How breast cancer survicors are turning scars into courage

Losing a breast brought profound emotional pain to Nancy Awuor, a breast cancer survivor. She faced mockery and sarcastic laughter from those who noticed she had only one breast.

At times, she loses balance and falls, a lasting physical reminder of the mastectomy she underwent a decade ago.

“It hurts deeply as a woman to lose a breast. Though I get emotional when mocked, I’ve accepted my condition because I’ll never regain it,” says Awuor.

Diagnosed with breast cancer in 2015 after discovering a lump on her right breast, Awuor initially dismissed it as a normal swelling. When it grew and she felt lymph nodes in her armpits, she sought medical attention.

Tests, including needle aspiration, mammogram and biopsy, confirmed stage two breast cancer, a diganosos that left her devastated.

“I cried, thinking I was going to die. Hearing it was stage two felt serious, but doctors assured me it was treatable in its early stages,” she recalls.

Awuor underwent a mastectomy followed by 12 chemotherapy sessions, which she describes as one of the toughest experiences of her life.

“Chemotherapy is painful and exhausting. My nails darkened, my hair fell out and I felt confused most of the time,” she says.

The financial burden was overwhelming. Although she had a National Health Insurance Fund (NHIF) card, its coverage was quickly exhausted and did not include some tests and medications. Awuor had to rely on family, friends and fundraisers to meet the Sh1.5 million cost of chemotherapy and other treatments.

She continues to attend regular check-ups to monitor her health. Now in remission, Awuor faces lasting challenges. At 32, chemotherapy triggered early menopause, shattering her dream of having more children.

“I wanted four children, but menopause was devastating. In our culture, having children is highly valued,” she says, admitting she once feared how her spouse would react.

Balance and confidence

Physically, the loss of a breast affects her balance and confidence. She wears a Sh40,000 prosthesis — costly but essential for her sense of wholeness.

“I sometimes fall due to imbalance. The prosthesis helps both emotionally and physically,” she explains.

During Breast Cancer Awareness Month in October, The Standard on Sunday met Awuor as she championed early screening.

“Check your breasts. If you feel a lump, get screened. Some screenings are free. Cancer isn’t a death sentence if caught early,” she urges women.

Margaret Makimei’s world also shattered when she was diagnosed with stage 3B breast cancer.

“I was terrified, thinking my life was over,” she recalls.

Makimei first noticed a lump in her left breast in 2019 but hoped it would disappear. By 2020, as it grew larger, she decided to seek medical help. An ultrasound and mammogram prompted a follow-up request, which she initially ignored.

“The lump kept growing, so I saw another doctor. A core biopsy confirmed stage 3B breast cancer after 14 days,” she says.

Makimei underwent a mastectomy, eight chemotherapy sessions, and 15 radiotherapy sessions.

“Chemotherapy drains you physically, emotionally, and financially. I spent Sh80,000 on medication alone. The Social Health Authority (SHA) failed to cover my treatment for two months, forcing me to default,” she explains.

In February 2025, a PET scan revealed cancer in her armpits, requiring hormonal therapy, cancer medication, and calcium supplements costing Sh54,000, Sh67,000, Sh9,000, and Sh4,000 respectively. She now relies on well-wishers for financial support.

To prevent recurrence, Makimei underwent a hysterectomy in 2024 to remove her uterus, ovaries, fallopian tubes, and cervix.

“I had accepted my situation, so I didn’t feel bad,” she says.

Early screening

The disease also strained her personal life. “My husband abandoned me, thinking I was pretending. He had money but refused to support me and told me to leave,” Makimei recalls.

Left alone with three children, she chose resilience. “I told myself cancer isn’t a death sentence,” she says.

Now a cancer awareness advocate, Makimei volunteers in clinics, encouraging early breast and cervical cancer screening. A donated silicone prosthesis boosts her self-esteem, but she manages lymph-edema, a mastectomy side effect, with massage and compression stockings. Chemotherapy also diminished her sexual desire. Despite these challenges, she remains hopeful. “Early detection saves lives. Get mammograms and check for changes, like lumps or color shifts,” she advises.

Dr Catherine Nyongesa, a radiation oncologist and founder of Texas Cancer Hospital in Nairobi, notes that the exact cause of breast cancer is unknown. Risk factors include early menarche, late menopause beyond 50, and prolonged hormone replacement therapy, which increase hormonal exposure. Age is a significant factor, with risk rising as women age.

“Women who never breastfed, had late first pregnancies, or have a family history of breast cancer, especially in first-degree relatives, are at higher risk,” Nyongesa says. Genetic predispositions, such as breast cancer susceptibility genes, also contribute.Breast cancer is a group of diseases with molecular and genetic variations.

“We classify it by types like triple-negative, lacking hormone receptors, or hormone receptor-positive cancers,” Nyongesa explains.

Most cases are ductal carcinomas, originating in milk ducts or glands. In Kenya and Africa, younger women are increasingly diagnosed compared to Western countries, possibly due to genetic or racial factors. More cases affect the left breast than the right. Men can develop breast cancer, but it’s rare, comprising 1 in 100 cases.

Fertility preservation

Nyongesa praises government efforts through the National Cancer Control Programme and Strategy, which emphasize early diagnosis and treatment.

“County hospitals now offer screening and treatment, with some Level 3 facilities providing free services,” she says. The Kenya Cancer Institute partners with private entities to train healthcare professionals and enhance care. During Breast Cancer Awareness Month, Nyongesa urges women to prioritize screening, lamenting its low uptake.

“If you notice changes, seek a second opinion. Early detection saves lives,” she says, advocating for fertility preservation, support groups and reconstructive surgery to restore confidence. “Cancer treatment requires medical, emotional and family support,” she adds.

The Breast Cancer Screening and Early Diagnosis Action Plan 2021-2025 reports cancer as Kenya’s third leading cause of death, causing 7 per cent of mortality with 42,116 new cases and 27,092 deaths in 2020. Breast cancer is the leading cancer among women, affecting 6,799 annually with 3,107 deaths, numbers that continue to rise.

Most cases are diagnosed at advanced stages, limiting curative options. The Kenya National Cancer Registry (2014-2019) shows 70 per cent of cancers are detected at stages 3 or 4, typically in younger women (35-50 years) compared to Western countries (50-55 years). Ninety per cent of cases are sporadic, with 5-10 per cent linked to genetics.

Invasive ductal carcinoma accounts for 75 per cent of cases. Key challenges include limited access to preventive, diagnostic, treatment and rehabilitative services. Awuor and Makimei’s stories highlight the resilience needed to navigate breast cancer’s physical, emotional and financial toll, underscoring the importance of awareness and early intervention.