Despite being treatable and preventable, cervical cancer still a nightmare for women

Jane Wangui, a Cervical Cancer survivor on January 26, 2024, during an interview at her home of Ndege Ndimu Estate in Nakuru County. [Kipsang Joseph, Standard]

Cervical cancer’s death rate in Kenya is unsettling. For those who are diagnosed with the killer disease, it is like embarking on a journey through a rough sea, where survival is a chance against giant waves. While some make it to the quay, many are tossed into the deep sea of death.

According to Globocan, 3268 women out of 5250 diagnosed with cervical cancer don’t survive it.

The fact that it is a preventable disease if treatment commences at an early stage has not helped matters.

The Kenya Editors Guild recently organised a workshop on cervical cancer in Nairobi, where medical experts explained details on the disease and the importance of girls being vaccinated.

A cancer victim, veteran journalist Mildred Ngesa, narrated to the audience her experience insisting that “the greatest tragedy, and the greatest stigma about cervical cancer is silence”.

The Human Papillomavirus (HPV) can affect any woman who has sex with an infected person. The mode of infection includes vaginal sex, oral sex or deep kissing. HPV is directly associated with the number of sexual partners one has. However, your doctor may do an anal pap test if you have had anal sex", said Dr Joseph Aluoch, a medical consultant.

"Your doctor will be able to diagnose low-risk HPV and cutaneous (relating to skin) HPV through a physical or visual exam,” he adds.

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This means that married men who engage in same-sex sexual acts on the periphery are likely to infect their spouses.

Professor Nelly Mugo, a research scientist with KEMRI, said HPV can affect vaginal cells and around the vulva. If a woman has low-risk HPV, she may see warts on her vulva - the outer part of her vagina.

These warts may present as a cluster that looks like a cauliflower. Doctors say other symptoms include bleeding after sex, unusual discharge of lumps in the vagina, pain while having sex and extended bleeding between periods.

Professor Mugo also added that as the cancer grows and advances, it may start to press against the nerves in the pelvic wall thus resulting in pain and swelling of the legs together with back and hip pain. These symptoms occur in women only.

She added that whilst at least half of sexually active women do have HPV at some point in their lives, this may not necessarily develop into cervical cancer.

There are many factors that predispose women to the risk of contracting cervical cancer, chief among them being sex with multiple partners.

"In Kenya, a better reporting system in hospitals has made the Government to get the correct data and statistics on cervical cancer," said Dr Patrick Amoth, Director General, of the Ministry of Health.

“Early onset of sexual activity, recurrent sexually transmitted infections, low social class, poor personal hygiene, family history of cancer and HIV/Aids infection have aggravated the number of cervical cancer cases in the country,” revealed Dr Amoth.

He also revealed that the Government is setting up cancer screening centres in different regions each with two screening machines.

The cervix is the lower part of the womb or uterus often referred to as the neck of the womb. The organs and tissues of the body are made up of tiny building blocks called cells. The cells are constantly becoming old and dying out and replaced by new ones. Doctors, especially gynaecologists and obstetricians, say normally, cells divide in an orderly and controlled manner. If, for some reason, the process gets out of control, the cells continue dividing, developing into a lump which is called a tumour.

Tumours can be benign or malignant. Cancer is the name given to a malignant tumour.

Dr Aluoch said a doctor can tell if a tumour is benign or malignant by examining a small sample of the cells under a microscope in a process called biopsy. A malignant tumour consists of cancer cells that can spread beyond the original area.

If the malignant tumour is not treated, it may spread and destroy the surrounding tissues.

Dr Aluoch, who is also the patron of the HIV Clinicians Society of Kenya, noted that screening aims to detect cancer at an early stage when treatment can be more effective. He added that prevention of cervical cancer can be achieved by routine pap smear, which is recommended for women above 25 years, every two years. But it is even better if one can afford an annual pap smear.

Experts say HIV infections increase the risk of developing cervical cancer. Scientific research has shown that up to 70 per cent of invasive cervical cancer is due to HPV.

"This virus can cause slow changes in the cervix, which may take between five to 15 years before developing into invasive cancer, and it is this process which is hastened by HIV infection", said Dr Aluoch.

Unfortunately, less than 30 per cent of women have access to pap smear screening. Vaccines against HPV are available and are recommended for girls aged between 11 and 12.

Professor Mugo says the HPV vaccine is 98 per cent effective as clinical trials indicate a high level of safety and efficacy. She urged young girls to go for the vaccination.

According to Dr Amoth challenges facing cancer patients are financial burden and lack of enough specialists.