Experts say misdiagnosis, poor lifestyle to blame for high cases

By , People Daily Digital
Thursday, April 22nd, 2021 00:00 | 2 mins read
Cancer patients await treatment at Kenyatta National Hospital. Photo/PD/PATRICK NJOROGE

Patrick Njoroge

Dr Joyce Aswani, a Head and Neck Cancer surgeon, says the African laryngeal cancer nightmare is partly due to delayed diagnosis.

 “This cancer can affect any part of the larynx but more often affects voice-producing parts called the vocal cords.

Males are affected more than females due to differences in lifestyles. “Men suffer more cases of head and neck cancers than women because males are heavier smokers and alcohol consumers,” she says.

Due to a poor referral system, about 80 per cent of patients are diagnosed at late stage with hoarseness as the earliest and commonest symptom, survival is next to impossible, she says.

“Patients complaining of hoarseness often receive less than minimal examination and routinely receive inappropriate treatment.

Public hospitals suffer from poor infrastructure, lack of effective information transfer, financial constraints and patient non-compliance when it comes to patient referral to established cancer centres,” Dr Aswani says.

Peripheral hospitals

She notes that low public awareness of early cancer symptoms among patients is partly due to few available qualified medical personnel and inefficient and heavily corrupt public healthcare system.

The medic adds with only 100 ENT doctors serve a population of 40 million plus citizens, it is  difficult to provide quality services.

“Majority of specialists prefer to operate from Nairobi mainly because peripheral hospitals lack facilities for satisfactory ENT practice.”

Dr Diana Menya, senior lecturer at Moi University College of Health Sciences quotes findings of a local study published in the International Journal of Cancer which reveal consumption of local brews chang’aa and busaa contribute up to 50 per cent of oesophageal cancer cases in Western Kenya.

The study also links increased oesophageal infections to drinking hot to very hot beverages, predominantly tea.

The findings are in line with previous research conducted in other high burden tea consuming areas such as Iran.

She says major risk factors behind rapid rise in oesophageal cancer cases in Kenya and the larger Horn of Africa region include regular smoking of cigarettes, cigars, pipes and chewing tobacco.

Other causes include untreated gastroesophageal reflux disease, having bile reflux, undergoing radiation treatment on chest or upper abdomen, being obese and consuming insufficient fruits and vegetables.

Dr Shaheen Sayed, a consultant pathologist at Nairobi’s Aga Khan University Hospital explains the large tumours sent to laboratories for cancer testing is an indicator that many patients delay visiting a doctor for treatment.

‘‘We get tumours measuring about 10 to 12 centimetres in size while in the West, patients see doctors after noticing lumps measuring one or two cm,’’ she says.

She says late diagnosis of new cancers and failure to promptly spot recurrences among survivors contribute to many premature deaths. 

Effects of chemotherapy 

Concerning treatment, Prof Nicholas Abinya of Kenyatta National Hospital says most common side effects of chemotherapy include mucositis, an inflammation and ulceration of linings of mouth and throat. Mucositis causes severe pain and difficulty while eating and drinking.

Patients also experience hearing loss and associated symptoms, including ringing in ears (tinnitus), kidney problems, nausea and vomiting.