Act early to prevent cancer of the cervix

Njoki requested me to drive her to Baba Dogo estate in Nairobi to be prayed for by a diviner.

This was the weirdest request I have ever received from a patient at the Sexology Clinic.

Not that I do not believe in divine healing, religion definitely has its place. However, it is rare for a patient to come to the hospital to request a doctor to take her to a diviner.

“Doctor, I know my request may sound strange but we have to agree that you and your lot have failed, so let us also give God a chance,” she said, tears rolling down her cheeks.

Njoki had advanced cancer of the cervix and all attempts to contain the progression of the disease had failed.

She had therefore been referred for terminal care at the hospice. I had met her severally in the course of her treatment and our relationship had grown beyond that of doctor-patient, to being friends.

Realising that I and my colleagues had failed, Njoki opted for divine healing, and who understood her situation better than me?

I obliged.

Njoki came to the clinic for the first time when she noted non-resolving vaginal bleeding. It initially happened after sex. There was no associated pain.

She thought her husband could have been too rough and caused injuries during the act. In fact, they had serious conflict about this which resulted in her denying the man sex.

Treatable cancer

As fate would have it, however, the blood started flowing even without sex. She also started having smelly vaginal discharge.

When I examined her at her first visit to the clinic I was convinced there was something seriously sinister – she had a friable growth on the cervix which bled easily. Further evaluation confirmed cancer of the cervix. 

Worse still, attempts to intervene surgically to excise the cancer were futile. The growth had spread to other organs including the kidneys and the intestines.

Njoki deteriorated very fast despite chemotherapy and radiotherapy. She developed anaemia and underwent blood transfusions severally, could not eat, lost weight and got worse by the day.

Realising that medical care had failed, we referred her for hospice care. She went home devastated that day, then came back two days later with a request for me to personally drive her in my car to the church in Baba Dogo for faith healing.

A few days after I took her for prayers, Njoki succumbed to the cancer. I felt sad. She was not only a patient to me, she had grown to be a friend.

We talked many times about the future and I felt she was not ready to die and leave her husband and children. Well, I do not know whether anybody can ever be ready for death but I felt Njoki was especially unprepared.

Njoki’s story was a grim reminder to me of the many women who continue to die from cancer of the cervix, a totally preventable disease.

When detected early, the cancer is treatable. Women who go for routine gynecological checks get the precancerous lesions detected and treated and never progress to the active disease.

Cervical cancer testing

In fact, the treatment for early signs of this cancer is very easy and inexpensive which is quite different from if the disease is detected late.

Routine screening for the disease accurately identifies those at risk of the disease as well as those with pre-cancerous changes in the cervix.

Tests such as Human Papilloma Virus infection and Pap smear are commonly used.

Unfortunately, many women do not go for cervical cancer testing. Many women have the knowledge but keep postponing the check, sometimes till they get the symptoms of the disease, which is normally too late.

Any woman who has ever had sex needs to undergo cervical cancer screening tests routinely. Further, those who have no signs of the disease as well as pre-pubertal girls who are yet to have sex can now get a vaccine to prevent the disease.

When I first met Njoki I asked her whether she had ever had a pap smear, one of the screening tests.

“What?” she exclaimed, “I do not like people peeping down there,” she mused.

She knew about the test but the discomfort of being examined made her avoid it. If anything, she had never had symptoms of any disease and she did not see the urgency of doing the test.

Many times in the course of treatment Njoki would say, “Doctor, use every opportunity you have to tell women to go for pap smear. It is the greatest regret I have in this life.”

May those who read this story fulfill Njoki’s wishes.