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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 2 “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: 4 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: 5 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 6 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 7 AFTER SCREENING, THEN WHAT? A Patients Journey 8 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 17 About Us Nairobi County Stakeholders Meeting Contents Mission, Vision, Values Our Activities Achievements Our Contacts 19 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 20 2012 Women 4 Cancer Awareness Camps Reach to Date Formed 15,000+ Volunteers Run 2500 + 11 Medical Camps 120+ 15 3 Follow Up + Cryotherapy Hysterectomy Radiotherapy / Brachytherapy No. of Women Screened Action www.women4cancer.org 21 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 22 Community Education & Awareness 23 Medical Camps 24 Nairobi Kitui Kisumu Kiambu Kerugoya Machakos Beneficiaries Diverse backgrounds, cultures, social settings 25 Our Beneficiaries Partner Organisation Offering Pap Smear Tests on site 363 Women Screened for Free www.women4cancer.org 27 Past Campaigns 28 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 29 The 4th Annual Kenya Chapter Going Forward www.women4cancer.org 31 Asanteni NGOS AND CANCER ADVOCACY 32 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