foundation-for-cancer-care-in-tanzania

FCCT Blog Post #20

Wed, 25 Mar 2026 21:49:56 GMT

KCMC-FCCT Tumor Board

Radiation-related questions were the focus of two of the three cases discussed at this month’s Tanzania-Minnesota tumor board. This coincides with the opening of the Radiation Treatment Center at KCMC last month. Currently, a number of patients are receiving palliative radiation therapy, and several are undergoing curative treatment for prostate cancer, breast cancer, cervical cancer, rectal cancer and lymphoma

A 54 yr old woman presented with abdominal distension and a large palpable abdominal mass. A CT disclosed a > 20cm intra-abdominal mass that appeared to be arising from the uterus. There was mass effect on the bowel and severe right hydronephrosis. Calcified uterine myomas were identified as well as a small non-calcified lung nodule in the lung bases on the abdominal CT scan. A lytic lesion was seen in the T8 vertebral body. An exploratory laparotomy revealed an unresectable, greater than 40cm abdominal mass infiltrating the retroperitoneum and involving small bowel. A biopsy showed a spindle cell tumor morphologically consistent with a gastrointestinal stromal tumor (GIST). The tumor was CD117 negative suggesting a rare, CD117-negative GIST. Other considerations included a leiomyosarcoma or liposarcoma however additional molecular and immunohistochemical stains could not be performed to provide a definitive diagnosis. It was unclear whether this tumor was originating from the uterus, the small bowel or retroperitoneum. The discussion revolved around the palliative goal of treatment and whether palliative chemotherapy (such as a doxorubicin-ifosfamide-mesna regimen) would provide benefit. CD117-negative GISTs are rare tumors often related to mutations in PDGFR and typically do not respond as well as CD117-positive GISTs to imatinib. Other tyrosine kinase inhibitors, such as sunitinib and regorafenib are not readily available in Tanzania.

A 42 yr old HIV positive woman with a preserved CD4 count of 460 on antiretrovirals developed rapid progression of metastatic squamous cell cancer of the cervix 2 months following total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH and BSO) for stage 3 cervical cancer. In January, 2026, she had undergone a TAH and BSO at an outside hospital and had biopsy-confirmed para-aortic lymph node involvement. She presented with back and abdominal pain from a rapidly enlarging para-aortic mass infiltrating the psoas muscle. This mass had grown substantially in the past 2 months since surgery and was causing significant pain and disability. The discussion revolved around whether palliative radiation (3000cGy in 10 fractions) or palliative chemotherapy (with a regimen such as carboplatin and paclitaxel) would be the best option. Cervical cancer, historically has been an “AIDS-defining cancer” with the immunosuppressive effects of HIV contributing to a more aggressive course.

A 61 yr old man developed progressive nausea, vomiting, headache and left hemiplegia 19 days after undergoing a subtotal resection of a right temporal grade 3 astrocytoma. Repeat brain imaging identified rapid recurrence of his right sided brain tumor with mass effect and midline shift. Despite mannitol and dexamethasone, he remained severely debilitated. A discussion revolved around goals of care given the severely debilitated status. Treatment options considered included repeat craniotomy vs definitive chemoradiotherapy with temozolomide vs short course palliative radiation in 15 fractions. Gliomas are the most common primary brain tumors in adults in Tanzania. Patients often present late and have poor outcomes. (https://www.ajol.info/index.php/eajns/article/view/276288) Molecular characterization of gliomas in Tanzania with IDH mutation status and MGMT promoter methylation status is virtually unknown.

Randy Hurley MD, cTropMed

Global Health Faculty, University of Minnesota

FCCT Blog Post #19

Wed, 19 Feb 2025 20:35:36 GMT

KCMC-FCCT Tumor Board

Four cases were presented in February 2025.

The first case involved a 34 year-old woman with locally advanced and possibly metastatic leiomyosarcoma of the orbit. She had presented with one year of left eye symptoms including pain, vision loss and proptosis. A CT of the head identified a 2.6cm mass infiltrating the orbit with bone erosion. Enucleation was performed; the pathology revealed leiomyosarcoma. A staging CT of the chest/abdomen and pelvis identified multiple bilateral micronodular lung nodules worrisome, but not definitive, for metastatic disease. The discussion revolved around whether sending the patient off for PET imaging would help clarify a diagnosis of metastatic disease. Another option, initiation of palliative systemic therapy with gemcitabine and docetaxel, was discussed. Given cost constraints and the patient’s limited financial resources, it was ultimately decided to refer her to Dar es Salaam for orbital radiation for local control and repeat the chest CT in several months to look for growth of the pulmonary nodules that would be more consistent with metastatic disease.

The second case involved a 46 year-old woman with metastatic adenocarcinoma of unknown primary with papillary histologic features. She presented with a large 40cm palpable anterior chest wall mass invading the sternum and involving the mediastinum, surrounding the aortic arch and associated with a pericardial effusion. There was bilateral axillary lymph node involvement, a large splenic mass and a 5cm liver lesion. The differential diagnosis included a lung or breast primary, a dedifferentiated mediastinal germ cell tumor or GI malignancy. In the USA, a battery of immunohistochemical stains, including differential cytokeratin stains, lung cancer, breast cancer and ovarian cancer markers would be helpful to identify a site of origin. Cell-of-origin next generation sequencing technology is also available in the USA. In this way, palliative chemotherapy could be best targeted to potential site of origin to maximize the chance of response. In the absence of this technology, the patient was initiated on palliative carboplatin and paclitaxel chemotherapy and had just received her first cycle

A third case involved a 68 year-old man with metastatic non-clear cell renal cell carcinoma. CT imaging disclosed bilateral renal masses (8cm right renal mass and 2.7cm left renal mass) and a 6.8cm metastatic deposit in the left pelvis infiltrating the left femoral neck and medial compartment muscles. A CT guided biopsy of the right kidney mass revealed a high- grade carcinoma with spindle shaped cells suggestive of a renal cell carcinoma with sarcomatoid features. In the USA, a plethora of treatment options exist for advanced renal cell carcinoma including numerous tyrosine kinase inhibitors, angiogenesis inhibitors and several immunotherapy options. Sunitinib, sorafenib and bevacizumab are the available treatment options for renal cell carcinoma in Tanzania.

The final case was presented by a Tanzanian OB/GYN resident in conjunction with a visiting OB/GYN resident from Duke University. This was a tragic case of a 29 year-old woman with newly diagnosed metastatic breast cancer with bilateral breast, axillary and bone involvement. She had newly diagnosed HIV with wasting syndrome. She was critically ill with sepsis, obtundation, multisystem organ failure and had an ECOG performance status of 4. She was also 20 weeks pregnant but had suffered a spontaneous miscarriage the night before tumor conference. The overwhelming complexity of her case was appreciated and palliative care services were discussed.

Randy Hurley MD, cTropMed

HealthPartners and Regions Hospital Cancer Care Centers

Global Health Faculty, University of Minnesota

FCCT Blog Post #18

Wed, 22 Jan 2025 20:31:40 GMT

KCMC-FCCT Tumor Board

After a several month hiatus, the KCMC-FCCT Tumor Board resumed January 2025 with the presentation of a fascinating case of a small-round blue cell tumor in a 23 year-old man. The case highlights on-going issues with access to immunohistochemistry for accurate diagnosis. KCMC has an outstanding pathology department with the ability to develop high quality specimens for H&E and also has telepathology capabilities. However, reagents for complex immunohistochemistry, a mainstay of modern pathologic diagnosis, are often difficult to obtain.

A 23 year-old man presented with a 19cm adrenal mass with intra-abdominal and lung metastases. One year prior, he had undergone right eye enucleation for an orbital mass clinically felt to represent an optic nerve glioma. A CT-guided biopsy of the adrenal mass revealed a small-round blue cell tumor. This histologic description refers to high grade tumors with small round cells with blueish appearance under the microscope. Given the location, neuroblastoma was in the differential diagnosis. Adult adrenal neuroblastomas are very rare tumors with a dismal prognosis. Other malignancies with this histology can include high grade neuroendocrine tumors (small cell carcinoma), Ewing’s sarcoma and high-grade lymphomas. Typically, a battery of immunohistochemical studies would be used to clarify the diagnosis including neuroendocrine markers, cytokeratins and hematologic markers; however, these reagents were not available. Given the dire situation, it was elected to begin multi-agent chemotherapy directed at neuroblastoma (which also has activity in high grade lymphomas and Ewing’s). Meanwhile, urinary catecholamine studies were obtained and sent to an international laboratory. We received an update at the February tumor board that the patient has had a dramatic response to chemotherapy and that the catecholamine results returned as normal suggesting that this was not a neuroblastoma. He will continue with multi-agent chemotherapy for a likely diagnosis of high-grade lymphoma.

Randy Hurley MD, cTropMed

HealthPartners and Regions Hospital Cancer Care Centers

Global Health Faculty, University of Minnesota

FCCT Blog Post #17

Wed, 18 Sep 2024 20:25:28 GMT

KCMC-FCC T Tumor Board

After a several month hiatus over the summer, the Minnesota-KCMC tumor board resumed in September with presentation of a complex metastatic breast cancer case.

