Dr. Nneka:
Good morning.
Martha:
Good morning.
Dr. Nneka:
How are you doing?
Martha:
I'm good. Thank you.
Dr. Nneka:
Good morning. This is Dr. Nneka Handschin from Infiuss health. Thank you so much for taking the time to have this meeting with us. We appreciate it.
We are seeking to improve patients' experience in Africa by offering Africans better access to health care, investigational products, and medical devices. This patient experience will help us in our discussions with pharmaceutical companies and researchers when we talk about clinical trials and clinical research, so we are grateful for it. Thank you so much for your time. Can you please introduce yourself?
Martha:
My name is Lefeh Martha. I just turned 44 yesterday. I am also a registered nurse working here in Cameron.
Dr. Nneka:
That's lovely to hear. We heard that you were recently diagnosed with breast cancer. Could you please give us information about how this happened, when it happened, and the circumstances surrounding that event?
Martha:
Okay, thank you. It all started in 2020. During that period of COVID. I was first diagnosed with COVID which brought me down. I was so sick. But by the grace of God, I got well. Just about two weeks later, around February, I got up one morning and found a lump on my left breast. It was not just a small lump, it was very big. I was wondering 'what is this?', I did not have any idea. I did not even think of cancer or whatever. As I saw it, I thought it would go away. So I stayed for 2 days, then I went to work. I was talking with my colleague about it and she said 'And you are just saying it like that. You are calm like that. You should go and confirm. So they would try to find out what it is because lumps in the breast are not good.'
It was as if she had woken me up. I left the ward immediately and went for a consultation. They checked me and prescribed me a breast echography and mammography. So I went and I did it. When the results came out, the results showed that it was not something serious. Because before then, I had a baby of about 2 years. When I delivered, my baby refused that breast. It didn't mean anything to me.
The echography was saying it was something serious but the mammography was saying it was not so serious.
So I came back home, I went to another hospital and consulted. They prescribed the same echography and mammography. Later, when I was talking with my daughter-in-law, she told me that she would contact a friend that would refer me to a certain doctor in the general hospital. He was experienced and had worked for more than 40 years. She assured me that when the man checked it, he would tell me exactly what it was. I contacted the doctor, and he checked me and asked for a biopsy, mammography again, and an echography. When I did the tests, the biopsy results showed that it was the accumulation of breast milk. He suggested that if they operated and removed the lump tissue, it was going to pass.
My dear, I was already dying of stress. I was seeing myself as somebody whose life is going to an end. Now when the results came, I presented them to the doctor, and he told me 'Okay, it's not serious. It's not something that would harm you. But, since you are working in a hospital where you could be operated on for free, go back there and present the results, then they are going to do your operation free of charge. Because if you have to do it in this general hospital, it will cost you a lot.'
So I came back to the hospital where I was working. I went to the Oncology Service. I presented the results to the doctor. But when that doctor examined the breast, he said 'No'. He can not just operate on the breast because what he is touching and seeing is not in conformity with the results. That we were going to do some other tests. That's when we started everything all over again. All the results that were coming out were saying the same thing. That it was not something serious. That when operated on, it will pass. It gave me a bit of comfort.
He finally decided to remove the lump. We did the operation in 2021. That is from February 2020, I was moving up and down with the breast lump, and no decision was taken. At one moment, some abscesses formed on my breast, they had to incise it and clean it. I was experiencing excruciating pain. It eventually got healed.
So when that doctor decided to operate in 2021, we sent the biopsy of the lump that was removed from the breast to a lab and from there the result came and they saw the cancer cells. I said to myself 'NO!'. That day was the worst day of my life, I didn't know I would stay till the next day.
When I saw the result, I went to the doctor that operated on me and saw that he was on leave for one month. But I thought to myself, "Oh, will I stay like this for one month?" I just left to see the doctor that referred me to the place, the doctor in the General Hospital. I called him, and he asked me to come. So when I went in, he saw the results and he was surprised. He was broken. Then he said 'There's no problem. I will put you immediately on treatment.' He specified that I'll have to do radiotherapy. I presented him with the results on a Friday and he prescribed the radiotherapy on Monday. So as I went in that Monday, I paid and he took me into the radiotherapy room with the mapped areas. That was how I started my radiotherapy treatment. I kept getting radiotherapy and no chemotherapy. I had 25 sessions of radiotherapy.
Dr. Nneka:
You're so blessed that you caught it at an early stage and that you were able to address it just days after you noticed the lump. And I'm really glad that you kept on going back even though the medical personnel thought it was not serious and just the build-up of breast milk. When they saw the breast cancer cells, you were able to get the therapy you needed quickly. So I'm guessing that everything is resolved and fine now?
Martha:
Yeah. The results said that it was at the second stage.
Dr. Nneka:
Was the treatment quite expensive? Did you have health insurance or did you have to pay out of pocket?
Martha:
I had to pay out of pocket. It was not all that expensive but at that moment, I was down financially. So my family, the lovely family that I have, quickly assembled the money. Then by that Monday, I went and paid
Dr. Nneka:
That's fantastic.
Can you tell us about your experience during radiotherapy? Was it safe? Did you have any side effects?
Martha:
Yes. The beginning was not easy for me. Because when I went through all those issues and stress, it was as if I was going into depression. Because I was manifesting almost all the signs of depression. I would be seated and when I remembered that my life was coming to an end, I would just fall. I was weak, so weak that I could not hold something. They were always rushing me to the hospital.
