For many girls, the 20s are a time to embrace their womanhood.
This often means getting the right cuts of cloth, flaunting their best attributes, and generally discovering their bodies in ways that teenage did not allow.
For Salome Chege, however, the 20s are a period to rediscover her inner beauty, to embrace a girly life beyond cleavages and figure-eight curves.
She would have loved to join the rest of the pride and celebrate her femininity through the latest in bra technology and blouse cuts, but she can’t.
Salome lost one of her breasts to cancer, joining a growing list of young Kenyan girls who are forced to re-evaluate the meanings of their bodies by a disease that is killing and maiming with abandon.
Studies show that breast cancer is ravaging Kenya’s young women, who now account for one out of every five cases.
Often, these, like Salome, are forced to go through mastectomy, a medical procedure where one or both breasts are removed.
Although the risk increases with age — starting as early as 20 years — most breast cancers globally occur during the reproductive and after the menopausal years of 45 and above.
David Makumi, the chairperson of Kenya Cancer Association, says the trend in Kenya is worrying, as this has become a disease “for women who have not reached menopause”.
And, in a population where 70 to 80 per cent of most cancers are diagnosed in late stages, treatment options are limited, and so Mr Makumi laments that majority of breast cancer patients are likely to undergo mastectomy, which explains the many young girls walking around with only one breast, or none at all.
Kenya’s cancer burden is increasing at an alarming rate. Although data is rare to come by, and often questionable, it is estimated that 28,000 new cases are diagnosed in the country every year, according to a government paper titled National Cancer Control Strategy. Of these, breast and cervix cancers are the most common.
Research also shows that about five to 10 per cent of breast cancers are hereditary, caused by abnormal genes passed from parent to child.
This means parents with breast cancer may pass the bad gene to the next generation, which will then pass it on and on, ad infinitum.
New agricultural practices have also been blamed for the rise in cancer cases in the country. For women, particularly, it is the exposure to foreign oestrogens which is most worrying.
While women produce their own oestrogen in the ovaries, says Andrew Weil in the book Eight Weeks to Optimal Health, a lot of farmers are using the hormone in chicken, pigs and cows to hasten growth, and the chemical finally finds its way into dining tables.
This ties to a World Health Organisation report that says that a number of modern behavioural risk factors have triggered an increase in diseases like cancer, including the pervasive aspects of economic transition, rapid urbanisation, 21st-century lifestyles, tobacco use, unhealthy diets, insufficient physical activity, and the harmful use of alcohol.
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For Salome, however, it is too late. She has already lost a breast, and in a society where a woman’s body is valued for its shapeliness, she knows she will have a hard time dating.
Her fears are not unfounded. A dipstick survey of educated men between the ages of 24 and 45 showed that most would have reservations courting or marrying a woman without breasts “for fear of mixing pity with romance”.
The ideal woman has been portrayed in a certain way, and for most Kenyan men, that means being curvy and having a “nice chest”. It is not a Kenyan problem though, as Taylor Chapman, in the book, Women in American Media: A Culture of Misperception, shows.
“Women are expected by society to adhere to the beauty standard,” she writes. “When (they) do not naturally fit the standard or do not constantly strive to fit the standard, they are considered to have failed themselves, and most often are told that they should be ashamed.”
Dr Jared Siso, a University of Nairobi lecturer and culture expert, says socialisation plays a big role in shaping the minds of people on what is ideal and what is not, and that it has made most men to think physical.
However, he says, “times have changed and these ideals have to change.” But is the society listening? Here, the experiences of three young women who have lost that universal symbol of femininity — their breasts…
I have learnt to accept myself after undergoing a mastectomy on one of my breasts. I live my life to the fullest and I feel beautiful.
I was diagnosed with breast cancer when I was 29. I used to go for check-ups religiously in the previous years, but I decided to stop because I felt I was wasting money.
I shouldn’t have because, at 28, I felt a lump and decided to go see my gynaecologist, who referred me to a breast specialist.
He did a Fine Needle Aspiration (FNA) on the lump and took the sample for biopsy, but the results were not conclusive. He suggested that we remove the lump, a sample of which he sent to South Africa for analysis.
By the time the report came back — six months later — I had moved on with life, not even thinking much about it.
The doctor called me to his clinic and told me that I had a particularly Infiltrating Lobular Carcinoma (ILC), and that he had to check both my breasts just to confirm that the other one was okay.
What he found took us both by surprise. My other breast was also infected. He had to rush me to theatre in the next couple of days to remove one breast and do a lumpectomy on the other.
At that time, I did not know anything about a mastectomy and what it entailed, but the doctor was gracious enough to explain.
After the surgery, I had bandages that gave my chest a small protrusion, making it look like I had a breast, so all was well. But when the bandages came out and I saw my flat chest, I was crushed.
That is when it hit me that I did not have one breast. I had to have six sessions of chemotherapy, a cocktail of drugs and 25 sessions of radiotherapy, all this while struggling to accept my chest.
I went through an emotional roller-coaster, from trying to find the right bra and prostheses to just finding a young woman to talk to who had gone through the same experience.
But I found an exit. I decided that breast cancer will not have the best of me. This is my life and I have to live it.
Self-acceptance is the most important thing after going through a mastectomy. There is more to me and to every young woman battling breast cancer than breasts.
The only problem is that I have only interacted with men from the medical field, who kind of understand.
But I have no problem telling someone that I am a breast cancer survivor and I have only one breast.
Immediately I meet a man who is interested in me, I tell him about my condition.
