look at the belief systems that are there out here. Yes. Many women tend to get this habit of wanting to separate themselves from their child. Yes. And they want to put their child on bottle milk. Yes. And of course they look for the suction. Yes. I don't know. Is that also having, can it help reduce breast cancer or increase breast cancer? The pumping? The pumping, yes. So the pumping helps. But let me put it this way. The mechanism of breastfeeding is not only the fact that the milk comes out. The other thing that puts is the hormone that helps, that is protective towards it. So the bonding with the child helps that. You know a lot of women suffer psychological issues even before they give birth or even after giving birth. Which dictates how milk is going to come out. So if we work on women's psychological issues or women were also more open to get a good vaulted place to discuss their issues. Breastfeeding will turn out to be something they can do comfortably and supported by other people. And remember the pump mechanism was not so that women can go to work. So that their husbands can play part because they are claiming paternal leave, isn't it? Yes, yes. So what I want to say is that it is not so that we delegate the bottle feeding completely to the child you share today. When she is resting you give the bottle of milk because you also are at home. Yes, because at the end of the day you are one. Yes. You are family. The man goes with the newspaper and is watching the game as the lady is struggling in the bedroom. Yes. I'm looking at the early stages of breast cancer. Yes. What are just some of the signs and symptoms that can enable someone to detect it early? The commonest one will be a lamb, the breast lamb. So somebody will come and say, oh I found a swelling in my breast. But be that as it may. It's usually by the time the lamb is there we've gone a bit too far. So it doesn't mean that the presence of a lamb denotes breast cancer. It can be a benine, what we call benine issues which are non malignant tissue. So having a lamb on your breast does not mean you have cancer? Having a lamb does not mean you have breast cancer but if it turns out to be breast cancer we are getting to late stages. Okay. Make sense? Yes. So niti pata lamb na ni iolampi fanyue investigation and it's positive, nima nda sana. A lamb is not a good sign in the presence of cancer. So once you detect it you should seek medical attention immediately? Yes, exactly. Sometimes I would like to offer that people who find lambs on their breasts should go to a place that is known to examine lamb breasts. The knowledge of your lamb on the breast on what is happening is better when people have done several. So I'm not sure exposing yourself to the nearest clinic would be the best, would be the nearest level 5 hospital. Because in the training there are people even nursing teams who have been trained to observe and say even this lamb is removing a discharge because it looks like an abscess. We need to do further things. Let's not just give an antibiotic and send. So it's not that I'm putting aside the clinical levels but our exposure in our tertiary in this level 6 has shown us a lot of these lambs are being missed out in the lower levels because somebody comes and it looks like an abscess and we're giving an antibiotic and then later the person comes and we are now the thing has metastatised to everywhere else. Miss diagnosis now. Miss diagnosis and those things. It's painful when you look at a woman crying because niliambiwa hitu ni kungahe or whatever they call it and it has just an abscess they put an antibiotic on it for us to come and tell you. Or by then we can't even give you chemotherapy because it's late. It's too late. Yes. Wow. Yes. And how long does it take for this type of cancer to develop? Is there any given period of time? I have an experience of a lady who in one month her cancer had metastasis. She felt the lump and the next thing she was telling me we took the X-rays, we took the CT scan, it's gone to the lungs, it's gone to the abdomen. So there's no given time. I think we approach it more on the preventive screening angle than when we get it what do we do. And for those who don't understand what you're saying metastasis. It means moving outside the local organ. So the organ of origin for example if it is the breast it has moved to the lungs. If it was from the lungs it has moved maybe to the bone like that. So cancer can move from one place to another. Yes. Because remember the cancer ourselves which can move through the bloodstream to anywhere else and attach there and grow. As long as there's nutrition in an organ malignancy or any cancerous tissues can grow anywhere and can move from one place to another including also to the brain. Wow. Yes. So one sign or symptom is just a lump. Do you have others? Yes. So other than the breast lump we are looking at things associated with the nipple. So is the nipple discharging, is there a change in the nipple color, is there a change in the sizes of the nipple? In whether it's intracted, it's drawn in. Is your skin around your breast different? Now women tend to have one breast larger than the other. So no cause for alarm. So that is normal. That is normal. So what you want to do is a change in that size. So if there's a change in the size then you should be concerned so that you'll be able to