Throat cancer scare as more people diagnosed in western Kenya

Immaculate Shivinza thought she had a trifling cough. That was in June 2014. To her, all she needed was a lozenge to lubricate and soothe the irritating throat. She was wrong.

The discomfort turned to persistent pain. The 47-year-old sought medical attention at the Kakamega County Referral Hospital but surprised when she was referred to the Kenyatta National Hospital (KNH).

At KNH she got the bad news. She had throat cancer.

“For a moment, I couldn’t believe it. I thought the doctor was teasing me until he suggested that I go to St Mary’s hospital for insertion of stent (special tube placed in gullet to aid in swallowing),” says Shivinza.

She wasn’t alone. Barely six kilometres away in Sigalagala, Edwin Murunga, 35, was at a loss when doctors discovered he was suffering from throat cancer in 2015.

“I started living in isolation when doctors disclosed to me that I was a cancer victim and loneliness almost sent me to grave save for the palliative care I was introduced to at Kakamega hospital,” Murunga says.

These may seem like isolated cases, but statistics from Kakamega Referral Hospital show a worrying trend. Records show that 47 of 72 patients with symptoms similar to those experienced by Shivinza were diagnosed with throat cancer between January and June this year.

County Health Executive Peninah Mukabane says between 50 and 60 throat cancer patients succumb to the disease every year in the area. “Most of them die within one year of diagnosis,” she says. According to her the disease remain top cause of admission of adults particularly men at the county referral facility and is among five top causes of death in the area. “We record at least 15 new throat cancer cases every month at this centre, which serves patients from the entire former Western Province that brings together Bungoma, Kakamega, Busia and Vihiga counties,” says Rose Otera, a cancer expert in charge of palliative care at Kakamega Hospice Centre.

Otera says this cancer affects the voice box, the vocal cords, and other parts of the throat, such as the tonsils and the oropharynx.

She says it can be difficult to detect throat cancer in its early stages. “Throat cancer patients could exhibit numerous symptoms that include a change in voice, trouble swallowing (dysphagia), weight loss, sore throat, constant need to clear your throat, stubborn cough, swollen lymph nodes in the neck, wheezing and ear pain,” says Otera.

Mukabane and Otera regret that most patients seek medical assistance when throat cancer has caused extensive damage. “If diagnosed early, throat cancer has a high cure rate. Unfortunately, most cases are discovered late and little can be done to reverse the situation,” says Otera.

It becomes practically impossible to cure throat cancer once malignant cells spread to parts of the body beyond the neck and head.

Research findings by experts at Moi Teaching and Referral Hospital (MTRH) in Eldoret show that throat cancer is the most common in men in Western Kenya. The 2010 research also found that the disease is third most common cancer in women.

Costly treatment

The research established that patients who suffer from esophageal cancer in Western have an average age of 59. Similar statistics at the Kakamega referral hospital shows the ratio of men to women diagnosed with cancer in Western is 5:1 compared to Nairobi where the ratio stands at 9:1, according to Otera.

Mukabane says the prevalence of the disease in the area had prompted Moi University and Africa Medical Research Foundation (Amref) to embark on research. “The research will determine the causes of the disease, why it is prevalent in the area and give recommendations on how the situation can be dealt with,” she says.

 Costly throat cancer tests and treatment make patients, most of them from poor backgrounds, shy away from seeking treatment.

“Endoscopy tests and CT scan cost between Sh8,000 and Sh12,000 while Palliam swallow tests require Sh1,500. Not all the tests can be done at this referral hospital, you could be forced to travel to Nairobi for endoscopy, histology and other advanced tests,” explains Otera.

Otera says some patients seen at the hospital and asked to take such tests just despair and opt to stay at home hoping for a miracle only to be brought back in worse conditions.

Shivinza’s family is all too familiar with the high costs of cancer treatment. “Sometimes she will go without taking the medicine for even two weeks because we cannot afford even a single dose,” says Nerab Amakobe, Shivinza’s sister-in-law.

They also have to do with expensive diet of liquid food like milk, fresh Juice water and sometimes soft drinks such as soda.

Certain lifestyle habits, warns Dr David Oluoch, increase the risk of developing cancer of the throat. Dr Oluoch is in charge of health services in Kakamega County.

Such contributing factors according to experts include smoking, excessive alcohol consumption, Vitamin A deficiency, exposure to asbestos and poor dental hygiene. It could also be inherited. Cancer treatment Centres in America have reported some link between throat cancer and certain types of human papillomavirus infections (HPV), a sexually transmitted virus.

 But amid all these, there is a ray of hope for residents of Kakamega. West Kenya Sugar company is in the process of expanding the Kakamega Hospice Centre at a tune of Sh10 million. “We have had engagements with them and they are willing to support us,” said Otera. The centre is also working in collaboration with USA based Tsuma Hospice Centre in promoting health care for patients in Western, according to Ms Mukabane. The county government has set aside another Sh1.5 million for non-communicable diseases, particularly cancer and diabetes and intents to mount campaigns aimed at sensitising residents about the said diseases.