Warriors of the Womb: Kenyan Women Leading the Fight Against Cervical Cancer

By Melisa Mong'ina - Cervical cancer is a malignant tumor that develops in the cervix. It is one of the most preventable and treatable cancers if detected early through screening.

For decades, cervical cancer has been one of the leading causes of cancer-related deaths among Kenyan women, posing a major health challenge. The primary cause of cervical cancer is persistent infection with high-risk strains of the Human Papillomavirus (HPV).

Other risk factors include: multiple sexual partners or early sexual activity, smoking, a weak immune system ( HIV infection), long-term use of birth control pills (5 years), having many children, and a lack of regular Pap smear screenings. This type of cancer is ranked as the second most frequent cancer among women aged 15 to 44 years.

According to the World Health Organization, globally, cervical cancer is the fourth most common cancer in women, with around 660,000 new cases in 2022. In the same year, about 94% of the 350,000 deaths caused by cervical cancer occurred in low- and middle-income countries.

The HPV Information Centre reports that, in Kenya, cervical cancer is the second most common cancer and the leading cause of cancer-related deaths among women, with 5,236 new cases and 3,211 deaths annually. However, it is preventable through HPV vaccination and regular screening.

Each year, thousands of women in Kenya hear the words no one wishes to hear: "You have been diagnosed with cervical cancer." For many, the diagnosis comes late, when the disease has already progressed..

Judy Wanyoike, a cervical cancer warrior narrates how she got diagnosed with cervical cancer. Her normal routine screening changed her life in a blink of an eye. The screening revealed abnormal cells in her cervix, leading to further medical tests. The biopsy results showed that she had stage 2B cervical cancer.

Judy Wanyoike, a Cervical Cancer survivor 

“My journey began with a routine screening that changed my life completely,” she recalls. “The doctors discovered abnormal cells, and after a biopsy, I was diagnosed with stage 2B cervical cancer. The news was overwhelming.”

At first, Judy experienced unusual bleeding between periods. She dismissed it as a minor irregularity and didn't think it would be something serious. But when the doctor delivered the diagnosis, it came as a shock. She found it hard to accept the situation but her doctor encouraged her and offered treatment options for her to undergo.

“I had noticed unusual bleeding between my periods but I ignored it. I never thought something was wrong,” she admits. “I was shocked when I was told I had cancer. My doctor supported me and explained the treatment options I was to take.”

Cancer treatment journey has never been easy for many patients. This has always been their worst nightmare, particularly the side effects that come with the treatments.

Judy's journey was not exceptional, she underwent surgery to remove the affected tissue, followed by grueling chemotherapy, radiotherapy, and brachytherapy. The road was bumpy but she held on and hoped for recovery.

“I underwent surgery to remove the affected tissue, followed by chemotherapy, radiotherapy, and brachytherapy. The road to recovery wasn’t easy but I was hopeful,” she says.

Beyond the physical toll, cervical cancer deeply affected Judy’s personal and professional life. “It drained my energy, affected my emotional well-being, and my physical health,” adds Judy.

Accessing treatment was a challenge for her. Navigating the health care system was frustrating. Delays in appointments, long waits for test results, and the financial burden of treatment only added to the stress.

“At first, I had to figure out how the healthcare system worked,” she explains. “Sometimes I would wait endlessly for appointments or test results. The financial strain of medical bills made it even harder.”

Despite the hardships, Judy emerged as an advocate for cervical cancer awareness. She also released the importance of regular screening, early detection, and prevention.

“Going through this experience made me realize how important early detection and prevention are,” she says.

She encourages women to go for regular screening since early detection saves life. She also urges young girls to get HPV vaccine to prevent infections.

“I now encourage women to go for regular screening and educate others on the importance of the HPV vaccine. And I urge girls aged 10-14 to get the HPV vaccine to prevent infection. It’s a simple step that can save lives,” she emphasizes.

Sally Agallo Kwenda, a person with lived experience in HIV and cancer, a member of KENCO, Founder of the Kenya Ostomy Association, and a Patient Advocate on matters related to NCDs, shares her journey from diagnosis to treatment. She was diagnosed with stage 2 cervical cancer in 2007 during her routine medical check-up.

“It was in 2007 during a routine organisational medical check-up that I did a Pap smear test. I wasn't experiencing any symptoms whatsoever, but I was found to have cervical cancer, and it was already at stage 2,” narrates Sally.

WHO reports that women living with HIV are 6 times more likely to develop cervical cancer compared to the general population, and an estimated 5% of all cervical cancer cases are attributable to HIV (1). 

When cervical cancer is diagnosed, the impact on a woman’s fertility is significant, especially if a hysterectomy is performed, as it involves the removal of the uterus, which eliminates the possibility of pregnancy.

Sally recounts that before her cervical cancer diagnosis, she had lost two babies, the first one at 2 months old and the other one was born prematurely at 7 months. She later lost her fertility due to cervical cancer.