When I started the radiotherapy, it was making me so weak. Each time I went for treatment and came back home, I was not able to do anything, I was very weak. I felt as if I wanted to vomit.
The doctor told me that I should make sure I have prepared a lot of food before leaving my house so that when I come back from each session, I will eat. Each time I came home, my family would have prepared some food, and I would eat and sleep. That was how I was getting on.
Dr. Nneka:
I am so sorry to hear that. It seems like you went through a really tough time.
Martha:
It was not easy. I thought I was dying. I didn't know that today, I would still be talking. I will say that God is good.
Dr. Nneka:
I'm grateful that you're feeling much better. Thank God that the radiotherapy worked is better now.
Martha:
I am better. I have also been going for checkups. I think I will be going for my last checkup next month. I did another mammography and breast echography about six months ago. And the results came out very good.
Dr. Nneka:
Fantastic!! In our company, what we do is research and investigate the safest and most effective therapies. We are interviewing patients and doctors to find out the different methods that we use in diagnosing and treating breast cancer. From a nurse's perspective and a former patient's perspective, how would you feel about participating in a clinical trial if there was a study that came up with new drugs and you were presented with such a new study drug? Would you have been willing to participate in such a clinical research trial?
Martha:
Yes, I would have done so. At that moment, I was ready to do anything.
Dr. Nneka:
Well, we're glad that the radiotherapy worked. That was an effective method for you.
Martha:
But when I finished that radiotherapy, I had some scars on my breast. They were cleaning it at the hospital. I had to stay in the hospital for almost a month while they cleaned the wound there before it healed. So, I went through a lot.
Dr. Nneka:
Would you consider yourself included in the disease management process? Did the doctors ask for your opinion? Did you feel listened to and heard?
Martha:
Yeah. The doctor that I met at the General Hospital. I think that he is the one that brought up my morale. Because he was always checking in on me, even when I was at home. He would always write and ask, 'How are you? I have told you that in case of anything, don't hesitate to inform me.'
But the place where I was so stressed was when I went to the hospital where I worked. Because the doctor there stressed me too much. Sometimes, when I go to see him, he would say he doesn't have time and he has a lot of patients to take care of. Other times, he would prescribe tests, that I could have done in the hospital for free, and he would send me to other labs to pay and do those tests. I understood what was going on but I was desperate. Whatever they asked me to do, my family would do it. The results would still come out the same. My life was in his hands, so I would just follow anything he said.
But, I was comfortable with that doctor at the general hospital, and he's the one that follows up on my case till today.
Dr. Nneka:
It's great to know that they are good doctors out there. Even though you've had a bad experience with the other one, it's great to know that this doctor from the General hospital was caring and knowledgeable.
Martha:
He's really good.
Dr. Nneka:
For future patients that may get diagnosed with breast cancer or any kind of cancer, are there any changes that you would like to see in the healthcare system, whether in Cameroon, in Africa, or internationally? Based on your experience, what changes or improvements could have made your diagnosis and treatment better or easier for you?
Martha:
The first thing that I would like is that they should take care of the psychology of the patient. Here In Africa, we know that we don't have enough healthcare facilities and that ill health is traumatizing. Healthcare workers should approach a patient with love and care. Talk to the patient and explain the treatment to the person. For instance, chemotherapy, I hear, is very expensive here. For people that have to go through that one, it is not easy. I just lost a sister two days ago to cancer of the uterus. She was depressed. So I would like them to work on the psychology of the patient.
Then they should also explain the treatment and the side effects of the treatment. Because when the person notices the side effects by himself or herself, it is somehow discouraging because they don't know what is awaiting them. They only discover because of the treatment they are going through. Meanwhile, if you prepare the patient, I think psychologically, the patient will prepare himself or herself also.
Then I'll also talk about the price. I think the cost of treatment is really expensive. That's why many are unable to meet up and they end up dying because the cost of treatment is very high. If they can do something about the cost of treatment, I think it will help a lot to save the lives of other people.
Then also concerning the equipment. We don't have enough equipment here. Like that radiotherapy machine that I was using, they were times you would go and they would say the machine is bad. Imagine you have already started your treatment, you just go to pay and hear 'the machine is not working this morning, come this other day.' Right now, as I'm telling you, it is what is still going on. I know about two of my colleagues that are suffering from breast cancer that are going and they tell them 'it's not working come tomorrow'. Although we have another center that has a lot of equipment, it's extremely expensive. So that's the problem we are facing.
Dr. Nneka:
Yes. We hope that Africa can get sufficiently developed with increased capacity, such that patients can get access to the health care that they deserve. It Is very sad to hear that people that have been diagnosed are not able to get treatment because of the lack of infrastructure.
We're so grateful to you for taking the time to talk to us about your experience. We pray that your health will keep getting better. And that there will be no more incidences of cancer or any other kind of illness.
Martha:
Yeah, I pray for that. That's my everyday prayer. Because I will never even wish my enemy to ever go through that.
Dr. Nneka:
Yeah. Thank you so much. We hope that we can work together to improve health care not only in Cameroon but in the whole of Africa.
Martha:
Yeah. Remember at any moment if you need me, I'll create time for you. Thank you very much.
Dr. Nneka:
We are honored. Thank you very much for your time.
Martha:
All right, thanks.
Dr. Nneka:
Goodbye
Check out the audio version of this interview.