A 56 year-old woman with a 4 year history of metastatic breast cancer with bone-predominant involvement had developed jaundice, melena, transfusion dependent anemia, thrombocytopenia and splenomegaly. Seventeen years ago, at the age of 39, she had undergone a right modified radical mastectomy and adjuvant chemotherapy for localized breast cancer. Pathology reports from that time were not available but she was treated with 5 years of adjuvant tamoxifen thru 2013. Four years ago, in 2020, she developed bone metastases. It is unclear if a biopsy was performed, but she was treated with palliative radiation to painful bone sites, six months of palliative single agent paclitaxel with excellent response, and was placed on anastrozole. Over the next several years, her disease was followed by imaging and CA 15-3. She was treated with capecitabine and at one point, another course of paclitaxel due to progression. Three months ago, she developed jaundice, melena and significant anemia and thrombocytopenia. Upper GI endoscopy identified a gastric ulcer. A CT scan showed liver lesions but also significant splenomegaly. A peripheral smear was reviewed at tumor board but did not show classic signs of hemolysis or a leucoerythroblastic blood smear suggestive of bone marrow involvement by breast cancer. A reticulocyte count was elevated as was the LDH. She has required red cell transfusions for the anemia. A consideration for immune hemolysis was given, but her hemoglobin has not responded to a course of prednisone.

Our discussion revolved around the fact that although breast cancer receptor status was unknown in this case, this is invariably a case of estrogen receptor positive metastatic breast cancer. Late recurrences of breast cancer (13 years after original diagnosis) most always indicate estrogen responsive disease rather than triple negative or Her2/neu driven disease. Indeed, the original pattern of recurrence (bone-only involvement) favors estrogen receptor positive disease. The current cause of her anemia, thrombocytopenia and splenomegaly were unclear. She obviously had an element of gastrointestinal bleeding confirmed by endoscopy but this would not explain the jaundice or splenomegaly. We discussed various ways that the cancer, itself, could cause this presentation: micro-metastatic disease to the liver could cause liver dysfunction and splenomegaly; bone marrow involvement from breast cancer could cause anemia and thrombocytopenia but classically would cause a leucoerythroblastic blood smear picture. Since she had been on a treatment-free holiday, we did not think the treatment, itself, was causing this picture. We also discussed non-breast cancer related causes of jaundice, high-reticulocyte count anemia, thrombocytopenia and splenomegaly. This included infectious causes such as hepatitis B, immune causes such as Evan’s Syndrome (immune thrombocytopenia and hemolytic anemia) and other malignancies such as lymphoma. Further investigation for hemolytic anemia and a bone marrow biopsy were suggested.

Randy Hurley MD, cTropMed

HealthPartners and Regions Hospital Cancer Care Centers

Global Health Faculty, University of Minnesota

PREVACAMP

Thu, 20 Jun 2024 09:03:58 GMT

In a country devastated by cancer, a comprehensive cancer centre would seem the ultimate solution. In reality, it is only one piece of the care and treatment objective. Awareness and education, while seemingly basic, are proving to be essential in improving the lives of those who are suffering.

The development of the KCMC Cancer Care Centre in Moshi means diagnosis and treatment of cancer are now possible in northern Tanzania. However, patients often arrive at the hospital in Moshi too late, many times at an incurable stage of cancer. Last year, 85 percent of the patients presenting for help at the Cancer Care Center were in stage III or IV.

For those who’ve dedicated their lives to caring for the sick and suffering, this is an unbearable reality.

The question that needed to be answered was “why?” Not surprising, the answer was simple. People living in this vast, desolate region were unaware. They didn’t understand cancer. They weren’t aware that early detection would increase their chances of living. They just didn’t know.

To complicate matters, many health care workers in the region lacked significant knowledge of cancer and were not trained to facilitate referrals.

There was a high need for raising cancer awareness in the population. That meant increasing knowledge about risk factors, symptoms and the possibility of treatment.

PrevACamp | Cancer awareness and education

As a community outreach program, the Prevention and Awareness Campaign (PrevACamp) was developed and implemented in October 2017 to raise awareness, enhance earlier diagnosis and strengthen referrals to KCMC Cancer Care Centre for treatment.

Cancer awareness, early detection and health promotion programs are intended to reach the 70 percent of Tanzanian’s living in rural areas. This population has more difficult access to adequate health care than the urban population.

Scope of programming includes:

Educational programs about different types of cancer.
Information about and promotion of the Cancer Care Center at KCMC.
Identification of patients at an early stage of cancer by screenings for different cancers free of charge.
Cancer awareness training of community level health care workers

Cancer prevention and awareness days

Cancer prevention and awareness days are events for the population in the Kilimanjaro Region, Tanzania. The venues for the events vary with the goal of reaching the whole region in a period of 2 years.

The events are promoted in the rural areas by church members, loudspeakers and radio, three days in advance. This ensures that a high proportion of the population can be reached.

Departments from KCMC collaborate with the CCC to during the events. The attendees receive counseling about different cancer types, risk factors, symptoms, screening and treatment.

A special focus is on cervical and breast cancer in women, as well as prostate cancer in men and Burkitt lymphoma in children — the most prevalent cancers in the country. HIV testing is provided as well as cervical, breast and prostate cancer screening.

Year-to-date, there have been six events, with two additional events planned before the end of the year. PrevACamp events are expected to continue in 2019 thanks to generous support of FCCT partners.

PrevATrain | Cancer awareness training for community level health care workers

In addition to raising cancer awareness in the community, there is basic training for health workers to strengthen their cancer awareness and impact of their work in cancer control.

The training is intended to improve the skills and confidence of the health care workers in cancer prevention and health promotion.

The aim is to facilitate early detection of cancer and adequate referral to hospitals for treatment.

PrevATrain is a pilot cancer awareness program and the first cancer awareness training involving community health workers in Tanzania. The training is an important measure to provide sustainability of the efforts by PrevACamp.

Episode 1. FCCT – The story

harnessgiving@olivestreetdesign.com (Websites Team) — Fri, 07 Jun 2024 00:43:40 GMT

In our very first episode, our host Dr. Gloria Temu sits down with FCCT's President Hazel Reinhardt to talk about the origins of FCCT, it's vision and what generally inspires Hazel, along with the team at FCCT, to make cancer care more accessible to people in Tanzania.

Hear about the triumphs and tribulations around delivering care in a big country with a population of over 60million people.

Enjoy!

KCMC-FCCT Tumor Board May 2024

harnessgiving@olivestreetdesign.com (Websites Team) — Thu, 06 Jun 2024 00:28:51 GMT

By Randy Hurley MD, cTropMed

HealthPartners and Regions Hospital Cancer Care Centers

Global Health Faculty, University of Minnesota

KCMC-FCCT TUMOR BOARD

Three cases were discussed at the May 2024 KCMC-FCCT tumor board. Only one case was presented in March 2024 and April 2024. All five cases are summarized below.

A 64 year-old female with localized rectal cancer presented with significant rectal bleeding after undergoing neoadjuvant rectal radiation therapy and 5 cycles of neoadjuvant capecitabine-oxaliplatin chemotherapy. A CT scan now showed ascites and a right pleural effusion. The rectal bleeding was severe, requiring transfusion of 6 units of blood and use of tranexamic acid. The concern was that the rectal bleeding could represent radiation proctitis or local tumor progression. The ascites and pleural effusion could represent disease progression or anasarca from cancer and chemotherapy. A diagnostic paracentesis and sigmoidoscopy were recommended.

A 68 year-old man with a family history of esophageal cancer presented with dysphagia and a 7cm esophageal mass with peri-esophageal adenopathy. Although squamous cell carcinoma of the esophagus was suspected, a biopsy was consistent (but not confirmatory) for malignant melanoma of the esophagus. Appropriate immunohistochemistry stains were pending. Malignant melanoma of the esophagus is exceedingly rare and treatment paradigms are lacking. In the USA, next generation sequencing is used to identify targetable BRAF mutations, and less commonly, c-kit mutations. Immune therapy is typically the mainstay of therapy. Consideration was given for placement of a gastric feeding tube followed by palliative chemotherapy and or chemo-radiotherapy.

A 57 year-old man had undergone a right hemicolectomy in February of 2023 for a locally advanced colon cancer and was lost to follow up. He now presents with abdominal symptoms and significant melena. A CEA was markedly elevated at 790 and a CT scan identified a large complex right lower quadrant mass with areas of necrosis and evidence of peritoneal carcinomatosis. Courses of palliative FOLFOX chemotherapy have been interrupted due to significant anemia from on-going melena. Palliative surgery for tumor debulking and to relieve bleeding is only rarely recommended in the United States especially in the face of peritoneal carcinomatosis. Unfortunately, advanced radiologic imaging with angiography to identify sources of intestinal bleeding are not available in Tanzania.

A 21 year-old man presented with an 8 year history of an enlarging anterior neck mass that now measured 30cm in size with areas of necrosis and skin breakdown. Eight years previously, a small neck mass had been removed surgically at another hospital but the pathology of this specimen was not available. A very impressive looking CT scan of the neck and chest was reviewed showing a mass deviating the trachea in the neck and extending into the anterior chest. Pathologic material from a biopsy was reviewed. This showed a vascular, fairly uniform tumor of uncertain etiology. A thymic carcinoma, dedifferentiated thyroid cancer, hemangiopericytoma and sarcoma were in the differential. Additional immunohistochemistry was recommended to confirm a diagnosis.

A 40 year-old woman presented in a second trimester of pregnancy with a 3cm breast mass the biopsy of which disclosed infiltrating ductal carcinoma. Receptor studies were pending. Recommendations were made to stage the axilla with ultrasound and perform a limited metastatic evaluation with chest x-ray and ultrasound. Lumpectomy and axillary node sampling can safely be performed in the second trimester of pregnancy and chemotherapy can safely be offered, when necessary, as well.

KCMC-FCCT Tumor Board October 2023

harnessgiving@olivestreetdesign.com (Websites Team) — Thu, 06 Jun 2024 00:25:13 GMT

By Randy Hurley MD, cTropMed

HealthPartners and Regions Hospital Cancer Care Centers

Global Health Faculty, University of Minnesota

September 20, 2023

KCMC-FCCT TUMOR BOARD

The October tumor board was our first multidisciplinary neuro-oncology tumor board. Two cases of glioblastoma multiforme (GBM) were discussed. Development of a neuro-oncology program at KCMC was the vision of the late Dr Mark Jacobson. The program is a collaborative effort between KCMC, FCCT, the East African Medical Assistance Foundation ( www.emaf.org ) and the Barrow Neurologic Institute’s Global Program ( www.barrowneuro.org/for-physicians-researchers/barrow-global/ ). The program includes neurosurgical expertise, high quality MRI imaging capability, appropriate neurosurgery equipment and now, multidisciplinary international tumor board case discussion.

