Late Effects of Therapy, Stigmatization and Social Reintegration following Childhood Cancer Survival in Kenya: A Case Report

Jpm Lemmen, N. Midiwo, F. Njuguna, G. Kaspers, S. Mostert
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Abstract

Childhood cancer survival is increasing in low- and middle-income countries like Kenya, which comes with a new healthcare challenge: late effects and quality-of-life of survivors. A case was studied to depict a Kenyan Hodgkin lymphoma survivor, illustrating some of the childhood cancer survivors' difficulties in Kenya. Late effects of therapy, stigmatization and social reintegration were explored. The investigators reviewed medical records and used semi-structured interviews and stigma assessments using the Social Impact Scale. The survivor developed severe pulmonary hypertension during treatment with ABVD and salvage protocols. Three years after treatment, the patient experienced chemotherapy-induced late effects (chronic heart disease) that hindered personal care, social activities and job opportunities and required follow-up. Stigmatization by the community burdened his family life and marital prospects. This case report is one of the first that testifies of combined medical and psychosocial challenges that childhood cancer survivors may face in sub-Saharan Africa and underlines the need for a holistic approach.
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肯尼亚儿童癌症生存后治疗、污名化和社会融合的后期影响:一例病例报告
在肯尼亚等低收入和中等收入国家,儿童癌症存活率正在上升,这带来了一个新的医疗挑战:后期影响和幸存者的生活质量。研究了一个案例,描述了一名肯尼亚霍奇金淋巴瘤幸存者,说明了一些癌症儿童幸存者在肯尼亚的困难。探讨了治疗、污名化和重新融入社会的后期影响。研究人员审查了医疗记录,并使用半结构化访谈和社会影响量表进行污名评估。幸存者在接受ABVD和抢救方案治疗期间出现严重肺动脉高压。治疗三年后,患者出现化疗引起的晚期影响(慢性心脏病),阻碍了个人护理、社交活动和工作机会,需要随访。社会的污名化给他的家庭生活和婚姻前景带来了负担。这份病例报告是第一份证明撒哈拉以南非洲癌症儿童幸存者可能面临的医疗和心理社会综合挑战的报告之一,并强调需要采取全面的方法。
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