MGHD 2024

Background: Cancer is a significant contributor to the global burden of non-communicable diseases. The International Agency for Research on Cancer (IARC) reported approximately 19.3 million new cases worldwide in 2020. In sub-Saharan Africa, over 800,000 new cancer cases were reported in 2020, of which breast cancer was the second leading after cervical cancer. The Butaro Cancer Center of Excellence (BCCOE) has been pivotal in providing comprehensive cancer care in Rwanda. However, there is limited research on the post-surgical experiences of Rwandan breast cancer patients following mastectomy. This study aims to explore these experiences, identify challenges, and understand coping mechanisms to enhance post mastectomy care and support. Methods: This qualitative, phenomenological study was conducted at BCCOE in Rwanda. The study employed in-depth interviews with adult female breast cancer patients attending post-surgical check-ups or receiving chemotherapy between April 30 and June 1, 2024. Participants were selected through simple random sampling from a patient database, ensuring inclusion criteria were met. Data collection involved semi-structured interviews using a guide developed from relevant literature, translated into Kinyarwanda for accuracy. Interviews were conducted in private settings, recorded with consent, and lasted 45-60 minutes. Transcripts were analyzed using thematic analysis and MAXQDA software was used to code and organize themes. The validity of the analysis was achieved through researcher triangulation. Data were stored securely, maintaining participants' anonymity and confidentiality. Ethical approval was obtained from the UGHE Institutional Review Board. Results: The study's findings are organized into seven thematic areas, illuminating the multifaceted challenges faced and coping mechanisms employed by post mastectomy cancer patients. Participants reported profound emotional distress concerning body image and self-perception. Many struggled to sustain their previous occupations due to physical limitations and encountered complexities in navigating healthcare and social dynamics. The impact extended to strained relationships with family and friends, highlighting significant interpersonal challenges. Coping strategies predominantly involved spiritual faith and seeking support from close relationships and community networks. The themes developed included 1. Emotional experience and body image and self-perception following mastectomy 2. Need for empathetic interaction and emotional support 3. Post mastectomy, individuals often face challenges continuing with their previous occupations 4. Navigating Healthcare and Social Dynamics 5. Mastectomy significantly impacts relationships with family and friends, often creating a strain that challenges the dynamics of family relationships and friendships 6. Coping with life after mastectomy 7. Support networks positively enhance the experiences of breast cancer patients after mastectomy and are essential in the recovery journey. Conclusion : The participants faced challenges including difficulties with follow-up visits due to long distances and high transport costs, and loss of previous occupations due to post mastectomy body changes. Stigma and misconceptions also emerged as pervasive issues. Therefore, there is a need for decentralized cancer care to facilitate local access to medication. Enhancing support programs to alleviate financial burdens, dismantle misconceptions around cancer, and establishing social support groups can emphasize the importance of comprehensive care strategies in improving the well-being of breast cancer patients after mastectomy.

Background: Worldwide, blood malignancies account for 10% of cancer cases. Early detection and treatment increase the survival rate for cancer patients. The symptoms of blood malignancies include weight loss, loss of appetite, and feeling weak. This makes it difficult for healthcare providers at health center level to detect and refer patients early. Butaro Cancer Center of Excellence(BCCOE) provides diagnosis and treatment services for cancer. This study aimed to explore experiences and initial health-seeking behaviors of patients with blood malignancies at BCCOE who sought care from a traditional healer for the same illness. Methods: A qualitative phenomenological study was conducted. In-depth interviews were conducted with patients with blood malignancies at BCCOE. Thematic analysis was used todevelop themes. Results: Twelve respondents were interviewed. Our results highlighted five themes that depict the experiences for patients with blood malignancies and health-seeking behaviors. 1) Accessibility barriers to health facilities and healthcare services push patients with blood malignancies to seek care from traditional healers 2). The care-seeking pattern is influenced by the nature of the illness, beliefs, community, family, and friends 3) Frequent visits to health facilities and misdiagnosis lead patients with blood malignancies to seek care from traditional healers. 4) Seeking care concurrently from traditional healers and conventional medicine delays diagnosis and treatment. 5. Patients with blood malignancies seek care from conventional medicine after realizing that traditional healers are unable to treat their illness. Conclusion: The findings of this study highlight important changes needed to improve health outcomes for patients with blood malignancies at BCCOE. Patients highlighted system barriers, reasons they sought care from traditional healers, and factors influencing health-seeking behaviors. Therefore, it is critical to consider training healthcare providers at the health center on the symptoms for blood malignancies and collaboration between traditional healers and medical professionals to improve cancer care.