Skin cancer remains a significantly underreported health concern in Kenya, despite being prevalent in various communities. One of the most notable cases is that of a 64-year-old farmer from Central Kenya, Michael, who was recently diagnosed with Kaposi’s Sarcoma (KS). Michael, who works outdoors daily as a farmer, developed a non-itchy yet painful lesion on the palm of his hand the primary tool of his livelihood. Despite the common association of KS with individuals living with advanced AIDS, Michael tested negative for HIV and has no known history of smoking, alcohol consumption, or family history of cancer.
His case highlights the complexity of skin cancer, which is not always linked to sun exposure, as many believe. This misunderstanding is particularly dangerous for individuals who spend significant time outdoors, such as farmers and people with albinism, who are often thought to be the only ones at risk from skin cancer due to sun exposure. However, skin cancer can also occur in areas that are typically covered, like the back or legs, further challenging common misconceptions.
Kaposi’s Sarcoma is just one type of skin cancer. It falls under the category of non-melanoma skin cancers and develops in the lining of blood and lymphatic vessels. Other skin cancer types include melanoma and cutaneous T-cell lymphomas (CTCLs). A prevalent form of CTCL is Mycosis Fungoides (MF), a rare skin cancer that can often be mistaken for a fungal infection. It presents as patches, plaques, or tumors and is difficult to diagnose without specialized knowledge.
These issues were discussed in a recent webinar on skin cancer in Kenya, featuring experts from around the world. Dr. Lawrence Mark, Chief of Dermatology at Indiana University, noted that while KS is most often associated with men with HIV/AIDS, it has multiple subtypes, each affecting different populations. These include Chronic KS, which affects people over 50, including women, African Endemic KS, which can also affect children, and iatrogenic immunosuppression KS, caused by medications that weaken the immune system. Regardless of subtype, all forms of KS look similar, often appearing as reddish or purple lumps or patches on the skin and mucous membranes, such as those in the mouth, nose, and throat. When left untreated, the disease can spread to vital organs, like the gastrointestinal tract and lungs, but early detection significantly improves treatment outcomes.
Dr. Roop Saini, a consultant dermatologist at Kenyatta National Hospital (KNH), emphasized the growing burden of skin cancer in Kenya. The country’s geographic location, close to the equator and at high altitudes, subjects it to higher levels of ultraviolet (UV) radiation, increasing the risk of skin cancer. The burden of this disease poses not only a medical concern but also a significant social and economic challenge. Many patients from rural, low-income areas face the dual burden of high treatment costs and loss of income, which impacts both families and the healthcare system. Dr. Saini stressed the importance of raising public awareness, promoting early detection, and implementing preventive measures to mitigate the long-term impact on public health.
Dr. Elias Melly, an epidemiologist at the National Cancer Institute of Kenya, discussed the challenges facing the country’s efforts to combat skin cancer. While the Institute has focused on early detection, including regulating carcinogens such as ozone-depleting chemicals linked to UV radiation, significant obstacles remain. These include late-stage presentations by patients, limited diagnostic and treatment resources, and insufficient data on the true prevalence of skin cancers. Dr. Melly advocated for the use of technology to address these challenges, such as establishing robust cancer registries and increasing the number of trained dermatologists.
Dr. Reuben Thuo, Principal of the College of Health Sciences (COHES) at JKUAT, emphasized the university’s commitment to enhancing the country’s cancer registry system. This initiative aims to address the problem of underreporting, especially in rural areas where access to specialists is limited. Additionally, JKUAT, in partnership with KNH, launched a Masters program in Dermatology in 2021, the first of its kind in Kenya, to help alleviate the shortage of dermatologists. The initiative is particularly important in regions like Taita Taveta, where there is only one dermatologist for the entire county.
The webinar concluded with a call for continued efforts to increase public awareness, early detection, and preventive care for skin cancer. The next session in this series will be held in May 2025.
