daniel chigunwe
Rumbidzai Zinyuke
Health Buzz
Chipo was a vibrant 40-year-old woman living and working in Harare.
Her life revolved around work and children and she rarely took time to prioritise her own health.
When she started bleeding irregularly, she did not think much of it. She just assumed that it was the pressure of work messing with her menstrual cycle.
Even when she started experiencing occasional pain in the pelvic area and constant fatigue, she never thought to visit a doctor.
After all, most women experience such, she told herself.
So she took some home remedies and pain killers and waited for the symptoms to go away.
But she was losing weight so much that people around her started noticing that something was not alright with her.
It was only when she started experiencing constant headaches and the bleeding became heavy that Chipo finally acknowledged that there was a problem and went to a clinic.
The clinic referred her to hospital where she received a devastating diagnosis: Stage 4 cervical cancer!
The cancer had spread beyond her cervix, making treatment more complicated and expensive.
While Chipo had heard about cervical cancer before, she had never imaged she could get it. The little knowledge she had about it was not enough to trigger panic in her once she started experiencing the symptoms.
Despite the late diagnosis, she fought bravely, underwent chemotherapy and radiation, with the support of her family and friends. However, the aggressive nature of the disease and the delayed start of treatment made recovery an uphill battle.
Chipo sadly lost the battle in November last year, leaving behind a devastated family.
Her story is not unique.
There are thousands of women in Zimbabwe and beyond, facing a similar fate.
According to the National Cancer Registry annual report, cancer of the cervix is the most common type of cancer in Zimbabwe accounting for 22 percent of the total number of cancer cases in 2019.
It accounted for 40,8 percent of all cases reported among black women in the country.
Zimbabwe is ranked fourth among the countries heavily burdened with cervical cancer globally, with an estimated 2 000 new cases diagnosed each year.
According to statistics, more than 70 percent of all women diagnosed with cervical cancer do not survive the disease which is the leading cause of mortality among women.
Arguably, the worst part about cervical cancer.
Most women with the disease have no signs or symptoms until it gets to an advanced stage, as was the case with Chipo.
However, cervical cancer is the most preventable and treatable cancer through early detection and vaccination.
The month of January is Cervical Cancer Awareness Month, when efforts are made to raise awareness about the causes of cervical cancer and the importance of screening and vaccination to prevent the disease.
The month serves as a stark reminder of why women should never ignore some of the most common symptoms they may develop.
Recognising the early warning signs can be lifesaving. Here are signs and symptoms that should never be ignored.
Unusual bleeding
One of the most common signs of cervical cancer is abnormal vaginal bleeding. This includes bleeding between periods, heavy or prolonged menstrual bleeding, bleeding after sexual intercourse and postmenopausal bleeding.
While such bleeding can be caused by other conditions, it is a strong indicator that warrants a visit to a health facility for a check-up.
Pelvic or back pain or discomfort
Pelvic and back pain due to other causes is common, but this could be one sign of advanced cervical cancer. Persistent pain in the lower abdomen or pelvis, especially if it is unrelated to menstrual cycles, could be a sign of advanced cervical cancer. The pain may occur during intercourse or be constant and dull.
According to experts, at this point, it is possible that the tumour has grown so much that it is now pressing down on the lower back or tailbone.
Unusual discharge
Changes in vaginal discharge, such as an increase in volume, foul odour, or the presence of blood, may indicate a problem with the cervix, including potential cancerous changes.
For most women, it is normal and healthy for discharge to change throughout the month, varying in thickness, opacity, and consistency.
But once there is a persistent discharge that has a different colour, or that has an odour, it could be the result of the “dying tissue” created by cervical cancer.
It is unfortunate that most women are not comfortable talking about these changes with anyone, even a health worker.
Pain during intercourse
While sex is supposed to be enjoyable, pain could signal that there is a problem.
There are of course many reasons for painful sex and most have nothing to do with cancer. But experts believe that if a woman experiences pain during intercourse, in addition to other symptoms, it may be the result of tumour growth throughout tissues and reproductive organs. This symptom should prompt a visit to a gynaecologist.
Urinary problems
Cervical cancer can press on nearby organs like the bladder causing symptoms such as pain or a burning sensation during urination, frequent urination without explanation, difficulty urinating as well as blood in the urine.
Unexplained fatigue or weight Loss
It is normal for someone who works extra hard to experience fatigue. But when the fatigue is constant and it is accompanied with a loss of appetite and weight loss, it could be a sign that the body is fighting a serious illness.
When the body is fighting off disease, it works harder and as a result becomes tired. As with many cancers, loss of appetite or unexplained weight loss can be a cause for concern. This symptom on its own does not mean cervical cancer, but it is always advisable to speak with a health professional should these symptoms persist.
Swelling in the leg
As cervical cancer progresses, it can spread to lymph nodes in the area between the hip bones. Cancer cells can also stop lymph fluid from draining away. This might lead to swelling in the one or both legs due to fluid build-up. The swelling is called lymphedema.
Testing HPV positive
This is less of a symptom, and more of a risk factor for cervical cancer. HPV is a sexually transmitted infection that causes the production of two proteins—E6 and E7—that turn off some of the tumour suppressor genes and allow the cervical lining cells to overgrow and develop mutations that can lead to cancer.
Experts say it can take between 15 to 20 years for cervical cancer to develop in women with normal immune systems.
Although there is no effective treatment for HPV, the vaccine is the most effective prevention method recommended for both boys and girls between nine and 14 years. Zimbabwe already has a programme aiming to vaccinate this age group in schools as part of measures to reduce the incidence of cervical cancer in later years.
Having HIV or AIDS
Another great risk factor for cervical cancer is having HIV. Women who are living with HIV are five times more susceptible to cervical cancer because of their compromised immune system.
It is, therefore, important for all women with HIV to get screened for cervical cancer regularly.
Importance of regular screening
Routine Pap smears and HPV testing remain the gold standard for early detection. Women aged 25 years and above are advised to follow screening guidelines appropriate to their age and risk factors.
The main ways to screen for cervical cancer include the HPV test to check for infection that can cause cervical cancer, a pap smear (cervical cytology) where cervical cells can be checked for changes caused by HPV that may turn into cervical cancer if left untreated. A pap smear can also sometimes detect conditions that are not cancer.
Zimbabwe has made strides in ensuring that many women, particularly those in marginalised communities can access screening services through the Visual Inspection with Acetic Acid and Camera (VIAC) services offered for free at various health centres.
VIAC involves examining the opening of the womb, or the cervix, for changes that may lead to cancer. If these changes are detected early, the cells can be eliminated before they become cancerous.
Screening is usually recommended in the general population of women, with regular screening every two to three years while women living with HIV need to be screened more frequently.
While screening is important, increasing the awareness of cervical cancer to ensure prevention is critical.
It is also important for all women, young and old to never ignore the symptoms when they do appear.
Armed with knowledge, Zimbabweans can defeat cervical cancer!
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