do the necessaritas. And again nipple discharge can be anything, can be clear discharge, can be bloody discharge, can be passive discharge. We want to investigate further when we get those type of things. And for those who have just come from breastfeeding, the mothers, sometimes they get discharged. Yes. At what point should it be a cause of concern or a cause of worry? Once you stop breastfeeding, the discharge should stop about three months. Remember the presence of the child stimulates the hormones that will cause them. But be that as it may, a regular checkup, self breast exam at home should be important. Good. Yes. So when you see something that is outside the norm of when you are breastfeeding, you seek the necessary help. Yes. Self examination. Yes sir. Before we touch on that particular aspect of self examination, let's look at some of the myths and misconceptions that exist in regards to breast cancer. I'm sure you've dealt with so many patients and you get to hear so many stories and then you're like, my goodness. You believe that? Yes. What are some of the myths and misconceptions that exist that you've come across so far? If you don't have a boyfriend, you get breast cancer. Because of the circling part. Yes. Oh my goodness. And then the other one is if you don't, if you breastfeed your child for less than two years. Then you get cancer. Essentially it's just one year. It's a lie. That's a lie. If mama so comes to visit you, then you do not get breast cancer. If you eat certain foods, then you do not get breast cancer. If you are taking contraception pills, you will get breast cancer. I mean those are just… Now these pills that people take, they can't affect… No. Not the normal pills. Like the pills I'm talking about oral contraception. Yes, exactly. Nipo and no plants. No, there's no study. It was initially there but it was nullified in 2016. Now in the case of what is that word? Losing a child. Yes. At some point the breasts always start to develop. The mama regalans that started to develop the milk production. Yes. And upon the loss of a child, there is that particular time when some women begin to have some secretion. Can that affect? So there are two types of loss of a child and this is like… We are talking about an abortion for example. So normally as the fetus is developing, in the first trimester the multiplication of the breast cells start to occur in preparation to milk production. Yes. And then in the third trimester they are fully matured the cells. So when a lady gets an abortion whether it's intentional or just an accidental abortion, then the undifferentiated cells can become malignant which makes them cancerous. So on abortion there is a link to abortions causing a person to get breast cancer. So there's a risk factor there? Yes, there's a risk. And how can we be able to reduce these kinds of beliefs? Because there are men who, of course, I saw it was trending for some time. Yes. I don't know if you saw that research about circling breast, reducing breast cancer. So cadence went on Twitter and they are like now we should now get our rights. What is the role of the man? In ensuring that their women, their wives have reduced chances of getting breast cancer? They help them with their self breast examination. You're there more than the woman is anyway. So it's encouraging to know how to do the breast examination. I mean if I'm doing it on a patient then a man can do it on a couple can do it on each other. He checks and you check. So a woman can check for the man? And the man can check for the lady? I want us to do self that examination right here practically. So ladies and gentlemen, let me bring in one of our colleagues here. Kuja mama kuja kuja. I want us to do self examination. So this is how you can be able to do self examination from home. Yes. So that you are well placed, you are knowledgeable. Yes. So just come. We can try on her. Of course. I don't know if she will try on a man. Is it the same? It's more or less the same. Of course the tissue for a man is smaller but the concept is just the same. Hi. Yes. What's your name? My name is Diana. I know she doesn't have a mic. She says her name is Diana. So she won't talk much but when you're with a patient before you do that test because some come to the clinic. Yes. What are the steps you take as you want to go through that particular examination? So first is exactly what I did with Diana. Hi. What's your name? And the eye contact is to make her comfortable and know and then introduce my name. My name is Dr. Mora and I'm going to do your breast exam which now entails me exposing. Of course for purposes of here we will not expose you but in a set up of the clinic I will say that I will expose you. And then I will ask are you comfortable with just me being the only one examining you or do you want me to bring in another person to stand and witness. So abroad you don't do breast exams and even in South Africa we don't do breast exams without a witness like somebody to stand next to you. Because medical legal issues are quite rampant. And have you had cases of husbands saying that they will not leave that room? Ya and in fact we like it when they did not leave because now I tell him have you seen what I've done that's what you should be doing. Ya but medical legally they should be somebody standing next to me when I'm examining the breast of a