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Inspection with Acetic acid and Lugol’s Iodine (VIA/VILI), HPV DNA testing which has given opportunity for self- testing. For breast cancer it would be breast examinations, but unlike breast cancer where the screen is looking for the cancer, in cervical cancer screening we are looking for precancerous lesions. In prostate cancer screening would involve doing a prostate exam and a blood test called Prostatic Specific Antigen (PSA). Tertiary prevention would be efforts geared to limiting metastatis (spread of the cancer) in the presence of primary disease. When all preventive measures have failed we then move to treatment. Treatment can involve surgery, chemotherapy, r a d i o t h e r a p y, i m m u n o t h e r a p y, hormonetherapy and so on. Different cancers have different treatment options so in say cervical cancer the mainstay will be surgery in early disease and the radiation therapy which is boosted with a bit of chemotherapy. For leukemia’s the main type of treatment is chemotherapy. All these treatments have serious side effects hence have not been very popular. Side effects can be infection, bleeding, blood clots, anaemia, hair loss, bone marrow failure, osteoporosis, infertility and so on. Other than the side effects the cost of most treatments are exorbitant. The only way the cost can come down would be to manufacture our own medicines and increase number of local specialists offering this service and this won’t happen if Kenyans don’t trust their local doctors to treat them. In my fertility line when you don’t see your client they probably moved on to anoth- er doctor or got pregnant; it’s unusual that they have passed on just like that! In oncol- ogy if you don’t see your client it’s a dreaded call to relatives to make sure they are okay and unfortunately many a time the answer is they kept their date with St Peter! I have friends and relatives who opted not to go for conventional therapy and opted for alternative remedies. I would not advocate the use alternative therapy other than to help control side effects of conventional medicine and definitely not as first line of treatment. Recent advances in treatment have made it possible for people to now live longer more productive lives despite having cancer. I may sound like a sadist but the hard reality is that we are all going to die even if some scientists believe they are going to get a cure from death. I was quite shocked at how many people seem to think that cancer is a disease like flu or malaria or even TB which when you diagnose you can treat and get cured. In many instances one can get cured from cancer but it depends to a great extent on how early diagnosis is made. If caught early yes it can be cured but the challenge comes that early cancer usually has no symptoms so unless one undergoes frequent screening its unlikely to be caught early. This then means that doctors especially oncologists will just give treatment to delay progression of the disease and improve quality of life, prior to the final end which unfortunately is death. I think this is why I chose fertility because when you don’t see your client they probably moved on to another doctor or got pregnant; it’s unusual that they have passed on just like that! In oncology if you don’t see your client it’s a dreaded call to relatives to make sure they are okay and unfortunately many a time the answer is they kept their date with St Peter! It was with great disappointment I read the reaction of some Kenyans to the appeal from Kenyatta National Hospital to assist in fund raising for the construction of a Hospice. Being a Kenyan I understand the outrage especially as the number of graft cases are on the increase and yes the Government should work tirelessly to limit or eradicate graft. In the meantime Wanjiku, Atieno, Wekesa, Swaleh all common Kenyans who cannot afford to go to some of the prestigious state of the art hospitals here in Kenya or to fly to the United States, France, India as demonstrated by our more affluent brothers need care and support. Where will they go to get relief of their symptoms and live their last days with dignity? That question is open and I leave you with my two cents crying call to see how you can be a part of the solution and for those of you with a conscience assist the less fortunate members of society. Dr. Maureen Owiti is a practicing Obstetrician Gynaecologist and fertility consultant based in Nairobi. You can commune with her on this or related matters via email at: [email protected].