United by Unique: Understanding the Uniqueness of Cancer Patients -

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By Dr. Miriam Mutebi, Consultant Breast Surgical Oncologist, Aga Khan University Hospital, Nairobi

The theme for World Cancer Day 2024-2026, “United in our goals, unique in our needs,” highlights a critical aspect of cancer care—each patient’s journey is different. While cancer patients may share common treatments and medications, their experiences, challenges, and responses to therapy are deeply personal. Recognizing this uniqueness is crucial in delivering personalized, patient-centered care that supports them throughout their journey.

Evolving Cancer Care: A Shift Towards Personalized Treatment

Cancer management has evolved significantly, thanks to advances in tumor biology research and a growing shift from a paternalistic approach to shared decision-making. In the past, doctors dictated treatment plans with little patient input. Today, we recognize the importance of collaboration—engaging patients in discussions about their treatment options, risks, and benefits to develop a strategy that aligns with their needs, values, and circumstances.

Addressing the Unique Concerns of Cancer Patients

While each cancer journey is different, common concerns arise, particularly in African settings.

1. Financial Toxicity

The high cost of cancer treatment, often paid out-of-pocket, places a significant financial strain on patients and their families. This economic burden can lead to delays in seeking care, incomplete treatments, and increased stress.

2. Fertility and Sexual Health

Many young cancer patients face the reality of how treatments—especially for reproductive cancers—can impact fertility and sexual health. Addressing these concerns early is crucial to providing holistic care that considers long-term quality of life.

3. Social and Cultural Stigma

Cancer remains highly stigmatized in many African communities, with misconceptions such as cancer fatalism (the belief that cancer is always a death sentence). Patients worry about how they will be perceived, whether they will lose their jobs, and how their diagnosis will affect relationships. Unfortunately, explicit discrimination against cancer patients in the workplace is still prevalent.

Balancing Patient Interests with Clinical Decision-Making

Considering patient and caregiver interests is not a challenge for clinicians—it is an integral part of quality care. Effective cancer treatment goes beyond medical interventions; it requires understanding a patient’s emotional, social, and financial realities. Many patients are diagnosed at advanced stages and may not complete their treatment due to these challenges. Addressing these concerns improves patient adherence to treatment and ultimately enhances survival outcomes.

Navigating Ethical Dilemmas in Cancer Care

Through shared decision-making, clinicians can balance medical expertise with patient preferences, ensuring that patients feel heard, respected, and involved in their care.

For instance, some young breast cancer survivors on hormonal therapy choose not to disclose their medical history in new relationships. While disclosure is personal, it is important to create safe spaces for open conversations without fear of discrimination. In some countries, the “right to be forgotten” legally protects cancer survivors from financial discrimination once they are declared cured. In African settings, where workplace discrimination persists, stronger legal frameworks are needed to protect cancer patients and survivors.

Mental Health in Cancer Care: The Missing Piece

Despite being a critical component of cancer treatment, mental health support is often overlooked in cancer care. Stigma, high costs, and lack of accessibility prevent many patients from seeking counseling or psychosocial support. Some patients delay mental health care, saying, “Daktari, si nipoone kwanza?” (“Doctor, shouldn’t I heal first?”)—a misconception that mental and physical healing are separate.

To bridge this gap, we must:

Normalize mental health conversations within cancer care.

Integrate psychosocial support as part of the standard of care for cancer patients.

Develop sustainable, cost-effective mental health models, such as peer support groups and patient and caregiver education programs.

The Path Forward: Embracing Personalized Cancer Care

Every cancer patient is unique, and their care should reflect this reality. The future of oncology lies in patient-centered, individualized treatment plans that address not only the disease but also the emotional, financial, and social aspects of cancer. By fostering collaborative decision-making, tackling stigma, addressing financial toxicity, and integrating mental health support, we can create a healthcare system that truly sees, hears, and supports every cancer patient’s unique journey.