Two recent reviews (Haizel-Cobbina et al and Aderinto, et al.) describe the landscape of neuro-oncology in East Africa and challenges to patient management ( https://pubmed.ncbi.nlm.nih.gov/34468839/ ) ( https://journals.lww.com/ijsgh/Fulltext/2023/05010/Navigating_the_challenges_of_neuro_oncology_in.8.aspx?context=LatestArticles ). There is under-reporting of brain tumor cases due to lack of access to neurosurgical care and diagnostic expertise. There is a lack of neuro-oncology expertise and access to radiation therapy. Of note, one third of brain tumor cases reported in East Africa were pediatric. The development of the neurosurgery program at KCMC helps address the unmet need for neuro-oncology care.

Of the two cases of GBM discussed at the tumor board, one presented with severe neurologic symptoms and a classic “butterfly” glioma on MRI imaging. Symptoms and radiographic signs of brain stem herniation were present and unfortunately the patient died shortly after presentation. The second case involved a woman with a frontal parietal lesion; plans were made for resection which was previously unavailable in this region of Tanzania. In addition, a collaborative effort between FCCT, The Tanzania Ministry of Health, KCMC and USAID will bring radiation therapy capability to KCMC which will enhance brain tumor management.

Multidisciplinary tumor board discussion improves patient care and serves as a quality metric in the United States. Recently, Schroeder, et al have highlighted the importance of multi-disciplinary neuro-oncology tumor board case discussion on improving patient care at the Bugando Medical Center in the Mwanza District of Tanzania ( https://aacrjournals.org/cebp/article/32/6_Supplement/54/726620/Abstract-54-Influence-of-Neuro-Oncology-Capacity ).

KCMC-FCCT Tumor Board September 2023

harnessgiving@olivestreetdesign.com (Websites Team) — Thu, 06 Jun 2024 00:22:25 GMT

By Randy Hurley MD, cTropMed

HealthPartners and Regions Hospital Cancer Care Centers

Global Health Faculty, University of Minnesota

September 20, 2023

KCMC-FCCT TUMOR BOARD

A single case of breast cancer was discussed at the September tumor board. A 52 year-old nulliparous woman with no family history of breast cancer presented with bloody nipple discharge, a palpable left breast mass and axillary adenopathy. A staging CT scan of the abdomen and pelvis identified an ovarian cyst that was evaluated laparoscopically and found to be benign. The patient underwent a left lumpectomy and left axillary lymph node dissection. The pathology of the breast specimen revealed grade 2 ductal carcinoma in situ (DCIS) without an obvious invasive component. However, the axillary lymph nodes contained invasive ductal carcinoma that was estrogen and progesterone negative but Her2/neu positive by immunohistochemistry. The patient had already initiated post-operative adjuvant chemotherapy with cyclophosphamide and doxorubicin with the plan to then receive paclitaxel and trastuzumab. The plan was to either refer her to Dar Es Salaam for radiation after completion of chemotherapy or offer her a mastectomy that could be performed at KCMC.

Part of the discussion surrounding this case involved the fact that in the USA, DCIS only rarely presents as a palpable mass but more commonly as abnormal micro-calcifications on a screening mammogram. DCIS does not spread to regional lymph nodes but can be a precursor to invasive cancer that can metastasize. In the USA, more extensive pathologic evaluation is available to rule out areas of focal micro-invasion of DCIS that may not be readily evident on routine pathologic evaluation. In the USA, breast MRI would also have been used to rule out a separate invasive focus of breast cancer elsewhere in the breast that could have been responsible for the axillary metastases. Dual her2/neu directed therapy with a combination of trastuzumab and pertuzumab is often offered along with chemotherapy. The role of post mastectomy chest wall radiation therapy (if the patient chose mastectomy) was also debated.

KCMC-FCCT Tumor Board July 2023

harnessgiving@olivestreetdesign.com (Websites Team) — Thu, 06 Jun 2024 00:21:19 GMT

By Randy Hurley MD, cTropMed

HealthPartners and Regions Hospital Cancer Care Centers

Global Health Faculty, University of Minnesota

July 19, 2023

KCMC-FCCT TUMOR BOARD

Again, very challenging cases were presented in July 2023.

The first case involved a 24-year-old woman with a widely metastatic adenocarcinoma with papillary features with lung liver and lymph node metastases. A biopsy was obtained from a large left supraclavicular lymph node. Immunohistochemistry on the pathology specimen is not readily available in Tanzania to confirm the site of origin of the cancer. However, imaging studies also suggested a very large exophytic right kidney mass suggestive of a renal cell carcinoma as the site of origin. Renal cell carcinoma in young adults is very rare in the United States. One of our Mayo Clinic oncologists, participating in the conference, suggested this may be a translocation renal cell carcinoma. ( https://bmcurol.biomedcentral.com/articles/10.1186/s12894-022-01060-1 ). A rare variant of renal cell carcinoma is the 46xp11.2 chromosomal translocation variant of renal cell carcinoma. Recently recognized, this variant is primarily seen in children and young adults and has a female predisposition. Histologically it often has papillary features. Advance molecular techniques are not available in Tanzania to confirm this diagnosis but the case illustrates the wide spectrum of pathology seen at KCMC. Fortunately, first line tyrosine kinase inhibitor therapy with sunitinib is available at KCMC and could be an option for palliative treatment for this young woman.

Two other cases of soft tissue sarcoma were presented. One case involved a 50-year-old with neurofibromatosis who had a 5cm leiomyosarcoma resected from the scalp. She also had a large mass along the chest wall eroding into a rib. This had not been biopsied yet. The concern was that this also represented a soft tissue sarcoma such as a malignant peripheral nerve sheath tumor. The second case was of a 19-year-old young man with a large rhabdomyosarcoma of the right shoulder causing pain and bleeding. Shoulder disarticulation surgery was required to manage the bleeding. The discussion revolved around the need for post-operative chemotherapy and the role of radiotherapy. A recent correspondence in the Journal of Global Oncology ( https://ascopubs.org/doi/full/10.1200/GO.23.00110?bid=289236149&md5=43a87e97c86eacd1b1abf77f5daec6e9&cid=DM14281 ) highlights the need to consider neoadjuvant and adjuvant radiation and chemotherapy in the management of soft tissue sarcomas. Thru our public-private partnership with FCCT, KCMC, the Tanzanian government and USAID, a radiation therapy facility is currently being constructed at KCMC and will improve the ability to manage sarcomas and other cancers at this institution

KCMC-FCCT Tumor Board May 2023

harnessgiving@olivestreetdesign.com (Websites Team) — Thu, 06 Jun 2024 00:19:30 GMT

By Randy Hurley MD, cTropMed

HealthPartners and Regions Hospital Cancer Care Centers

Global Health Faculty, University of Minnesota

May 17, 2023

KCMC-FCCT TUMOR BOARD

The virtual Tanzania-Minnesota tumor board for May 2023 was held last week. (A tumor board was not formally conducted in April 2023 because KCMC cancer center personnel were visiting here in Minnesota.) Four cases were presented that continue to demonstrate the complexity and challenge to cancer care in Tanzania as well as some of the unique cancer presentations encountered.

A case of a 31-year-old man with locally advanced and metastatic colorectal cancer was presented. He required a diverting colostomy and plans were underway for palliative chemotherapy. We have previously discussed in these tumor board posts that there appears to be an early age of presentation of colon cancer in Tanzania. This work from KCMC has previously been published and reviewed in our April 2022 tumor board blog post (Herman et al, JCO Global Oncol 2020;6:375-381.) Little is known about genetic predisposition to colon cancer in Tanzania. The most common form of hereditary colon cancer predisposition in the USA (Lynch Syndrome, which accounts for about 5-10% of colon cancer in the USA) can be screened for with immunohistochemistry for microsatellite instability. These tests are not yet available in Tanzania.

Two cases of soft tissue sarcoma were discussed and pathology reviewed. A 57-year-old with a high-grade uterine sarcoma with lung metastases was receiving palliative chemotherapy. A 31-year-old with a prior upper arm injury had developed a large 10cm soft tissue mass involving the posterior compartment of the arm. A biopsy suggested either an angiofibroma or possibly a low-grade soft tissue sarcoma. Discussion centered on whether the patient should be referred to Dar Es Salaam for pre-operative radiation

The final case showed the unique presentations of cancer in sub-Saharan Africa. A 48-year-old HIV positive woman on antiretroviral therapy presented with a squamous cell cancer of the conjunctiva that had progressed to involve the entire orbit manifesting as a bleeding fungating ocular mass. This required a palliative enucleation of the eye. She also had evidence of bulky 6cm lymph node metastases in the submandibular region. Consideration was being given to neck dissection and palliative chemo-radiotherapy with 5 fluorouracil and cisplatin. Squamous cell cancer of the conjunctive is not routinely seen in the USA but has been described in sub-Saharan Africa in association with HIV pandemic. The exact cause of these locally disfiguring cancers is not known. Speculation has been given to UV sunlight exposure in the setting of immunosuppression. The role of human papilloma virus has not been elucidated. KCMC published its experience with Ocular Surface Squamous Cell Neoplasms in 2010 in Ophthalmic Epidemiology ( Epidemiology and management of ocular surface squamous neoplasia in Tanzania – PubMed (nih.gov) )