lady and especially for male doctors. It's best when they have a female nurse or an assistant will stand next to them when they're examining to reduce any issues after that. Because remember we're not allowed to video record any hospital or clinic visits. Is gender an issue here? For example you've seen someone like myself I come into your clinic and I want to be examined. Are there any restrictions or limitations that exist in terms of gender? You know what you just need to be careful is so that nothing goes his. If you're going to do what we call very close or intimate types of examinations where you notice a patient might be uncomfortable, something can be misread. It's always good to have a chaperone next to you. So a chaperone can be a relative but most of the time you want another medical profession. Because they are a nurse aide, a nurse, a clinical officer, a fellow doctor who understands what you're doing is not anything beyond the medical aspect of what you're doing. Go ahead. So normally what I prefer even on my own if you're doing the self breast exam you want to use the opposite hand for the opposite breast. For example here like that for yourself. The opposite hand for the opposite breast. All right the farthest one. So if it is on the right hand. So you do the left side of the breast. And if it's the left hand. You do the right side of the breast. So essentially when you're at home. Normally we encourage after you shower when you lie down on the bed it's easier. Right? With the hand that you're examining ready to examine. With the hand of the breast you're examining tucked behind your legs. Why should you do it after taking a shower? Usually it shrinks. I don't know whether you notice that. It shrinks, it gives the shrinkage. For some reason it's easier to examine. You've taken a hot shower or cold one. Ya it's just a shower. I think just relaxation. Everything is relaxed. The 10th thing is not their normal day. Long day. I think women experience this after a long day with a bra. It feels like you've carried tons of bricks. But after the shower it's almost like there's a relaxation. So that the tension on the knotting in the breast is not necessarily a lamp that you now freak out and start looking for more. You can attest to it. Any bra where the lady whose cup size is above her seat knows exactly what I'm talking about. Yes. You know, I ask them, they should be bra less days. So for purposes of examination I'm normally facing her. But because we want the viewers to see what I'm doing. That's why I'm standing parallel to her. But it should essentially be face to face. So when I'm facing her like this. Okay. So why is it also important when I'm facing her, she will tell me, her face will tell me where this pain. So when I touch the presence of tenderness somewhere is an indicative factor. So when you touch the lamp and it's painful also. Because there's some people who already have lamps, they've been checked and it's nothing. But then it starts being painful. We want to see you again. So we have painless lamps. And painful lamps. So most of the painless lamps are the ones that are cancerous. But if it starts being painful, I also want to know why. Yes. So for this side, I will start. So I prefer to do mine from her examination I'll do. Because I'm examining her, it will be anti-cloc wise. So with your permission. So I will press onto the breast like that. Going from the outermost circle of the breast. All the way round. And you make sure you're keen not to skip anything from there. So you're going round. And you're going round. And you're going round. And you're going down. And then you know the size of the tissue or the breast tissue also determines until I reach where the nipple is. And when I'm reaching the nipple, I will squeeze the nipple to see if there's any discharge. So those are things you watch. Then for women we must also be alert. When is your cycle? Because just before your men says you can actually have a discharge which will disappear. A lot of women tend to have that. The ovilatory places where they'll get a discharge. The areola which are the dimples or the things round the nipples. Can become even bigger for some people during their cyclic times. And then it will go back. And there are some even there is a lamp. So when we finish the breast we go under the armpit. And also check. Because the breast tissue is also under the armpit. Do you know a lot of women we miss their breast cancer because it's under the armpit thinking it's a boil. So the breast like where I've touched. You see that part that irritates you and that's part of the breast tissue. So the cancer can still also be there. So you check under your armpit. So you go round? You do that. For me if I'm doing my own self breast exam I do clockwise. Because I'm the one examining I do anti-clockwise. So you want to go clockwise from the outermost the one next to the chest wall moving in centrally. So don't skip. Just take it slow. Feel and as the more you do more of the self breast exam the more you realize the consistency of your breast. Because the people whose breast generally just have lamps. The fatty tissue just has formed the lamps. It's normal. So for the first ultrasound or mammogram then you're told everything is fine so you learn okay this is now a new lamp. But it has to be consistent. You keep checking. You can do this