3 February 2012

Kenya: Thyroid Cancer Unit in Dire Straits

"Cancer of the thyroid is one of the cancers in human beings that are curable when diagnosis and treatment is done early," Dr David Ndirangu, head of the nuclear medicine unit at KNH, says.

If it is in the late stages, however, treatment entails chemotherapy plus many sessions of radioiodine ablation.

Experts do not know the exact cause of thyroid cancer. Like other cancers, changes in the DNA of your cells seem to play a role.

People who have been exposed to a lot of radiation have a greater chance of developing this cancer.

It is among the rarer cancers and mostly attacks women. "The ratio of thyroid cancer in male and females in one to nine," says Dr Ndirangu.

No one really knows why women are prone to it, but hormones may play a role.

According an Economist Intelligence Unit report, the number of new thyroid cancer cases by 2020 will stand at 199,566 per year. In low-income countries like Kenya, new cases are expected to rise to 17,461 per year.

Despite these rising numbers, Kenyatta National Hospital is the only public hospital in East Africa that procures the radioactive drug from South Africa. The supply of the pill is limited to only two patients every two weeks.

"So every month we treat only four patients," Dr Ndirangu says.

The thyroid cancer unit was opened by Jomo Kenyatta on December 11, 1968. Since then, it appears that no renovation or expansion has been done.

There are only has two beds, a broken and dirty toilet, a broken window, old beds and mattresses and bedding - and it gets worse.

"We only have one ward for both males and females. We take in only two patients at a time, so if a male is admitted, female patients have to wait for about two weeks to be admitted," Dr Simeon Monda, deputy director of clinical services at KNH, says.

"If only we had 10 beds in five wards, the waiting list would not be that long."

The waiting list as at January 26 was three months long.

If you are discovered to have thyroid cancer, you will have to wait till May to get the radioiodine pill and be admitted to the isolation ward.

The long waiting period is also attributed to the closure of SA's nuclear plants for servicing in December.

Dr Monda says the Kenyan government has now streamlined the procedure for bringing the radioactive drug into Kenya, but oncologists are pushing for the creation of six more isolation wards, two each in towns like Mombasa, Nyeri and Kisumu, to serve patients in these regions.

"But these units cannot be set out on their own; they need a complete nuclear medicine department, equipped with nuclear medicine physicians, of whom there are few in Kenya," said Dr Anselm Opiyo, head of cancer unit at KNH.

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