Cervical cancer: Leading cause of cancer deaths in Zim

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Tariro Gara (not her real name), a 28-year-old woman, was diagnosed with cervical cancer in February last year at Harare Hospital after she started to bleed and release liquids from her body.

She was then referred for radiotherapy on October 25 2011 at Parirenyatwa Hospital for six weeks. Gara is about to finish her six-week radiotherapy course, but her condition is improving at a slow pace.

Haemorrhage has been reduced, but the doctor says she needs blood transfusion.

Although she was admitted in hospital on December 17, almost a week later, the transfusion had not yet been performed as the machines at the hospital had broken down.

“We paid for the blood on Thursday (December 17) and they have not given her yet. The government should at least buy some new machines to help cancer patients. The machines they are servicing were bought in 1997 and they are now old,” a relative said.

Gara is one of the women in Zimbabwe who have cancer of the cervix, a leading cause of cancer deaths and morbidity in the country.

Research has shown that cervical cancer starts in the cervix, the lower part of the uterus that opens at the top of the vagina.

Cervical cancer at its preliminary stage has no symptoms.

Symptoms that may occur include abnormal vaginal bleeding between periods, after intercourse or during menopause, continuous vaginal discharge which may be pale, watery, pink, brown, bloody and foul smelling.

Cancer of the cervix is caused by exposure to tobacco smoke through direct or indirect smoking, use of traditional herbs inserted in the vagina and poverty that limits access to information and services.

Ministry of Health and Child Welfare permanent secretary Gerald Gwinji said pap smear screening services are mainly provided by the private sector, with just a few public health institutions in the country.

Pap smear is a screening test used to check changes in the cells of a woman’s cervix.

Gwinji said the few public institutions offering the service are facing challenges resulting in them charging the cancer patients for them to continue to offer the service.

“The problem with cervix cancer is the centralisation of services and the prohibitive costs of services and lack of awareness of cancer of the cervix.

By end of January 2012 all central hospitals would be providing this service and plans to roll out visual inspection under ascetic acid,” he said.

He said in sub-Saharan Africa, 70% of cancer of the cervix are due to the human papilloma virus, which is sexually transmitted condition and human immuno virus facilitate the transmission of human papilloma virus.

Gwinji said cancer of the cervix is one of the most prevalent cancers among women worldwide. At least 500 000 cases are diagnosed annually and at least 300 000 women die yearly. Of the total deaths, 80% are in developing countries.

“Lack of access to early detention (screening and early diagnosis) of cervical cancer services results in delayed presentation little can be done to save life,” he said.

Gwinji said cancer of the cervix is caused by unsafe sex practices. Lack of women empowerment results in women not being able to make decisions regarding their own health and lack of awareness of cancer of the cervix.

Data made available by the ministry showed cervix cancer cases have been on the increase between 2004 and 2008, with cases ranging from 468 in 2004, 890 in 2005, 626 in 2006, 636 in 2007 and 185 in 2008.

The mortality rate has been increasing from 2004 at 9% to 19% in 2007. Mortality rate is a measure of the number of deaths in a population.

A research conducted by Professor Christopher Chetsanga in 1986 revealed that out of 1 984 cancer patients surveyed, 24% suffered with cancer of the service, with 8,3% mortality.

Cancer Association of Zimbabwe knowledge officer Tafadzwa Chigariro, said the country has a high Aids prevalence rate and this might be the other reason why there is a high rate of cancer of the cervix. He said cervical cancer is a sexually-related opportunistic infection.

Chigariro said cervical cancer cases are high compared to other cancers such as breast cancer. He however could not give statistics saying the association figures were for their members only.

“The government should provide resources and equipment that can be used for chronic cases,” he said.

Women with cancer of the cervix at its preliminary stages may undergo surgery during which infected tissues may be removed. In extreme cases the cervix, uterus and other tissue around the vagina can be removed as well.