regardless of the size of the breast. Any size of the breast exam can be done. And men it's easier because men it's unless somebody is a little and even if they have the man boobs what they call man boobs generally not as big as even the smallest lady so it's easy for men to detect their lamps and all that. Wonderful. So we done with that? It's a simple as that. Simple as that. Imagine. And you only need to do it every month. Some people keep it up every two weeks but I find it cumbersome. Two weeks. Two weeks is. But why don't you just do it monthly? Two weeks is too much. I find it too close. What's the window period between the first two weeks and the second two weeks if we're doing a good job. At some point you mentioned you touching the back of your head. Yes, to expose. You see when I touch that you see when I'm like this how is my breast and then look at that. So the breast tissue is more exposed. Easier for you to examine in a better circumference way. Yes. Thank you. Thank you. No lollipops it's not the dentist. No we don't give lollipops up as the dentist. No we don't give lollipops up as the dentist. We don't give lollipops up as the dentist. Ladies and gentlemen that is how you do breast cancer self-examine. That's how you do self-examination from home. Your partner can help you. If at all you are alone you can also do it yourself. Yes. So most importantly is you move from one breast to the other with your hand up examining the opposite breast and the hand up examining. So laying down usually is very more comfortable. But using a mirror can help. Okay me I have problems with mirror because I'm like I never I'm confused when I see the mirror. I don't even know what's happening with mirror. So I prefer and I find it more comfortable when you are lying down. But not that you mentioned something that is quite intriguing. You said for some people they always have those you know lamps all around themselves. But now how can you differentiate or detect that this is a normal one and this is a cancerous one? So now this takes me number one we want to schedule your screening. So what happens I teach you how to do the breast exam. So you want to have a doctor examine your breast and if it's lumpy do you the necessary test and ultrasound or a mammogram tell you everything is okay and then I tell you when I teach you now when you feel your breast is like this are the lamps these are normal lamps. So anything out of this is abnormal. So again consistent check of your breast is what will help you know if there's a deviation to the lamps that you normally have. And there are people who have come like I said they are non cancer non malignan cells. So the lamp is still there we've tested we've done biopsy it's come negative for breast cancer but we need them to continuously check. So we're looking at increase in size of that lamp anything that changes with that lamp bring you back in your breast. But how can we reduce misdiagnosis? One of the things is what we had mentioned is in a center that has been developed to do the cancer screening. For example like part of where I work is called Kilimani Cancer Center this month we are doing free screening for breast free screening you just go on Facebook look for Kilimani Cancer Center call that number show up. Let's do that. Pick your phone right now. In fact there's a body waiting we already had this system set in place we've done we've gone to places where we are doing the screening for people. Come it's at 40 suit that is Nia Kenyatta National Hospital suit number 808 Dr. Deritu Anthony and you'll find me and him there. I know Dr. Deritu. He is my mentor. So there you go. Here you will come and you'll find able doctors will be able to see you and teach you how to do the self-press exam. We have able staff who have been taught and trained we've been gone out doing outreaches will still continue and even there will be more screening so we are even looking at doing personally I'll be doing the wellness checks so even after October anybody who is interested in just doing a wellness check per se they will get my details from the same Kilimani Cancer Center and we'll be able to do it at a fee for just a general wellness check for all the other types of cancers that you have and I know we are doing breast cancer but I must put in pap smia, pap smia, pap smia for cervical cancer because it's the leading cause of death in this country still. So in as much as we're also tackling the breast we're also going to do the pap smias so wellness check is going to be through out the year but this time it's free after October we start going back to charge so for now take advantage of this particular free cancer screening. Kilimani Cancer Center 40 to 808 Do they need to book? Call to book, yes. How can they do that? They go to the Facebook of Kilimani Cancer Center there is a number there call and book. Kilimani Cancer Center on Facebook ensure that you go there and book gets screened it is for free. Najiwa kina onapenda vizabure? There is a sasa. Thank you so much. That was a very lovely illustration that you've just given. Now there is a stigmatization that you know evolves around cancer. How can we reduce this stigmatization and what are some of the stories that you've had that are actually touching in that touching line in terms of stigmatization? Story comes in mind there many because I've dealt