Cancer in My Community is a Cancer.Net Blog series that shows the global impact of cancer and how people work to care for those with cancer in their region. Aynur Kenjaeva, MD, MBA, graduated from Tashkent Medical School in Tashkent, Uzbekistan, in 2012. Dr. Kenjaeva’s residency was in oncology and radiology. Dr. Kenjaeva then worked as a medical oncologist at the Kazakh Institute of Oncology and Radiology in Almaty, Kazakhstan. In 2018, Dr. Kenjaeva was the recipient of the IDEA Grant from Conquer Cancer, the ASCO Foundation, and recently graduated from a Master of Business Administration (MBA) program in California. Dr. Kenjaeva has no relationships relevant to this content to disclose.

Why I care for people with cancer

Dr. Siddhartha Mukherjee, the New York Times bestselling author and a medical oncologist, has called cancer the “emperor of all maladies.” He describes cancer in these words: “It is terrifying to experience, terrifying to observe, and terrifying to treat.”

My first experience around people with cancer was during my clinical training in the chemotherapy department at Tashkent Medical School. It was challenging for me both emotionally and professionally. I felt the pain and hopelessness of some of the patients. But as I was learning about cancer biology and treatment, I started to understand its complexity.

At the time, residency in oncology was not popular among future doctors, and cancer centers always needed more oncologists. During my residency, I faced the grim challenges of treating people with cancer who were hopeful for healing, even if it wasn’t always meant to be.

What cancer is like in Kazakhstan

In Kazakhstan, the most common types of cancer include breast cancer, cervical cancer, lung cancer, stomach cancer, and colorectal cancer. The government finances effective screening programs for breast, cervical, and colorectal cancers. Meanwhile, screening programs for prostate, lung, and stomach cancers will be available in a couple of years.

In Kazakhstan, people are often diagnosed with advanced cancer despite all of the screening measures in place to find cancer early. Although some cancers, such as cervical, skin, and breast cancers, can be detected at early stages by visual examination methods, people often don’t seek care until the cancer is at an advanced stage.

In my opinion, one of the reasons for the number of advanced cancer diagnoses in Kazakhstan is a lack of education among the public, mainly in rural areas, about cancer and the screening programs available to citizens. Another reason is that some people with cancer receive a delayed diagnosis from their care team. People with cancer are typically referred to an oncologist by their primary care physician, and I’ve seen how a lack of knowledge around the early signs of cancer among primary care physicians and other specialty doctors can lead to a delayed diagnosis.

What cancer care is like in Kazakhstan

Kazakhstan is the only country among post-Soviet Union countries that provides free cancer care to all of its citizens. The Kazakh Institute of Oncology and Radiology (KazIOR) is the equivalent to the National Cancer Institute (NCI) in the United States and is a leading cancer center in Central Asia. KazIOR is not only the hub for cancer care in Kazakhstan, but it also collaborates with neighboring countries such as Uzbekistan, Tajikistan, Kirgizstan, and others.  

The cancer care structure of Kazakhstan includes the main national cancer institute and 18 regional cancer hospitals. Kazakhstan’s government and national cancer institute are working to improve cancer care in the country through the implementation of modern technology, the improvement of cancer research, and further development of palliative care and rehabilitation for people with cancer.

The national cancer institute works to promote awareness of cancer and its prevention by organizing charity events, providing “open door consultations” at cancer centers, and providing information through webinars and national TV channels. People with cancer can dial in to call centers where they can ask questions and have any concerns they have about their care addressed. The national cancer institute also provides psychological care to all people with cancer and their families. During the COVID-19 pandemic, people with cancer have even been able to request televisits with medical oncologists.

How people with cancer in Kazakhstan cope with their diagnosis

In my practice, I see all different types of people with cancer who experience the disease in different ways. Some of my patients feel comfortable sharing their cancer experience and ask for support from family and friends. They are open to talking about their diagnosis and may seek psychological support.

However, there are also some patients who feel stigmatized when they are diagnosed with cancer. These patients may change their lifestyle to keep their disease a secret. They often do not share their emotions with family and friends and do not believe in psychological support.

When people with cancer hide their experience, it can contribute to certain myths or misperceptions about cancer. Therefore, it’s important that the government and Kazakhstan’s national cancer institute promote screening programs and bring awareness and education to the general population about cancer and its preventive measures.

Where patients can find local resources and support in Kazakhstan

People with cancer in Kazakhstan can ask questions and find resources on KazIOR’s website as well as on the website of the Astana Cancer Center. Several non-governmental organizations, such as the Together Against Cancer Foundation and the Kazakhstan Palliative Care Association, are working to combat cancer by organizing events to raise awareness about cancer and its prevention, providing financial aid to low-income families, and organizing international conferences and other national projects to improve cancer care.