She took a deep breath in and another to exhale the anxiety. Her emotions were heightened as she waited for the doctor to see her. The music playing in the waiting room was occasionally interrupted by a news bulletin on the television mounted on the wall, amplifying her nervousness.
For nearly two years, Lucy had believed the unusual discharge would go away, that her body would eventually return to normal. But it didn’t. The abdominal discomfort increased, and so did the uncertainty.
“I was using at least three sanitary pads daily. One day, I went to the bathroom, and the heavy brownish discharge scared me. I was really terrified. That’s when I booked to see the doctor,” Lucy recalls, describing the pivotal moment that finally pushed her to seek medical attention.
The doctor didn’t immediately tell her she had cancer. After initial tests raised suspicion, a second confirmatory test confirmed the worst she had early-stage cervical cancer. Her world crumbled.
“The doctor advised me to update my NHIF account and referred me for a few counseling sessions before we developed a treatment plan. I was lost. Cancer. The word itself felt like a death sentence,” she remembers.
Her mind raced back to her two children their health, their future, and their education each scenario more terrifying than the last. But the doctors reassured her that if she began treatment immediately, she had a strong chance of managing the condition.
Lucy, a 51-year-old mother of two, was diagnosed with cervical cancer in 2023. She was initially told that the cancer was at stage 1B and was referred to Kenyatta National Hospital for treatment. However, upon a second opinion at Kenyatta University Teaching and Referral Hospital (KUTRH), an MRI scan revealed that she was actually at stage 2B.
Her treatment began with three chemotherapy sessions, each three weeks apart. After a break of six weeks, she started radiotherapy, which consisted of 25 sessions, followed by five more chemotherapy sessions and brachytherapy. A follow-up CT and MRI scan after the first phase of treatment revealed that the cancer had shrunk by 59%. Now, she is waiting for a PET scan in early March to determine the next course of treatment.
Lucy’s journey reflects a larger reality faced by many women in Kenya and around the world. According to the World Health Organization (WHO), cervical cancer is the fourth most common cancer among women globally, with approximately 660,000 new cases and 350,000 deaths in 2022 alone. The vast majority of these deaths 94% occur in low- and middle-income countries, with the highest burden in sub-Saharan Africa, Central America, and Southeast Asia.
In Kenya, cervical cancer is the second most common cancer and the leading cause of cancer-related deaths. GLOBOCAN data from 2020 reported 5,236 new cases and 3,211 deaths from cervical cancer in Kenya, with an estimated incidence rate of 40.1 cases per 100,000 women per year.
Dr. Alfred Mokomba, an oncological gynecologist, explains that cervical cancer is primarily caused by the Human Papillomavirus (HPV), particularly strains 16 and 18, which are often transmitted sexually.
“Women with high-risk sexual behaviors, such as multiple partners or partners who have multiple partners, those with weakened immunity, including people living with HIV, and individuals who frequently contract sexually transmitted infections like gonorrhea and chlamydia are at higher risk of developing HPV and, subsequently, cervical cancer,” he explains.
Dr. Mokomba further warns that girls who begin sexual activity at a young age are especially vulnerable because their cervical lining is not fully developed, making it less capable of fighting off infections.
One of the most alarming aspects of cervical cancer is that it often has no symptoms in its early stages. Many women do not seek medical attention until the disease has progressed significantly.
“Some women only visit the hospital when they experience abnormal vaginal bleeding, a watery foul-smelling discharge, pain during intercourse, or post-intercourse bleeding. In advanced stages, cervical cancer can lead to urinary and stool incontinence due to the formation of fistulas,” Dr. Mokomba explains.
The diagnosis of cervical cancer involves multiple procedures, including pap smears, HPV testing, and a speculum examination to assess the cervix. If abnormalities are detected, a biopsy is performed to analyze cervical tissue. Additionally, colposcopy, which uses a microscope to examine abnormal areas, is another diagnostic tool used to confirm cervical cancer.
Encouraging early screening is critical in fighting cervical cancer. Dr. Diana Wangeshi, a lecturer and member of the Rotary Club of Nyeri, is passionate about raising awareness among women’s groups.
“I give talks on cervical cancer, emphasizing the importance of pap smears, recognizing abnormal vaginal discharge, and seeking medical attention if anything unusual is noticed,” she says.
Dr. Wangeshi’s PhD research explored why Western countries have a lower cervical cancer burden, attributing it to robust prevention, treatment, and management programs. She examined WHO guidelines on cervical cancer prevention in East African nations, including Kenya, Rwanda, Uganda, Tanzania, Ethiopia, and Burundi, and found that while most of these countries had cervical cancer policies, implementation remained weak.
“There is limited data on who is affected and who is not. Most available statistics are estimates from GLOBOCAN. We need hospital-based cancer registries to capture accurate data for policymaking,” she suggests.
Internationally, organizations like Rotary Foundation have invested over $10.3 million in cervical cancer initiatives since 2014. Recently, the “United to End Cervical Cancer in Egypt” program received a $2 million grant to vaccinate over 30,000 girls aged 9-15 against HPV. Research shows that HPV vaccinations before sexual activity can significantly reduce the risk of cervical cancer.
For Lucy, her diagnosis became a turning point not just for her health but also for her sense of purpose. She now dedicates herself to encouraging early screening and supporting other women going through the same battle.
“I share my journey the struggles, the joys, and the victories. If my story can help just one woman seek screening early, then it’s worth it,” she says.