KCMC-FCCT Tumor Board April 2023

harnessgiving@olivestreetdesign.com (Websites Team) — Thu, 06 Jun 2024 00:17:13 GMT

By Randy Hurley MD, cTropMed

HealthPartners and Regions Hospital Cancer Care Centers

Global Health Faculty, University of Minnesota

April 14, 2023

KCMC-FCCT TUMOR BOARD

February. A recurring theme continues to be the need for radiation therapy facilities at KCMC to provide adequate cancer care. A case of a 45-year-old man with a plasmacytoma of bone was discussed. The man had presented with paraplegia from a thoracic vertebral spinal mass and required urgent decompressive laminectomy with hardware stabilization. The pathology disclosed malignant plasma cells consistent with a plasmacytoma. Arrangements for further evaluation to rule out multiple plasmacytomas of bone and multiple myeloma were requested. The patient had been referred to Ocean Road Cancer Center (ORCI) in Dar Es Salaam for post operative radiation therapy. This would be standard treatment in the United States; however, there was hesitancy at ORCI due to the presence of stabilizing hardware in the spine. This would not be a contraindication to radiation in the USA. Plasmacytoma of bone is part of the spectrum of malignant plasma cell disorders encompassing monoclonal gammopathy of unknown significance all the way to multiple myeloma and plasma cell leukemia. The incidence of multiple myeloma is rising in the United States and is much more common in African Americans. The etiology is likely multifactorial; however, exposure to pesticides and even Agent Orange has been implicated. There are at least seven different categories of drugs used to treat plasma cell disorders in the USA and it is now one of the most common indications for stem cell transplant in adults.

Little is known about the incidence of plasma cell disorders in Tanzania. Fortunately, however, KCMC has published data on all hematologic malignancies at KCMC’s cancer care center for the 3 year period from the opening of the cancer care center in December 2016 thru May of 2019: Leak AL et.al, PLOSone, 2020; 1-12 ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202623/) . Multiple myeloma accounted for forty three of the 209 cases of hematologic malignancy in that time period, second only to non-Hodgkin’s lymphoma. The median age at diagnosis was 58 years and the majority presented at advanced stage.

Breast Cancer Screening Added To KCMC’s Screening And Earlier Diagnostic Efforts

harnessgiving@olivestreetdesign.com (Websites Team) — Thu, 06 Jun 2024 00:15:51 GMT

By Randy Hurley MD, cTropMed

HealthPartners and Regions Hospital Cancer Care Centers

Global Health Faculty, University of Minnesota

January 18, 2023

Breast Cancer Screening Added To KCMC’s Screening And Earlier Diagnostic Efforts

In an earlier newsletter I shared the news that the Cancer Care Centre at KCMC had received a grant to develop cervical cancer screening capacity at district hospitals in the Kilimanjaro Region. All research points to screening and earlier diagnosis as a key to better outcomes for cancer sufferers.

KCMC’s latest effort to expand cancer awareness and screening focuses on breast cancer. Often, Tanzanian medical professionals are not familiar with cancer and although they may see a patient with breast cancer symptoms, they do not make a correct diagnosis. KCMC plans to address this challenge through a course aimed at medical professionals. The course is designed to equip Tanzanian medical professionals with the necessary knowledge, attitude, and clinical skills to efficiently diagnose breast cancer and distinguish it from other benign breast pathologies. This course is being organized by Dr. Marianne Gnanamuttupulle, a surgeon on staff at KCMC.

In addition to clinical skills, participants in this 5-day course are expected to gain confidence to advocate for the importance of self-breast examination and to effectively communicate with other health care providers, patients, and their families. This includes breaking bad news, responding to their psychological and physiological concerns regarding a breast cancer diagnosis and discussing their appropriate treatment plan.

Worldwide, in 2020 breast cancer in women surpassed lung cancer as the most diagnosed cancer with an estimated 2.3 million new cases and making breast cancer the 5th leading cause of cancer related deaths globally. Deaths related to breast cancer are higher in low-income countries. The global cancer burden is expected to increase by 64% to 95% in low-income countries due to demographic changes and increased risk factors associated with globalization and economic growth.

In Tanzania, breast cancer is the second most common cancer representing 14.4% of new cancers and is the second leading cause of cancer mortality among women. The number of new breast cancer cases is projected to increase by 82 % by 2030. Projections for breast cancer deaths follow the same pattern, with an increase of 80% in breast cancer deaths by 2030. In Tanzania, approximately 80% of women are diagnosed with advance stage (III or IV) breast cancer due to limited availability of screening programs, late presentation, poor access to treatments such as chemotherapy, surgery, and radiation therapy. This means treatment is less effective and outcomes are poor, which leads to higher morbidity and mortality.

Prevention can help reduce the devasting effect of breast cancer in low-income countries; however, early detection of this malignancy remains the cornerstone in breast cancer control improving both outcome and survival.

Warmest regards,

Hazel Reinhardt

President/CEO

KCMC-FCCT Tumor Board January 2023

harnessgiving@olivestreetdesign.com (Websites Team) — Thu, 06 Jun 2024 00:14:39 GMT

By Randy Hurley MD, cTropMed

HealthPartners and Regions Hospital Cancer Care Centers

Global Health Faculty, University of Minnesota

January 18, 2023

Five cases were presented at the January tumor board that continue to show the complexity of cases challenging the oncologists at KCMC.

Two of the cases involved multiple primary tumors: The first case involved a 74-year-old man with known prostate cancer who had undergone a right nephrectomy for a renal mass. The pathology, reviewed virtually by participating pathologists in the USA, revealed a high-grade urothelial cancer most likely arising from the renal pelvis. A discussion took place regarding the role of adjuvant carboplatin/gemcitabine chemotherapy. The second “multiple-primary” case involved a 67-year-old woman who had a resected follicular thyroid cancer that subsequently developed generalized weakness, malaise, and adenopathy. It appeared she had developed a non-Hodgkin’s lymphoma based on the histology of a lymph node biopsy; however, the immunohistochemistry available was not definitive and thus specific recommendations could not be given

Another case involved a 34-year-old man with a resected fibrosarcoma of the L3,4,5 lumbar vertebral spine. Plans were underway to provide adjuvant ifosfamide based chemotherapy. He would then be referred to Ocean Road Cancer Institute in Dar Es Salaam for radiation.

A fourth case involved a 40-year-old woman with ovarian cancer complicated by venous thrombosis.

A fifth case discussed demonstrated the power of multidisciplinary tumor boards. A 72-year-old man working at the hospital had presented with a multi-focal liver mass 6 months ago. Imaging findings suggested unresectable hepatocellular carcinoma (HCC) however the patient had not responded to front line therapy with the tyrosine kinase inhibitor, sorafenib. In the USA, a combination of bevacizumab and atezolizumab is an effective alternative regimen for HCC; bevacizumab is available in Tanzania but atezolizumab is not and would be prohibitively expensive. Hepatocellular carcinoma is one of the very few malignancies which oncologists are willing to treat based on characteristic imaging and without a tissue biopsy. In the USA, a characteristic liver mass on MRI in the setting of cirrhosis and an elevated alpha-fetoprotein (AFP) is considered diagnostic of HCC. In Tanzania, chronic hepatitis B infection is the most common cause of underlying liver disease associated with hepatocellular cancer. However, this man did not have hepatitis B and had a nearly normal AFP. Therefore, a recommendation was given to consider an alternative diagnosis. Because of this, a liver biopsy was performed. We received confirmation 2 weeks after the tumor board that the biopsy revealed intra-hepatic cholangiocarcinoma. Alternative gemcitabine-based chemotherapy for cholangiocarcinoma will be offered to the patient.

KCMC-FCCT Tumor Board November 2022

harnessgiving@olivestreetdesign.com (Websites Team) — Thu, 06 Jun 2024 00:13:17 GMT

By Randy Hurley MD, cTropMed

HealthPartners and Regions Hospital Cancer Care Centers

Global Health Faculty, University of Minnesota

November 16, 2022

Our November tumor board was held on Wednesday 11/16/22. Three cases were presented, two of which required neurosurgery expertise and therefore neurosurgeons from the University of Minnesota participated.

The first case involved a 52-year-old woman with a contralateral cervical lymph node recurrence of estrogen receptor positive her2/neu positive breast cancer occurring 10 years after primary treatment for her initial estrogen receptor positive breast cancer. Bilateral breast ultrasound had not identified a new primary breast cancer and a search for metastatic disease with CT imaging was negative. She had been placed on anastrozole pending the availability of trastuzumab. A discussion centered on the role of cervical lymph node excision and role of post op radiation therapy

Two neurosurgical cases were presented. One involved an unfortunate 24 yr old man with an unresectable spinal cord ependymoma causing paraplegia. This is a rare central nervous system tumor where surgical resection, if feasible, is the main stay of treatment followed by radiation. This patient was not able to have this tumor completely removed. Due to the current lack of radiation therapy facilities at KCMC, he would need to be referred to Dar Es Salaam for additional treatment

The second neurosurgical case involved a 59 yr old man with metastatic lung cancer. He had presented with headache, inability to walk and focal neurologic signs. An MRI of the brain identified a mass in the right fronto-parietal lobe. Subsequent CT imaging identified a right upper lobe lung mass. A craniotomy was performed and the brain mass was resected. Pathologic examination confirmed this to be an adenocarcinoma. A CT guided needle biopsy of the lung mass revealed an adenocarcinoma consistent with a lung primary. In the United States metastatic disease to the brain from a lung or breast cancer primary is the most common cause of a malignant brain mass. Because the incidence of tobacco use is so low in Tanzania, lung cancer is actually quite rare. In the United States, lung cancer in “never smokers” has a higher likelihood of harboring one of several genetic driver mutations that can be treated with oral tyrosine kinase inhibitors. These drugs along with progress in the use of immunotherapy for lung cancer has led to improvements in the median survival of advanced lung cancer in the United States. Little is known about the pathogenesis of lung cancer in Tanzania and the role of driver mutations. Tyrosine kinase inhibitor therapy and immune therapy are not yet available to those in need in this country.

