Bomet: The hotspot of ‘painful swallowing’

Judith Chepkemoi from Longisa in Bomet County struggles to swallow food after being diagnosed with cancer of the oesophagus two years ago. The 23-year-old feeds through tubes and is on nutritional support under palliative care at Longisa Hospital

“I had difficulty and pain while swallowing food and bought medicine over the counter assuming it was a sore throat, only to be slapped by a medical report that I had cancer,” recalls Chepkemoi who has undergone 12 chemotherapy sessions by March this year for the stage 4 cancer.

Chepkemoi is among hundreds of locals suffering from cancer of the oesophagus in Bomet County which leads in oesophagal cancer with 50 per cent of annual cases, according to the National Cancer Institute of Kenya. Oesophagal cancer is ahead of cervical, breast, stomach and prostate cancers in terms of death.

Besides Bomet, other areas with a high prevalence of oesophagal cancer include parts of Nyanza, Rift Valley, upper Eastern and North Eastern and sections of the Coastal region.  

Chepkemoi goes for regular check-ups at Longisa Hospital which had documented 800 cases of cancer of which 400 were confirmed with cancer of the oesophagus.

Dr Stephen Omondi, an oncology pharmacist at the hospital said “most patients come with Grade Four of oesophagus cancer when they cannot feed, even swallowing saliva. At such, we have nothing much, but place them under palliative care.”

Also, patients with symptoms of cancer can hardly afford endoscopy and biopsy tests which cost Sh45,000 at Tenwek Mission Hospital. The figure is high for those living in poverty.

Longisa Hospital does not have an endoscopic machine and samples are sent for lab tests either at Moi Teaching and Referral Hospital (MTRH) or the Kenya Medical Research Institute (Kemri).

National Cancer Institute Chief Executive (CEO) Alfred Karagu said investigations are underway to establish the main cause of the cancer in Bomet and possible solutions as scientists have linked increasing oesophagal cancer cases in certain regions to consumption of hot tea, alcohol consumption, tobacco smoking and exposure to wood smoke besides deficiencies like selenium.

A March 2019 study at Tenwek Hospital in Bomet revealed that consumption of hot tea at 72°C (some of the hottest in the world) in Western Kenya has been linked to rising cases of the throat or food pipe cancer-whose number of new cases almost equals the number of deaths.

Dr Michael Mwachiro, a surgeon at Tenwek Mission Hospital where he’s in charge of the Endoscopy Centre said “ongoing research has linked the esophagus cancer to a strong family history”

Research at Moi Teaching and Referral Hospital added alcohol, oral hygiene and temperature as the other possible cause of oesophagal cancer which goes undetected in the early stages.

 In East Africa, Kenya is the worst-hit ahead of Tanzania with Malawi leading in Africa but Dr Mwachiro says protection against oesophagal cancer includes “a screening endoscopy if you come from a high risk or hotspot areas and if you have a confirmed first-degree relative” but difficulty or painful swallowing and weight loss are early enough signs.   

Source: WHO