Business Daily (Nairobi)
Abyssinia Lati
12 May 2008
Agatha Mwajuma's life has been a war and her latest battle left her traumatised and feeling isolated. It all began in 2006 when she went for her routine pap smear as recommended for a HIV-positive woman. Unlike negative women who should take the test once a year, she has to take it every six months.
"I was told that there were some changes in the cells, but the doctor was not sure if they were cancerous so he put me on antibiotics for two weeks," she says.
Sadly, the antibiotics did not work. She was in the early stages of cervical cancer. The doctor recommended that the affected area be removed.
"On the day of the surgery, four doctors walked in and told me that because I was HIV-positive, they fear ed the cancer might reoccur and that they wanted to remove the whole uterus," she says.
Just six month after diagnosis, she went ahead with the surgery.
Ms Mwajuma is among thousands of women who have been diagnosed with cervical cancer. The global situation is also grim. According to the World Health Organisation (WHO), about 500,000 cases are reported each year, with nearly 80 per cent of those reported in developing countries.
In Africa, reported cases are on the increase and by 2020 it will the most common cancer among women and will account for 50 per cent of the deaths, says the global health agency.
In Kenya's situation it is rising by five per cent every three years and it accounts for 70 per cent of gynaecological cases.
The most recent studies done by the Nairobi Cancer Registry of 2002 reveals that it rose from 18 per cent in 2000 to 23 per cent in 2002.
The report reveals that it was only second to breast cancer in mortality rate among women in Nairobi and the environs. Dr Omondi Ogutu, the chairman of the Kenya Obstetrical and Gynaecological Society, paints a desperate picture. It is not about breast cancer any more.
He says that about 600 cases of cervical cancer are reported at Kenyatta National Hospital annually. It is a scary statistic.
Rose Ngau, the nurse-in-charge at Family Health Plaza on Langata Road in Nairobi, has worked as a nurse in reproductive health since 1986 and recalls that cervical cancer used to affected older women, but today, women as young as 18 years are afflicted. "Cervical cancer could be increasing because of lifestyle changes like nutrition, sexual habits and HIV," she says.
About 100 years ago, a group of epidemiologists noticed that the cancer was common in prostitutes and uncommon in nuns; expect those that had been sexually active before entering the convent.
The group noticed that the disease was also prevalent among women who became second wives to men whose first wives had died of cervical cancer. This showed that it was a sexually transmitted agent. However, it was not until the late 1970s that German researchers isolated human papillomavirus (HPV).
Development in the research of the HPV has shown that there are over 70 known types, but about five are linked to cervical cancer; HPV types 16, 18, 31, 33, and 35. Cervical cancer vaccines Cervarix from GlaxoSmithKline (GSK) and Gardasil from Merck & Co are meant to protect women from the strains of the virus that cause the cancer.
Cervarix is already in the Kenya market and the local GSK office has had a series of pre-launches while preparing for the major launch on July 2, 2008.
According to Patrick Abelle, head of vaccine at GSK East Africa, the vaccine trials are currently under way in various countries in Tanzania, Senegal and Uganda.
Initially, Cervarix was to sell at between Sh20,000 to Sh30,000 for the full dosage of three taken over a period of six months, but the cost has since been brought down to Sh14,000.
However, Sister Ngau says it is too expensive for the poor woman who stands a higher risk of developing the cancer.
Geoffrey Mutuma, the chairman of the Nairobi Cancer Registry, says some of the risk factors of breast and cervical cancer are opposite. Breast cancer is believed to be caused by late births and few children while cervical cancer is caused by early birth and many children, which is likely to happen to poor women mostly in rural areas and urban slums.
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