One of the amazing features of this tumor board was highlighting the availability of neurosurgery at KCMC. One of the many lasting legacies of the late Dr Mark Jacobsen was to spearhead the development of a neurosurgery program at KCMC. Dr Happiness Rabiel, a neurosurgeon trained in Tanzania, India and Colorado has joined the KCMC team. Her work is supported by the Barrow Neurologic Institute in Phoenix Arizona. Neurosurgery care is a much needed, and fortunately expanding field in East Africa ( https://pubmed.ncbi.nlm.nih.gov/29702965/ ). KCMC is now part of that expanding field!

KCMC-FCCT Tumor Board October 2022

harnessgiving@olivestreetdesign.com (Websites Team) — Thu, 06 Jun 2024 00:11:35 GMT

By Randy Hurley MD, cTropMed

HealthPartners and Regions Hospital Cancer Care Centers

Global Health Faculty, University of Minnesota

October 26, 2022

Three cases were reviewed at the October tumor board video conference: a case of locally advanced acral melanoma, a case of esophageal cancer in a 15-year-old and a case of advanced colorectal cancer. The cases help highlight the contrast in biology of cancer in the USA vs East Africa.

A 72-year- old man presented with a one-year history of black discoloration of the skin of the heel of his foot associated with palpable inguinal lymphadenopathy. A wide excision of the lesion on the heel revealed a superficial spreading malignant melanoma with a 2mm depth of invasion. Four inguinal lymph nodes were removed, the pathology of which was pending. If these lymph nodes were involved with melanoma, this would be a clinical stage 3 melanoma. In the USA, melanoma is most commonly “cutaneous melanoma” often occurring in sun-exposed areas of skin in fair-haired, light skinned individuals. Significant advances have been made in the management of locally advanced and metastatic melanoma in the USA with the use of immunotherapy. Additionally, roughly 50% of cutaneous melanomas harbor a mutation in the BRAF gene; oral BRAF inhibitors are effective in the adjuvant setting and in treating unresectable and metastatic melanoma. In contrast, melanoma in dark skinned individuals is rare. Melanoma occurring on the palms and soles (i.e., non-sun exposed areas) and underneath the fingernails and toenails is termed “acral melanoma.” This is a rare subtype of melanoma in the USA and although rare in Tanzania, it is the most common type of melanoma in dark-skinned individuals. The biology of this disease is different from cutaneous melanoma since it is less likely to respond to immunotherapy and less likely to harbor BRAF mutations.

A case of a 15-year-old with locally advanced squamous cell cancer of the esophagus was presented. The patient had developed difficulty swallowing and a necrotic ulcer over the neck. CT imaging and a barium swallow were followed by endoscopy and biopsy. The patient was found to have a mass in the cervical esophagus with fistula formation to the necrotic neck ulcer. A gastrostomy tube had been placed with a plan for palliative chemotherapy and radiation. In the USA, the median age of diagnosis of esophageal cancer is 67 years old. Roughly half of these are squamous cell cancers related to tobacco and alcohol or distal esophageal cancers related to Barrett’s esophagus. In the USA, esophageal cancer in a 15-year-old would be virtually unheard of. East Africa is one of the regions of the world where there is an increased prevalence of squamous cell esophageal cancer. Little is known about the true incidence, etiology and response to treatment of this disease. KCMC participates in the African Esophageal Cancer Consortium, a USA National Cancer Institute and International Agency for Research on Cancer sponsored coalition of cancer centers in East Africa ( https://ascopubs.org/doi/10.1200/JGO.17.00163 ). They are part of a prospective observational clinical trial hoping to define the therapeutic landscape for esophageal squamous cell cancer in East Africa ( https://bmccancer.biomedcentral.com/articles/10.1186/s12885-021-09124-5 )

KCMC-FCCT Tumor Board September 2022

harnessgiving@olivestreetdesign.com (Websites Team) — Thu, 06 Jun 2024 00:08:25 GMT

By Randy Hurley MD, cTropMed

HealthPartners and Regions Hospital Cancer Care Centers

Global Health Faculty, University of Minnesota

September 27, 2022

Two cases were discussed at the KCMC-Minnesota tumor board this month

The first case was a 60-year-old woman with a locally advanced breast cancer manifesting as a 5cm breast mass with palpable axillary and supraclavicular adenopathy. The patient also had an enlarged contralateral right axillary lymph node concerning for either a second primary cancer in the right breast or, a rare situation of contralateral axillary metastases from a left sided breast cancer. A biopsy of the left breast mass revealed infiltrating ductal carcinoma. Immunohistochemistry for estrogen receptor, progesterone receptor and Her2/neu were pending. The tumor conference was attended by KCMC’s breast surgeon, Dr Marianne Gnanamuttupulle, who has training in nipple-sparing mastectomy techniques. Dr Gnanamuttupulle has recently published KCMC’s experience with breast cancer. ( https://ecancer.org/en/journal/article/1282-clinicopathological-characteristics-of-breast-cancer-patients-from-northern-tanzania-common-aspects-of-late-stage-presentation-and-triple-negative-breast-cancer ).

Breast cancer is the second most common cancer affecting women in Tanzania after cervical cancer. Of the 4 main biologic subtypes of breast cancer (triple negative, luminal A, luminal B and her2 driven) the more aggressive histologic subtype, triple negative breast cancer, is the most common in Tanzanian women. This subtype is seen in 28% of the cases. Recommendations were discussed including further staging with CT scan and biopsy of the right axillary lymph node. It was anticipated that the patient would undergo neoadjuvant systemic therapy once her receptor status was known

The second case was a little more uncertain histologically. This case involved a 37-year-old woman who developed right sided chest pain, shortness of breath and a palpable posterior chest wall mass during her last month of pregnancy. Following a cesarean section, a CT scan identified a large right pleural based mass, collapse of the lower lobe of the right lung and mediastinal shift to the left. An Incisional biopsy of the chest wall mass revealed a small round blue cell tumor. Histology slides were available for review by a participating pathologist from Froedtert Hospital in Milwaukee. A typical differential diagnosis of small round blue cell tumors would include small cell lung cancer, non-Hodgkin’s lymphoma, and rarer sarcomas such as Ewing sarcoma or rhabdomyosarcoma. Unfortunately, immunohistochemistry capability is currently limited at KCMC and thus a definitive diagnosis was hard to establish. The patient’s poor performance status and distance from the medical center precluded any palliative cancer directed therapy

KCMC-FCCT Tumor Board August 2022

harnessgiving@olivestreetdesign.com (Websites Team) — Thu, 06 Jun 2024 00:01:04 GMT

By Randy Hurley MD, cTropMed

HealthPartners and Regions Hospital Cancer Care Centers

Global Health Faculty, University of Minnesota

August 17, 2022

Two complicated cancer cases were discussed at this month’s tumor board.

The first case was a 7-year-old girl with a large 22cm tumor mass involving the right humerus and shoulder. Radiographically, this appeared to be an osteosarcoma. Photomicrographs of the histologic pathology specimens were available and reviewed by a participating pathologist from Froedtert Hospital at the Medical College of Wisconsin in Milwaukee. In addition, the patient had enlarged cervical lymph nodes. Part of the debate in clinical management pertained to whether the enlarged cervical lymph nodes should be biopsied. Although osteosarcomas and soft tissue sarcomas in general, rarely involve lymph nodes a consideration could be given for lymph node biopsy. This was deemed a low-risk procedure and if metastatic sarcoma were identified, it could definitely alter management. Infectious causes of enlarged cervical lymph nodes, including tuberculous lymphadenitis, could be an alternative diagnosis. The management plan included multi-agent neoadjuvant chemotherapy followed by repeat imaging and assessment of response. Unfortunately, this young girl might be faced with a “fore-quarter amputation,” a devastating procedure with amputation of her right arm and shoulder.

The second case was equally complicated and highlights the need for improved immunohistochemistry pathology capability at KCMC to more accurately classify tumors. The case involved a 47-year-old woman with two different primary cancers: colorectal cancer and ovarian cancer. She initially underwent resection of a colon cancer and adjuvant FOLFOX chemotherapy 4 years ago. Two years later she developed ovarian cancer manifesting as an ovarian mass and ascites. Following total abdominal hysterectomy and bilateral salpingectomy the patient was treated with adjuvant carboplatin and taxol much like we would offer here in Minnesota. She had been undergoing surveillance with CT scans , follow up colonoscopy and CEA and CA 125 tumor markers. Most recently, she developed a rectal mass the biopsy of which suggested a new rectal cancer primary tumor. After evaluation with colonoscopy, CT scan and pelvic MRI, she received neoadjuvant chemotherapy and radiation with only a modest radiographic response. Then, at the time of attempt at surgical resection of the rectal tumor, she was found to have peritoneal carcinomatosis. The rectal cancer excision was aborted, and she underwent an omental biopsy. The discussion revolved around whether the rectal tumor was truly a second colorectal cancer primary tumor or whether this could have been a pelvic/rectal recurrence of ovarian cancer. Typically, extended immunohistochemistry on the pathology specimens, not available in Tanzania, could distinguish recurrent ovarian adenocarcinoma from a primary rectal adenocarcinoma. Immunohistochemistry on the pathology specimen for microsatellite instability could also help detect Lynch Syndrome, a hereditary cancer family syndrome that might help explain the multiple primary tumors in this patient. An interesting discussion evolved around the goals of further systemic therapy. Although platinum-based chemotherapy with the anti-angiogenesis agent, bevacizumab, is available in Tanzania, a concern was raised regarding the potential for bevacizumab to create a rectal fistula. Such a complication, although rare, would be very difficult to manage, even in Minnesota, especially in a patient were the goals of care may primarily be palliative.

