Effectiveness and Treatment Experience of Human Epidermal Growth Factor Receptor-2 Positive Breast Cancer Patients on Targeted Therapy, Kenyatta National Hospital

Abstract

Among the four-breast cancer molecular subtypes, HER2-positive breast cancer accounts roughly to 20% of the occurrences, aggressive and has a poorer prognosis than other sub-classification. Trastuzumab has had a significant impact on the natural past of the breast cancer (HER2-positive). Though, there is scarcity of comprehensive data in Sub-Saharan African countries including Kenya. The study involved establishing effectiveness and describing the experiences of patients diagnosed with breast cancer (HER2- positive) and put on Herceptin. The effectiveness and treatment experiences of breast cancer patients on Herceptin was investigated in this research using qualitative and quantitative data collection methods. Quantitative and qualitative data was collected over a period of 6 weeks. This was done in CTC at Kenyatta National Hospital among clients with HER2 positive breast cancer. A questionnaire based on patient-reported outcomes (PROs) was used to collect quantitative data from 44 randomly selected participants. In addition, 14 interviews with people who had been purposively selected from the study population. Quantitative data was analyzed using social sciences of statistical package (SPSS version 26.0). The findings of the univariate analysis were presented using proportions and frequency. To assess associations between categorical variables, bivariate analysis was done using Chi-square, with p-values of 0.05 or less considered significant. Text, frequency tables, and bar graphs was used to present descriptive statistics. Thematic analysis was used to analyze narrative data that had been clustered together in qualitative data analysis.The Kenya National Hospital-University of Nairobi Ethics and Research Committee (KNH/UON ERC) granted permission. The highest percentage (48.8%) of participants were 50 years and above. Most (36.4%) were married, and majority had stopped working (77.3%). Many (88.1%) earned a monthly income below 10000Kshs, and most participants had primary education (52.3%) and all participants had NHIF cover (100%). Physical changes experienced by participants were tingling sensation and numbness (14.4%), joint aches (13.7%), fatigue (13.1%) and high blood pressure (11.4%). Psychological experience includes insomnia (27.0%), anxiety (25.8%), depression and cognitive impairment at (23.6%) respectively. Sociological changes experienced were financial burden (30.5%), family distress (28.4%), social isolation (21.1%) and marital strain at (20.0). Chi -square relation showed county of residence, income and education were statistically significant with level of understanding treatment regimen. In conclusion HER2 -positive patients on Herceptin experience physical, psychological, and sociological changes. It aggravates psychological and sociological changes due to high price, low level of understanding and low income.