Download Early detection and patient navigation for cervical cancer

Early Detection & Patient Navigation
for Cervical Cancer
3rd Annual WE CAN East Africa Breast & Cervical Cancer Advocacy,
Education & Outreach Summit |April 22-23, 2016; Nairobi, Kenya
Ms. Benda N. Kithaka
Co-Founder & Board Chair
Advocacy
Community Education & Awareness
Screening & Early Detection
Patient Navigation & Access to Treatment
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“The greatest need we have today in the
human cancer problem, except for a universal
cure, is a method of detecting the presence
of cancer before there are any clinical
signs of symptoms.”
Sidney Farber,
letter to Etta Rosensohn, November 1962 (The Emperor of All Maladies, Siddhartha Mukherjee)
Early Detection
Cancer screening for early diagnoses


Before the signs and symptoms
To reduce disease and death from the disease
Two Types:


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Population-based screening: offered systematically to all
individuals in the defined target group within a framework of
agreed policy, protocols, quality management, monitoring and
evaluation
Opportunistic screening: offered to an individual without
symptoms of the disease when they present to a health care
practitioner for reasons unrelated to that disease.
Ideal Situations to Advocate
for Cancer Screening
Advocate for Population Based cancer screening
if and when:





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It is a Public Health Problem; affects the general
population
Natural history is well known
There is accurate diagnostic assessment
Effective treatment options exist
Earlier treatment improves disease outcomes
Cervical Cancer
Onset of
Intercourse
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No Signs or Symptoms
Signs & Symptoms
Schiffman.
N Engl J Med. 2005
Impact of Early Detection on
Disease Outcomes
At Pre-Cancer Level
 Lower cancer incidence
 Detection + Removal of pre-cancerous lesions
= Elimination of Cancer [progression towards cancer is stopped]
At Early Stage Diagnosis
 Lower invasive cervical cancer
 Less cervical cancer deaths
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AFTER SCREENING,
THEN WHAT?
A Patients Journey
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Decisions Facing a Patient
Patients Realities
Fear
Death / What will people say?
Cultural
Cultural beliefs regarding treatment
Financial and economic
Lack / inadequate [Treatment, Transport, Nutrition]
Logistics – Travel
Distances, New to Nairobi
Communication and language
Doctors Jargon
Health care system
Machine Breakdowns, Long Waiting Lines,
Labyrinth at KNH
Pain Management
Access to Medicine and Care
Side Effects
Overcoming and Understanding
Age
Younger patients assumed to have better
prognosis
Patient Navigation
… a means for improving access to
recommended cancer screening
services, follow-up, diagnosis, and
treatment in medically underserved
populations.
Dr. Harold P. Freeman In 1995
Our Model
• Awareness
• Advocacy
• Screening
Outreach
Treatment
• Access
• P.P.P
• Follow Up
• Survivorship
• Follow Up
Care
Suspicious Cells = Diagnosis, Treatment Plan,
Navigation = Follow Up, Blood Transfusion, Nutrition, Accommodation, Bookings,
Systemic Issues = Negotiation, Communication
Media Engagement
Goals of our Patient Navigation
We aim:
To eliminate barriers to care:

Patient navigation makes sure patients are aware of and can
access available services and are not lost to follow-up.
To ensure timely delivery of services:

Patient navigation works to move patients through the health
care system in a timely manner from the point of a suspicious
finding to the resolution of that finding.
To save lives from cancer:

Patient navigation ensures that a patient with a suspicious finding
finds resolution through more timely diagnosis and treatment. It is
during this critical window of opportunity that lives can be saved.
Patient Navigation
Ideally a patient navigator …

Is a compassionate, effective guide in bridging
the gaps to help patients, their caregivers, and
their families

Ensures patients do not “fall through the cracks”
 as a result of fragmentation between health care providers,
hospital centers, and community-based services.
Challenges
Volunteers


Emotional bonding with patients
No formal training in patient navigation
Financial constraints


Cycle of fundraising
Cancer doesn’t wait
We have learnt to recognize that we can only give
what we have, so we give from the heart
Prevention & Early Detection
Organising a screening programme is
complex.
Effects only visible after a long period.
Between the Screening, pre-cancer
diagnosis, and diagnosis, we have a
great opportunity to save lives from
cancer by taking steps to navigate the
system for ease of access
Patient Navigation bridges the gap.
Community education is at the heart of
cancer control.
Illustration:
Guy Billout
References
1. Battaglia, T.A., Freund, K. M., Calhoun, E., Dudley, D. J., Fiscella, K., Paskett, E.,
Raich, P. C., Roetzheim, R. G. and The Patient Navigation Research Program
Group (2008), National Cancer Institute Patient Navigation Research Program.
Cancer,113: 3391–3399. doi: 10.1002/cncr.
2. Freeman, H. (2006). Patient Navigation: A community based strategy to reduce
cancer disparities. Journal of Urban Health: Bulletin of the New York Academy of
Medicine, 83(2), 131-141.
3. Freeman, H.P., Muth, B.J., Kerner, J.F.. (1995). Expanding access to cancer
screening and
clinical follow-up among the medically underserved. Cancer
Practice, Jan-Feb 3(1) 19-30.
ABOUT US
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About Us
Nairobi County Stakeholders Meeting
Contents
Mission, Vision, Values
Our Activities
Achievements
Our Contacts
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Our Mission
To raise public awareness of the benefits of early testing,
and facilitate early detection and treatment to reduce the
prevalence of cancer.
Our Vision
A Kenya where every woman can access cervical cancer
screening and Treatment.
Our Values
Learning, Teamwork, Passion, Integrity, Compassion
.
2012 Year
Formed
Achievements
16 Medical
Camps
2500+
Pap Tests
www.women4cancer.org
.
120+
Treated
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2012
Women 4 Cancer
Awareness Camps
Reach to Date
Formed
15,000+


Volunteers Run
2500
+
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Medical Camps
120+
15
3
Follow Up +
Cryotherapy
Hysterectomy
Radiotherapy /
Brachytherapy
No. of Women
Screened
Action
www.women4cancer.org
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Our Activities
 Cervical Cancer Advocacy

Community Awareness and Education



Breast, Cervical, Prostate, Colorectal, Esophageal, Skin
Early Detection Benefits
Cancer Advocates Training
 Cervical Cancer Screening for Early Detection



Clinical Breast Examinations
Pap Smears & HPV screening using Mobile Van Technology
Medical Camps with Comprehensive Medical Services
 Treatment Follow Up


Elaborate Patient Navigation
Referral System
www.women4cancer.org
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Community Education & Awareness
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Medical Camps
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Nairobi
Kitui
Kisumu
Kiambu
Kerugoya
Machakos
Beneficiaries
Diverse backgrounds, cultures, social settings
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Our Beneficiaries
Partner Organisation Offering
Pap Smear Tests on site
363 Women Screened for Free
www.women4cancer.org
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Past Campaigns
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Our Fundraising Model
Innovation and Cause Marketing
 Funds Appeal Events
 Kenyans of Goodwill
Private Public Partnerships
 Corporate Sponsorships
 Negotiated Rates
We rely on well-wishers to actualize our Vision
www.women4cancer.org
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The 4th Annual
Kenya Chapter
Going Forward
www.women4cancer.org
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Asanteni
NGOS AND CANCER ADVOCACY
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Phone: +254 20 261 8996
Mobile: +254 717 117 446
P.O. Box 13263 – 00100
Nairobi - Kenya
Email: [email protected]
Website: www.women4cancer.org
Contact Us!
Dennis Pritt Road
Biblica Centre