KCMC-FCCT Tumor Board July 2022

harnessgiving@olivestreetdesign.com (Websites Team) — Wed, 05 Jun 2024 23:58:31 GMT

By Randy Hurley MD, cTropMed

HealthPartners and Regions Hospital Cancer Care Centers

Global Health Faculty, University of Minnesota

July 20, 2022

At this month’s tumor board, three advanced and complicated cancer cases were presented, CT and MRI scans reviewed and plans of care discussed. After the hour-long meeting, we were informed that our KCMC colleagues had six other colorectal cancer cases that they would like to discuss but unfortunately time did not allow. It reminds me that investing in cancer services in low-income countries is equally important as bolstering the primary care system since the burden of cancer is already astounding and will only increase in the next decade.

A case of a 14-year-old girl with metastatic rectal cancer was presented. The median age of onset of colorectal cancer world-wide (previously age 60s) is becoming younger and younger in age, however colorectal cancer in adolescents is decidedly rare. Likely a combination of epidemiologic factors such as genetic predisposition, chronic inflammation and changes in gut microbiome have contributed to this shift in age of onset.

A second case involved a 52-year-old woman with locally advanced triple negative breast cancer. She initially had surgery in Dodoma Tanzania and was referred to the Cancer Center at KCMC for adjuvant Adriamycin, Cytoxan, and Taxol chemotherapy. Dodoma is the capital of Tanzania but does not have a cancer center. This patient had to travel a distance of 500 km from Dodoma to receive care at KCMC in Moshi. She completed 6 months of chemotherapy only to develop a contralateral cancer in her right breast as well. Breast cancer is the second leading cause of cancer deaths in women in Tanzania (as it is here in the United States). African women have a higher incidence of unfavorable histologic subtypes of breast cancer such as triple negative breast cancer. In the United States, bilateral triple negative breast cancer is often seen in women with an inherited predisposition to breast cancer due to a mutation in the BRCA1 or BRCA2 gene. It is unknow what the frequency of these mutations are in women in sub-Saharan Africa.

The final case involved an elderly gentleman with locally advanced/unresectable prostate cancer that not only caused urinary obstruction, but also caused bowel obstruction requiring a colostomy. Although immunohistochemistry on the prostate biopsy suggested a prostate cancer primary tumor, the MRI images were more suggestive of a rectal cancer primary tumor. The patient had already initiated androgen deprivation therapy with Gosselin and bicalutamide and his PSA had improved. However, he had local tumor progression in the rectum concerning for either a small-cell transformation of prostate cancer or perhaps a separate primary rectal cancer .

Episode 2. Laying the foundations – Building the Cancer Care Centre.

harnessgiving@olivestreetdesign.com (Websites Team) — Wed, 05 Jun 2024 14:14:05 GMT

Dr Oliver Henke is a German Haemato-Oncologist who has been working at the KCMC Hospital’s Cancer Care Centre for the past five years. In 2016 he and his family left their life in Germany to move to Moshi, Tanzania, so that he could join in the efforts by the KCMC and FCCT to offer oncology services at the hospital.

What started as a simple idea amongst a group of doctors; to provide some oncology consultation services in the wards, gradually developed over the years and has become the specialised unit that the cancer centre is today. Through lots of hard work and dedication, the centre is now an institute to be reckoned with; offering diagnostics, monoclonal antibody treatment, leukemia treatments and palliative care, amongst other services.

In this episode you will also hear Dr Henke’s first-hand accounts of treating patients who are often in destitute circumstances, giving them a fresh lease of life. Enjoy!

FCCT Tumor Board May 2022

harnessgiving@olivestreetdesign.com (Websites Team) — Wed, 05 Jun 2024 00:00:52 GMT

By Randy Hurley MD, cTropMed

HealthPartners and Regions Hospital Cancer Care Centers

Global Health Faculty, University of Minnesota

May 19, 2022

Three Tanzanian cases were discussed during the KCMC-Minnesota multidisciplinary tumor board today that all required surgical oncology input. Three surgical oncologists, in addition to medical and radiation oncologists from Minnesota were able to provide recommendations to the KCMC team on rather challenging cases.

One case involved a man with a locally advanced colon cancer with perforation and abdominal wall abscess formation in the setting of active tuberculosis. The abscess had been drained and plans were developed to perform a diverting colostomy prior to neoadjuvant chemotherapy and eventual surgical resection.

A second case involved a patient with a distal esophageal adenocarcinoma. Esophageal cancer is rather common in East Africa but is typically of squamous cell histology. Typically, this adenocarcinoma would be treated with neoadjuvant chemotherapy and radiation prior to surgery. Radiation is not yet available at KCMC and thus this patient was to be referred to Dar Es Salaam, 500km away.

The final case involved a 70-year-old woman with advanced gall bladder cancer that had been evaluated with CT scan and laparoscopy with biopsy. Gall bladder cancer is rare in Tanzania. In the United States it is often identified incidentally at the time of cholecystectomy for gall stone disease. Historically, there is a female predominance for gall stone disease and gall bladder cancer. There is a variation, worldwide, in the prevalence of gall bladder cancer with the highest rates in South American countries such as Chile and Bolivia as well as in India and parts of Asia (Globocan data). This correlates with the prevalence of gall stone disease but also the prevalence of salmonella typhi infection worldwide. (Dutta U, et al; Am J Gastroenterol 2000). It is postulated that chronic irritation from gall stone disease and inflammation from infection can act as a promotor for malignant transformation. Unfortunately, locally advanced gall bladder cancer has a grim prognosis; goals of care emphasizing palliation were advised.

Initiation of a KCMC -University of Minnesota Tumor Board

harnessgiving@olivestreetdesign.com (Websites Team) — Tue, 04 Jun 2024 23:48:47 GMT

By Randy Hurley MD, cTropMed

HealthPartners and Regions Hospital Cancer Care Centers

Global Health Faculty, University of Minnesota

May 16, 2022

Using video conferencing techniques, the first of a planned monthly multidisciplinary tumor board was held Wednesday morning April 20th, 2022, at 7am Minnesota time (3pm Tanzania time). Medical and surgical oncologists and general surgery residents from KCMC participated with oncology professionals form Minnesota. Multidisciplinary case presentation at a tumor board is considered a quality metric for oncology programs.

Our Tanzanian colleagues presented three cases of rectal cancer that highlighted the often-late presentation of cancer, the degree of sophistication of KCMC’s diagnostic and treatment capabilities and the importance of geographic barriers to care.

One of the cases involved a 69-year-old woman with two simultaneous primary cancers: a muscle invasive bladder cancer and a locally advanced (T4N2b) rectal cancer. She had undergone evaluation with cystoscopy and biopsy, flexible sigmoidoscopy, computed tomography and pelvic MRI. Preoperative radiation therapy and neoadjuvant FOLFOX chemotherapy for rectal cancer was prescribed, much like we would do in Minnesota. However, a radiation facility is not available yet in northern Tanzania. The patient had to travel to Dar Es Salaam to receive her radiation. This would be equivalent to a patient living with cancer and receiving care in Minneapolis having to travel to Milwaukee to receive preoperative radiation therapy here in the United States.

There is an increasing incidence of colorectal cancer in Tanzania and sub-Saharan Africa. Our Tanzanian colleagues at KCMC have recently published their 10-year experience with colorectal cancer (Herman et al, JCO Global Oncol 2020;6:375-381). Their publication draws attention to the increasing incidence of colorectal cancer, the predominance of left-sided colon cancers, the often-late presentation and early age of onset. The authors speculate on the epidemiology of these features of colorectal cancer in Tanzania. They have considered changes in diet and exercise but also the possible contributions of as-of-yet uninvestigated factors such as genetic predisposition and infectious causes related to changes in the microbiome that may contribute to the rising incidence of colon cancer in northern Tanzania.

SITA’S STORY

harnessgiving@olivestreetdesign.com (Websites Team) — Tue, 04 Jun 2024 22:31:45 GMT

SITA’S STORY

Twice a month, Ramadhani Mtaturu leaves his wife and seven children to ride a bus more than 250 miles, from a village close to his home to a village close to a hospital. Rmadhani is seeking hope and healing for his baby girl Sita. He makes the eight-hour journey from Singida to Moshi, Tanzania without hesitation.

Sita was diagnosed with Retinoblastoma stage IIIB a year ago. Doctors referred her to the Cancer Care Centre on the Kilimanjaro Christian Medical Centre [KCMC] campus in Moshi for specialized care she could not receive at the local hospital in Singida.

From the start, traveling to Moshi was a substantial obstacle, and not simply due to the complicated journey. Sita’s father could not afford the bus fare [an estimated $12-$13 in U.S. dollars]. As a farmer in a desperately dry area of northern Tanzania, the expense was more than a year’s wages, but heartbroken by his baby girl’s condition, Ramadhani was willing to sell his family’s farm to get the money needed to travel to the hospital.

Concerned that the financial hardship might prevent Ramadhani and his daughter from returning for treatments, Singida Hospital used funds provided by generous Foundation for Cancer Care in Tanzania [FCCT] donors to facilitate transportation to Moshi, .

Transportation was only one of the obstacles the family faced; they were also without insurance and money needed to pay for the baby’s care. Because completing the full course of prescribed treatment – which involves multiple visits to the Cancer Center – greatly improves a patient's chance for survival, KCMC treats pediatric cancer patients at no cost to the patient or their family.

Sita’s family is overwhelmed by the generosity and so very grateful. “I can work little by little to make money for bus rides and doctor bills,” Ramadhani says, not fully understanding thatthese acts of kindness by donors and partnering hospitals are not meant to be re-paid. “I can even sell my cows.”