with so many women but the one that quickly comes is this lady she had what people called stage 4 breast cancer and everybody told that she needs to put her things in order leave the husband to marry another wife well husband decided was going to marry another wife in stage 4 cancer what have you send the children wherever they are well now she's cancer survivor it's been 5 years gone down and she's now very vocal and she's strong in that she does not want women to be told something and just take it lying down so stigmatization comes mostly because of ignorance and ignorance is not bliss whoever did that we don't know who that is it's not bliss they say ignorance is bliss it's stupidity it's not bliss in ignorance what you know you overcome what you know you succeed in the more knowledge you have about something the more better you are like these people who are fleecing other people it's because of ignorance all fleecing that is occurring all stealing that is occurring is ignorance once you become into the light it's fine there's a stupid joke that goes around that says if you want to hide something from an African man in a book there's no bliss there so ignorance is what when we come in and we do a lot of awareness programs like what we're doing right now we've already touched something on somebody who is going to watch us let's examine our breast like this it's not too late because let me tell you we have doctors who are trained and well trained to deal with these cancer issues so don't be afraid if you listen to the grape vine all this one told me I'll be well and you died and then that's a bad doctor no remember doctors treat God is on wheels but calm your point of faith is with works by coming to see the doctor who will help you I love that your point of faith is it works by coming to see that doctor some men look down on women just because they got cancer and for some cases they even have one of their breasts getting removed and then now we say that you're no longer the woman that I used to love before how can you reduce such kind of mentality is there a way that we need to talk to our men is there a way we need to talk to our men to be able to embrace their women regardless of the state at which they are exactly one of the things that we can do is obviously have talks with men and address what it means for them to have a wife who has gone through breast cancer and therefore has had a mastectomy which is removal of the breast so it's talking about with them having a closed door meeting with men and addressing their insecurities because a lot of people live each other for small minor issues that's a discussion I've had with one of my very good friends minor issues are the reasons why people live each other so if we get to understand the partnership because there are 5 types of love once you have those 5 types of love in a relationship chances of a person working off is restricted by the fact that they have the God kind of love for you how what would be your message to that cancer survivor who is watching it today that has is also strong enough I mean so many cancer groups cancer awareness groups they are trying to make cancer to become a national disaster they are trying to rally that what would be your message to that particular person watching it today number 1 cancer survivor is congratulations and we thank God that you have survived because the team that was used was used by God number 2 give your testimony encourage other women who are going through it because a lot of people psychologically is what takes them to the grave what system has been shown we have so many systems that have developed like now you saw Kenyatta National Hospital launching its palliative pain and palliative care team and palliative doesn't really mean that we are really concerned talking about people who are dying it means that we are also helping you as you walk through your disease and we do a lot of counseling in that pain and palliative care and that's what I would encourage them work with people, testify those things be there be an example of the screening don't shy of facebook get a facebook page and talk about your recovery journey and how you got it early and how you got it late and got so you through so it's always so important to testify and have that documented I know there is somebody watching today and is wondering can breast cancer be cured can breast cancer be cured? can it be cured once you've gotten that diagnosis just to break that kind of information out there for someone to know so normally with cancers we don't call them cure we put it on either remation or actually we call it disease free time so what we want is for you to get to lower than detectable levels of the cancer in your system and yes that is possible that is possible for those who believe in concoctions on a summer they will drink this mix it with this add it with this and drink at the at the end of the day do those things work no unless the concoction is juice lemon juice just for your own entertainment they don't really work they don't really work so to ask do you know how many people we see who have drunk concoctions and they've come so late and it's something we could have done something about again awareness lack of awareness ignorance let's do away with that what I would encourage even the government to do ask guys are ready send us Kirinaga Mbu