If he decides not to call me after that, I always say that is his loss. He has missed a chance to be with a great friend.
I am now educating young women in high schools and colleges on breast cancer and early detection. However, resistance from teachers is holding me back.
There is a lot of stigma associated with mastectomy. Young women with one or no breasts go through a lot of self-image problems that make them question their sexual attractiveness and even fertility.
We have to go the HIV/Aids way, to be aggressive and educate everyone so that young women who have gone through a mastectomy have a soft landing and get married, and all women go for consistent check-ups.
Young women with one or no breasts should know that they are beautifully and wonderfully made. There are people with no hands, legs, eyes… yet they still function and thrive in our society.
As for dating, be straight with a man upfront and see if he will run or stay and guard your heart, for it is a precious gem. Keep moving forward, this life is beautiful.
I have undergone mastectomy and there is no shame in it. I would gladly tell suitors because I am just like any other individual. I relate with all my peers very well.
To the men who shun women with one breast, no sickness is a person’s choice, and one breast does not make one less of a woman.
When I felt a slippery lump in my breast while taking a shower one day in April last year, I went to hospital and after an ultrasound, the doctor told me not to worry because cysts are never cancerous, so I should just go home and observe it.
After a month, the lump became hard. I went back and he told me to go for surgery. The lump was removed and, on examination, it was found to be cancerous.
I was with my father when the doctor broke the news, and I remember just laughing it away because I thought he was joking. The doctor suggested that I go for a mastectomy.
I was shocked and in denial, but my father told me that the Bible says if one eye causes one to sin, one should remove it. I told the doctor: “Whatever you do to me to survive is okay with me.’’
In May last year, I underwent a mastectomy. It took a month for the wound to heal, and then I started chemotherapy.
The insurance company paid for the medical expenses, but when they discovered I had cancer, they stopped. My parents paid part of the medical expenses as we organised a fundraiser.
Still, after some time we ran out of cash, but I had joined a welfare programme and the hospital paid for my last six sessions of chemotherapy sessions and radiotherapy.
After the mastectomy and chemotherapy and injections and drugs and radiotherapy, I thought my problem was over.
And then, seven months after the surgery, I felt a hard lump on the same breast that had been cut. I went back to hospital. The lump was back. And cancerous. Back under the knife again. This time, a wider incision.
I started another cycle of chemo, but by the time I was on the third, I developed complications and stopped. I am now taking hormonal therapy.
Cancer denied me some things that I loved doing — like swimming — but that was only during treatment. Some friends disappeared but I got new, real ones. For those battling cancer, make merry. When things are hard, just know it will be over soon.
I didn’t have a problem looking at myself in the mirror after the mastectomy. I was just mad, not sad. I thought I should I have done something to prevent the cancer.
I felt guilty because I had known I had a lump yet stayed for two months without going to the doctor. I was annoyed because the ultrasound showed everything was okay, yet it wasn’t. I had never thought I would be on the list of women below 35 with breast cancer.
But that is in the past. I don’t dwell on things that I can’t change, so let me tell you how it happened. I was diagnosed with breast cancer when I was 27. One day, I felt a lump on my breast, but I did not bother going to the doctor until two months later. He did an ultrasound and said it looked normal.
The test was repeated after three months because the lump was growing fast. The doctor told me to go for surgery to have the lump removed. When I first checked my breast, I had felt one lump; the ultrasound showed three lumps; and during surgery the doctor said he saw four lumps.
Clearly, mastectomy was the best bet to save my life. So I had a wound in my breast, but I still needed another cut, this time a complete removal. At about the same time, I was planning to go to China on official duty.
I started weighing the options — China or mastectomy? I confided in the doctor about my dilemma, and he told me I could go to China and then come back for surgery. But my wound was quite bad, so he gave me six bandages to cover the breast.
However, the wound was so leaky that I used all the six bandages in less than one day, even before I left for China! I called the doctor and asked for more bandages. Alarmed, he told me to cancel the trip and immediately head for surgery.
The only people who knew I had cancer were the doctor, the pathologist and I. Being the second surgery within weeks, the insurance company requested for my medical reports and after confirming I had cancer, they refused to pay.
The mastectomy was going to cost Sh450,000 and I hadn’t told anyone about my condition. To make matters worse, the surgery had to be done the next day because the doctor was flying out of the country. I had a day to raise Sh450,000 or postpone the surgery.
I called my brother to accompany me to the doctor’s, and there the news was broken to him. He was shocked, but there was no time to digest the information. We managed to raise the deposit and I was wheeled into theatre the next day.
It was only after I woke up in a hospital bed that it hit me that my chest would look like a man’s. I was scared.
I tried touching my breast but all I could feel were bandages and the many tubes draining fluids. The chest was tight and I was scarred. Mastectomy, it occured to me, meant one thing — losing a breast.
I requested to see the breast they had cut, at least for the last time. The smell of formalin, used as a preservative, made me realise that I had lost a part of me.
Soon afterwards, I sought a second opinion in India, and the doctor there confirmed that I indeed had cancer.
This has cost my family over Sh2 million. I am on hormonal treatment for five years and hope to one day do reconstructive surgery if I get Sh1.8 million.
What helped me most was the fact that I had a wonderful family, an understanding employer and rock-solid colleagues.
Young women, cancer is a reality. Have that lump checked immediately you feel it. And if you are diagnosed with cancer, stay positive, carry on with life as normally as possible, be happy and enjoy life.
Take the sickness as a challenge, a measure of your strength, and don’t let it be stronger than you