Sita’s healing journey is not over. She will require ongoing chemo treatments and continued care by eye specialists at the Cancer Care Centre. Thanks to the support and assistance from FCCT donors, partners and friends, she is in good hands on her long, yet hopeful, road to recovery.

Episode 3. Changing narratives – Rethinking cancer treatment in Tanzania.

harnessgiving@olivestreetdesign.com (Websites Team) — Tue, 04 Jun 2024 14:49:34 GMT

As a specialised Haematologist, Dr Elifuraha Mkwizu is a central figure in the diagnostics and research practices at the Cancer Care Centre. Having trained as an internal medicine physician in Russia, and then specialised in Haematology in India, he draws some profound comparisons in the way that cancer diseases are managed medically as well as culturally.

For instance, in Tanzania a lymphocytic leukaemia is treated as palliative, or to put it simply, as a terminal state of cancer. However, ‘..cancer should be treated like a chronic disease, like diabetes, like hypertension..it should not be a death certificate to anyone’, says Dr Mkwizu. And so while he and the staff at KCMC are out to change the narrative, as a case in point, the first ever patient with an acute leukemia was fully treated at the centre in 2021. In this episode you’ll hear about the ‘tears of joy’ that the young 29 year old man sheds on every return visit to the clinic.

But there’s still lots to do, and the challenges are many. As Dr Mkwizu explains, there is a desperate need for more diagnostic capabilities and treatment in order to catch diseases in their early stages, and give patients a better chance to get cured, through detailed treatment plans.

Winner’s Story

Mon, 03 Jun 2024 22:36:03 GMT

Winner’s Story

Winner is like a beautiful butterfly, fluttering around the ward, spreading her beauty wherever she goes. Her pink, sparkly dress that seems to fit her personality perfectly! She brings so much life to the pediatric ward, a much-needed change in a place that sees far too much sadness and despair.

It’s hard to believe that almost a year ago, Winner was brought to the hospital to with increased swelling in her neck, constant fatigue, weight loss, and an overall feeling of sickness.

Based on the symptoms presented, and with no other further investigation done, Winner was told she had tuberculosis, and put on a six-month treatment regimen. She followed the treatment schedule, but six months later, she was still experiencing the same symptoms, with no improvement.

Winner and her mother returned to the same hospital, but this time, they were told Winner had typhoid and brucellosis, and was kept in the hospital for five days. When the doctor wanted to do a biopsy of Winner’s lymph nodes, her Grandmother demanded they be transferred to KCMC for further testing.

At KCMC, a biopsy of Winner’s lymph nodes were done, along with additional blood work, a bone marrow biopsy, lumbar puncture and a CT scan. When the biopsies were sent to Dar es Salaam for evaluation, Winner’s diagnosis was not tuberculosis or typhoid; she had Hodgkins Lymphoma Stage I.

Luckily, Winner was at the right place, and being treated for the right diagnosis. She and her mother met with KCMC doctors and immediately began a treatment plan consisting of chemotherapy every four weeks, for a total of six rounds.

Currently, Winner is half-way through therapy, and has experienced good and bad days. When she receives her chemotherapy, she must stay in the hospital for 3 days. The chemotherapy has caused her to feel very tired, nauseous, have fevers, and dizziness. Yet through it all, Winner has remained positive and kept her bubbly personality!

Despite missing a lot of school, Winner has been able to work on her exams and maintain her grades. She is anxious to be finished with treatment so she can return to school, play with her friends, swim and enjoy her childhood. Winner and her mother are so appreciative to all the doctors and nurses for everything they have done and the care they have shown them through this stressful process.

There is no doubt this little lady will live up to her name, and be a Winner at the end of this!

MARY’S STORY

harnessgiving@olivestreetdesign.com (Websites Team) — Sun, 02 Jun 2024 22:40:20 GMT

MARY’S STORY

Mary is one of those people who just exudes grace, strength and bravery. She is a breast cancer survivor, and is ready to go out and tell the world her story!

October 2016, Mary noticed a lump while doing a breast self-exam. With the support of her husband, they headed to Kilimanjaro Christian Medical Centre. After a biopsy was performed, Mary received the news that it was breast cancer. She didn’t let it get her down – Mary drew her strength from other women she knew who had successfully battled breast cancer.

Confident about the decision she was going to make regarding treatment at KCMC, Mary made a conscious choice to keep her cancer diagnosis quiet from her extended family and friends. She didn’t want outside opinions on how she should treat her cancer.

Mary and her husband decided to move forward with the treatment plan and have the recommended surgery as soon as possible. Mary’s strength and bravery was evident in her decision to have a mastectomy instead of just the recommended lumpectomy. Mary wanted to reduce her chances of relapse as much as possible.

Following surgery, the next step in her treatment plan was chemotherapy. Finding that KCMC was now offering chemotherapy was an answer to prayer – her husband was sick at the time, and she needed to stay in Moshi to care for him. Had the treatment only been offered in Dar es Salaam, the distance and time away from her husband would have caused Mary to forego her care.

In February 2017, Mary met with Dr. Furaha at the KCMC Cancer Care Centre. Together, they discussed the treatment plan, and all the possible side effects of chemotherapy. Mary continued to feel confident about her decision to move forward with the recommended treatment. After five long months, 8 cycles of chemotherapy and numerous blood draws and clinic visits, Mary completed her treatment. She responded so well to chemotherapy that she didn’t even need any additional radiation appointments. Now, with therapy six months behind her, Mary is still cancer free and feeling great!

Mary has become one of the Cancer Centre’s loudest voices, speaking at the prevention and awareness campaigns, and at World Cancer Day. She has a story to tell, and a message for the people: Don’t let fear stop you from seeking care from a doctor at a trusted medical facility. If you notice an unusual symptom, see a doctor right away to get it checked out, and don’t listen to the advice around town.

Mary believes she is alive and able to tell her story because of the Cancer Care Centre, and the convenience of having a treatment centre close to home. When others see her, they see hope. It’s why Mary is determined to spread her message across the Kilimanjaro Region!

Episode 4. Meet Anna Massawe – A champion in palliative care.

harnessgiving@olivestreetdesign.com (Websites Team) — Sun, 02 Jun 2024 14:52:13 GMT

Anna Massawe is a Palliative Care Coordinator Nurse working at the Cancer Care Centre. As a young girl she dreamt of being a policewoman, but her father always knew that she was destined for a career in care services, given her nurturing spirit and her passion for helping people.

She began her career in medicine at the KCMC hospital, where she joined as an Orthopaedic Nurse. After a successful ten year stint, she spent three years undertaking further studies in nursing at the Kilimanjaro Christian University College. She then returned to KCMC to work in the urology department, where she saw lots of HIV patients. It was at that point that she began to take an interest in palliative care, as most of the HIV patients that she saw also had cancers, and they were not receiving the necessary type of care for their conditions.

Today, Anna is a champion of palliative care at KCMC; working and training aspiring health workers on the practices of giving palliative care. A typical day will see her drive along with a team of doctors and nurses to visit patients at their homes, often miles out in rural areas with little if any sanitary services. There, she will tend to their metastatic wounds and hand them some life essentials including food and basic sanitary provisions. While she is there she always makes sure she speaks with her patients, making sure that they feel heard and above all cared for. Anna’s story is truly inspiring. Enjoy!

Jane’s Story

harnessgiving@olivestreetdesign.com (Websites Team) — Sat, 01 Jun 2024 22:42:31 GMT

Jane’s Story

Jane had a heart for oncology long before the Cancer Care Centre opened in 2016. Her experience with oncology began with her nursing career in 2008, where she worked in the internal medicine department at Kilimanjaro Christian Medical Centre, with a concentration in palliative care. It was there she was first exposed to the reality of the cancer epidemic in Tanzania. Because of her experience with the palliative care patients, and the need for trained nurses in Oncology and chemotherapy administration, Jane was chosen to go to Duke University in North Caroline for three months for additional training. During those three months Jane received training in chemotherapy administration, safe handling, and management of side effects. This invaluable experience allowed her to come back to Tanzania with a wealth of knowledge and the confidence to provide quality care to the Oncology patients. Following her training, Jane was deemed the “chemo nurse” of the hospital. She was reassigned to the Dermatology ward, where she saw Oncology patients from all departments and administered their chemotherapy.

As the Cancer Centre was being established, they knew it was imperative to have knowledgeable, trained nurses to care for these complex patients. Jane was the perfect person for the job. She had the necessary knowledge, experience, training, and most importantly, passion. She was the perfect fit!

Since starting at the Cancer Centre, she has continued to receive more training, and has passed her knowledge on to many other staff members, both in the clinic and inpatient wards. Jane is dedicated to her work, despite limited resources to address her patients many challenges. Passion may be her greatest strength, as is evident in every interaction with her patients. From providing weekly education to her patients, to sitting with a woman recently diagnosed with breast cancer who is fearful about losing her breast, Jane takes those extra moments to show care and compassion.

Jane wants to continue expanding her knowledge, and desires to become a specialist in Oncology nursing. She’s already well on her way to accomplishing it!

Episode 5. Prevention through awareness – Beating cancer by spreading knowledge.

harnessgiving@olivestreetdesign.com (Websites Team) — Sat, 01 Jun 2024 14:55:09 GMT

As a Public Health specialist with a Phd doctorate in cervical cancer screening in women, Antje Henke has been working at the Cancer Care Centre since 2016, when she moved to Tanzania from Germany, along with her husband Dr. Oliver Henke and their three boys. Since then, she has been co-working with the medical staff at KCMC to spread knowledge about cancers and to teach people about the ways to detect symptoms early.

‘In the whole of Sub-Saharan Africa, only little research has been done into cancer…cancer is a major problem, but data and cancer registry are really missing here’, says Antje.