please I'm ready create awareness I'm ready I want us to look at the treatment the expenses that are there how draining can it be and what do we need to do about it the biggest yes it's a psychological it's an emotional and it's a financial drain to people the financial part is the recurrent we have cycles of kimo so somebody can have several amounts of kimo like we can do up to 6 cycles which means you get kimo 6 times and that is expensive so things like NHIF insurance but they really don't help that much I wish there would be more cover for such diseases because remember it's still a good majority of people who have cancer and a lot of people die with disease so even if they die we want to say that we're going to do post mortem so I find that somebody has it and nothing was done about it so one of the things financially if the government could provide increase the amount of NHIF but perhaps provide for a patient who is getting chemotherapy or radiation therapy that would be good you get more psychological and social support systems for their caregivers because let's also not forget the caregivers I think also the caregivers get even equally overwhelmed by taking care of a person with cancer because they are helpless because remember we all have to fight against the hero mentalism so here you are helpless helping somebody emotionally and psychologically so financially that could be useful we set in parameters we set in like what are like funds national funds where we get them from but this is going to be for cancer patients and this is how we are going to help them with all the things that they need because remember it's not a one it's not like a headache where I give you paracetamol and you're okay this is a journey and even after we finish kimo we still need CT scans so that MRIs for whenever it's necessary all the other things that will come up after we are evaluating you you as a patient to call you disease free or in remission Stanley Kenya what food can you eat that can fight breast cancer alright you can answer that food now there's no food to fight there's no food because they also say the fatty nalifed fatty food the only thing is alcohol relation even smoking there's no relation to it alcohol relation has been shown to increase the effects of breast increase the risk of breast cancer taking alcohol increases chances of getting breast cancer yes ladies I've seen beautiful ladies even men calm down I am down what must you say for them calm down I am taking for my sisters even men even men okay I want us to finish this conversation and I want to give you a chance to have a final word what should be our take on for the day speak to that Kenyan who is watching you that Kenyan youth who is watching you this particular Tuesday morning that is your camera thank you so what I'd like to encourage is let's do screening screening screening once you know something send it to the neighbor we used to have this thing where we used to say if you want people to know more things you tell a woman because they are faster than an email but we have Facebook now we have everything speak about awareness let your people in your rural home know about these things about screening and number two if you find something whatever it is don't be afraid I've told you about Kilimani Cancer Center come even if you don't come for the regular screening which I don't think you should miss but you can come for us to do check up on you on Kilimani Cancer Center at Fosti Suit we also have a place in Drs Plaza Kenyatta National Hospital number 52 so just come get yourself checked and by the way early detection helps a lot this thing we can fight it let's just fight stand up and fight for the people who have cancer also to get their rights because I mean everybody deserves a chance to get a healthcare plan so that's what I would say that is Dr Mora Bosire Doctor thank you so much Ram thanks for coming I believe we have touched someone's life who is watching today amen and as we are saying let's talk about these things let's not be ashamed about it let us come out and talk about them and come out of these myths conceptions and stigmatization let us promote the good things that are there but exist that can be able to push someone to look forward to tomorrow because being diagnosed of breast cancer is not a death sentence it's not and the which doctors are not that privileged to cause it so just come let's talk about this thing the more people know about it the more people know their solutions because the reason why people in the rural homes don't come is they don't know they think that it's time to write their will and go and there is Dr Mora and Dr Anderitu trying to solve this problem and it come out so there is hope thank you so much keep tweeting keep the hashtag going the hashtag is one in the morning at Ramaguko and at Y244 channel keep engaging with us we value your feedback and we want to say that thank you so much for what you are doing keep it up I am sure that we are going to ensure to come next time like this I am sure we will have saved so many lives take advantage of this cancer it was all about cancer awareness and specifically breast cancer have you learned something? I sure have my name is Ramaguko we have come to the end of this particular segment but we still have more instead of for you on this particular show this is one in the morning