To help tackle this issue, an awareness and prevention outreach program called Prevacamp was started at KCMC in 2017, which Antje has been leading. As part of the program, cancer specialists and nurses from the hospital visit other hospitals and locations in the Kilimanjaro region to provide educational talks and spread awareness about cancer diseases.

On top of this incredible work, some auxiliary programs have also been set up to help alleviate people’s preoccupations of being diagnosed with cancer and help them deal with life after diagnosis. Prevatrain was created in order to increase the availability of specialized assistance, by training up aspiring health-care workers, while Prevaschool was rolled out to offer cancer education in schools, so that young people could be prepared should they ever be affected by cancer in the future.

In this insightful conversation you’ll hear about the pioneering work that is underway to create more cancer awareness, detection and prevention in Tanzania.

Enjoy!

FERDINAND’S STORY

harnessgiving@olivestreetdesign.com (Websites Team) — Fri, 31 May 2024 22:53:01 GMT

FERDINAND’S STORY

To many people in Ferdinand’s community, Ferdinand is a walking miracle. He’s the reason many of them have changed their views on cancer and cancer treatments.

10 months ago, Ferdinand was unable to even walk. He had to quit his job as a purchasing officer due to severe pain in his lower back and an inability to perform the duties of his job. After some initial scans, Ferdinand was sent to KCMC for further evaluation. More scans were done, which showed an abnormality in his lower back. He was admitted to KCMC for further tests, blood work, and a minor operation, all of which revealed a diagnosis of Multiple Myeloma – a type of cancer formed by malignant plasma cells.

Ferdinand was referred to the Cancer Care Centre and advised to start on treatment right away. His family knew the importance of starting treatment, but also knew this came with high-cost medications, in addition to transportation for frequent clinic visits.

Like many Tanzanians, Ferdinand was torn between using the local herbal medicines or the western medicine offered at the Cancer Centre. He decided on trying local herbs, but after only a month, returned to the Cancer Centre for chemotherapy. His treatment regimen consisted of coming to clinic every three weeks for his chemotherapy, for a total of eleven cycles.

Due to the high cost of treatment, his family and community organized a meeting to discuss supporting Ferdinand in his fight. Together, the community raised money for one of his costly chemotherapies, costing more than $60 per medication, per cycle; they continue to support him with their fundraising efforts. Without the help from his family and community, his treatment would not have been possible.

After only a few months of treatments, it was evident that Ferdinand was moving in the right direction, both in his treatment and in his body, He was feeling good, with little to no side effects, and was even starting to have less pain with movement. Today, he’s doing exercise and is now able to walk several meters. People are amazed to see the progress he has made in only a few short months!

Ferdinand feels like his mission is simple: “God rescued me, so now I will rescue other people”. As a courageous fighter, Ferdinand is ready to use his story to educate and bring awareness to others in his village. He intends to spread his message: see a doctor with the first signs of symptoms, instead of using the local medicines. He has seen too many people dying due to their lack of seeking a doctor and receiving proper treatment.

Already, Ferdinand has started to make a difference. People don’t see a man who is in pain and unable to stand, bend or move around anymore – they see a man who’s on his feet, full of life, and full of hope. And slowly, but surely, they are coming around to his message.

Anthony’s Story

harnessgiving@olivestreetdesign.com (Websites Team) — Thu, 30 May 2024 22:55:54 GMT

Anthony’s Story

Anthony sits patiently at the Cancer Care Centre waiting to get labs drawn. It’s his fifth cycle of chemotherapy for his stage 3 colon cancer diagnosis. Sadly, Anthony is used to waiting patiently. Once Anthony first noticed symptoms, four months passed before he was referred to KCMC for further investigation. Starting at a local district hospital, he was told nothing was abnormal, and was treated for an amoeba for two weeks. From there, Anthony went to two other hospitals, only to be told nothing was wrong. Despite this, Anthony knew that his symptoms were abnormal, so he came to KCMC for a more thorough investigation. At KCMC, a colonoscopy was done, which showed a tumor in the large intestine. A biopsy was taken, and after more waiting, and further imaging, the final evaluation revealed stage 3 colon cancer.

It took a month for Anthony to fully accept the diagnosis. However, after many discussions with the oncology doctors and his wife, he decided to proceed with the recommended treatment.

Anthony consistently shows up to the clinic every two weeks to receive another cycle of chemotherapy. He has twelve cycles to complete, and is currently on cycle five. His treatment plan involves a chemotherapy that runs over 24 hours, which means he must stay overnight at KCMC. Despite the intense chemotherapy schedule, he continues to remain positive and is grateful for the care he has been given at the Cancer Care Centre.

He continues to respond well to the chemotherapy – Anthony’s family and friends don’t even see him as being “sick” because he looks so good! He has been fortunate to have support from his family during his treatment, and has even made some dietary lifestyle changes.

Five months into his treatment, he continues to wait patiently for blood tests, clinic appointments and chemotherapies to finish. And of course, Anthony waits and hopes for a clean bill of health at the end of this long, difficult journey.

KCMC-FCCT Tumor Board February 2024

Thu, 15 Feb 2024 07:35:01 GMT

KCMC-FCCT TUMOR BOARD

Three urologic cases were discussed at the February tumor board.

One case involved a patient who had undergone a nephrectomy at an outside institution several years ago for renal cell carcinoma. There was now evidence of peri-aortic adenopathy; however, CT guided needle biopsy was deemed infeasible. The discussion revolved around the likelihood that this was recurrent renal cell carcinoma versus a new primary malignancy such as non-Hodgkin’s lymphoma. Thru this discussion, we learned that PET CT scanning is now available in Kenya; PET scanning was not felt to be useful in this case: empiric tyrosine kinase inhibitor therapy with sunitinib directed at renal cell carcinoma was planned.

A second case involved a 25-year-old with metastatic renal medullary carcinoma (RMC) presenting as a large renal mass with extensive liver metastases. RMC is primarily seen in young persons of African descent who harbor the sickle cell gene. RMC is rare in the USA; however, Sub-Saharan Africa has the highest prevalence of sickle cell disease worldwide and therefore a higher incidence of these rare tumors. The prognosis for this malignancy is poor ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7096200/ ).

A third case involved a patient with locally advanced bladder cancer evaluated with cystoscopy and biopsy. A CT scan also identified peritoneal thickening suggestive of either peritoneal carcinomatosis or, perhaps, an alternative etiology such as stigmata from prior tuberculous peritonitis. Laparoscopic peritoneal biopsy was planned for further evaluation.

We concluded tumor conference with an update by our Tanzanian colleagues on several projects related to hepatobiliary cancer. Using tumor registry and electronic medical record data, two retrospective reviews on the presentation, management and outcomes of hepatocellular carcinoma and pancreatobiliary cancer are planned. This data will be used as baselines for prospective treatment studies of these two malignancies at KCMC.

KCMC’s cancer registry was established in 1998. It is one of 5 regional cancer registries from the 32 geographic regions of Tanzania. Staffed by three cancer registrars/statisticians, it obtains data from 18 hospitals in the Kilimanjaro Region of Tanzania, covering a population of over 1.5 million. It is a member of the African Cancer Registry Network ( www.afcrn.org )

KCMC-FCCT TUMOR BOARD

Wed, 20 Sep 2023 07:43:01 GMT

KCMC-FCCT TUMOR BOARD

EXPEDITION TANZANIA

Mon, 20 Jul 2020 08:51:32 GMT

Taking the Trip of a Lifetime Has Never Been so Meaningful

Lifelong memories for you. A second chance at life for the people of Tanzania.

FCCT is seeking applicants to join an expedition to Kilimanjaro in July 2020. The team will work together to raise funds to support the charity and then visit the the center and journey on to the rooftop of Africa.

Find more information here .

To sign up, please call (952) 913-2511 or email info@tanzaniacancercare.org .

foundation-for-cancer-care-in-tanzania

FCCT Blog Post #20

FCCT Blog Post #19

FCCT Blog Post #18

FCCT Blog Post #17

PREVACAMP

PrevACamp | Cancer awareness and education

Scope of programming includes:

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Cancer prevention and awareness days

PrevATrain | Cancer awareness training for community level health care workers

Episode 1. FCCT – The story

KCMC-FCCT Tumor Board May 2024

KCMC-FCCT Tumor Board October 2023

KCMC-FCCT Tumor Board September 2023

KCMC-FCCT Tumor Board July 2023

KCMC-FCCT Tumor Board May 2023

KCMC-FCCT Tumor Board April 2023

Breast Cancer Screening Added To KCMC’s Screening And Earlier Diagnostic Efforts

KCMC-FCCT Tumor Board January 2023

KCMC-FCCT Tumor Board November 2022

KCMC-FCCT Tumor Board October 2022

KCMC-FCCT Tumor Board September 2022

KCMC-FCCT Tumor Board August 2022

KCMC-FCCT Tumor Board July 2022

Episode 2. Laying the foundations – Building the Cancer Care Centre.

FCCT Tumor Board May 2022

Initiation of a KCMC -University of Minnesota Tumor Board

SITA’S STORY

SITA’S STORY

Episode 3. Changing narratives – Rethinking cancer treatment in Tanzania.

Winner’s Story

Winner’s Story

MARY’S STORY

MARY’S STORY

Episode 4. Meet Anna Massawe – A champion in palliative care.

Jane’s Story

Jane’s Story

Episode 5. Prevention through awareness – Beating cancer by spreading knowledge.

FERDINAND’S STORY

FERDINAND’S STORY

Anthony’s Story

Anthony’s Story

KCMC-FCCT Tumor Board February 2024

KCMC-FCCT TUMOR BOARD

KCMC-FCCT TUMOR BOARD

KCMC-FCCT TUMOR BOARD

EXPEDITION TANZANIA

Taking the Trip of a Lifetime Has Never Been so Meaningful