“It was a traumatic moment for me as I had lost two babies. One at 2 months and another at 7 months, who was premature. I believe this was due to HIV related complications,” Sally recalls.

She adds “I lost my fertility after getting cervical cancer, and this meant that I wasn't going to deliver again since the intervention was a total hysterectomy. Due to my already compromised immune system from HIV, the treatment option had to be surgery.”

She was fortunate to have a very supportive employer who rallied with her through her treatment journey. Her employer covered all the medical expenses, making the treatment process easy for her.

“I was privileged to have been employed by an organisation that offered the best medical insurance for its staff. I therefore went through treatment without any hitches. I'm forever grateful. My employer took care of all that was required,” she says.

Cervical cancer also affected Sally's marriage. Her husband abandoned her after the hysterectomy procedure left her infertile. He couldn't accept a future with a woman who couldn’t bear children. The situation left Sally broken and devastated, making her not report to work for almost a year.

“Cervical cancer cost me my marriage. My husband left after I had a total hysterectomy because he could not imagine living with a woman who could not give him kids. This caused me a lot of emotional pain, and for a long time, I couldn't return to work. This went on for almost a year. Again, I had a very understanding employer,” Sally recalls.

Despite the challenges, Sally became a beacon of hope. She turned her pain into purpose by advocating for cervical cancer awareness and encouraging women to go for regular screening since early detection saves life.

“I not only share my story of hope but also create awareness so that women can be screened early. If I hadn't been screened early, my story would have been very different right now,” she explains.

She urges women to go for Pap smear screening without waiting for any symptoms because it is rare to see one. For women living with HIV, she advises them to go for annual screening.

“I would encourage women not to wait for signs or symptoms, because sometimes there may be none, just like in my case. Women living with HIV should be screened every year,” urges Sally.

Sally also emphasizes the importance of fidelity and sexual health education. She encourages men to stick to one sexual partner and strongly advocates for HPV vaccination among young girls.

“Men stick to one sexual partner and be faithful! The pain caused by cancer is something I wouldn't wish on my worst enemy. Therefore, I urge everyone to embrace the HPV vaccine that's now available for prevention. Let us get our young girls vaccinated too,” she emphasizes.

Why Early Screening and the HPV Vaccine Matter—A Gynecologist Explains

The human papillomavirus (HPV) is typically acquired through sexual intercourse, where one partner carries the virus. The virus causes abnormal changes in the cervical cells, leading to dysplasia. These changes progress through stages from 1 to 3, eventually developing into carcinoma in situ and, ultimately, cervical cancer.

Dr. Ong'ech John Odero, a gynaecologist and researcher at Kenyatta National Hospital emphasizes that having multiple sexual partners or being in a relationship with someone who has had many sexual partners increases the risk of acquiring HPV, and cervical cancer. Additionally, a woman whose partner's previous spouse had cervical cancer is also at a higher risk due to the potential transmission of HPV.

Dr. Ong'ech John Odero, a gynaecologist and researcher at Kenyatta National Hospital

“A woman acquires HPV from a male sexual partner who is mostly a carrier. Once a woman acquires the virus, the cervix goes through abnormal cervical changes called dysplasia which progress through stages 1 to 3, and then it becomes cancer carcinoma in situ which later gets full blown to cervical cancer,” explains Dr. Odero.

Adding “If a woman herself has many sexual partners then she's likely to acquire the HPV. Additionally, if a woman has sex with a man whose wife died of cervical cancer then the chances of acquiring HPV is also high.”

According to him, cervical cancer is highly preventable and there are several methods to prevent it. The first is regular screening with a Pap smear to detect abnormal cell changes in the cervix. Another preventive measure is HPV testing, which helps identify the presence of the virus.

The third preventive method is the HPV vaccine, which is most effective when administered before any exposure to the virus. Lastly, maintaining sexual fidelity and using condoms are important ways to reduce the risk of HPV transmission and, by extension, cervical cancer.

“Regular Pap smear screening is a major preventive measure which is done every three years to women aged 21-65 and it is recommended to any woman who is sexually active. Secondly, we have HPV testing which assists in identifying the presence of the virus in the cervix,” he says.

Adding “We also have HPV vaccination which must be given to a woman who is HPV negative because once you get the infection the vaccine won't work. Lastly, partners being faithful to one another reduces the risk of acquiring HPV infection which causes the virus.”

He advises that cervical cancer screening should begin as soon as a woman becomes sexually active, as women who have had sex are at risk for HPV and cervical cancer. Dr. Odero also addresses the ideal age for the HPV vaccine, which is generally recommended for girls between 9 and 13 years old, provided they have not had any sexual exposure.

“Regular cervical cancer screening should be done as soon as a woman starts having sex since she is at a risk of getting HPV and cervical cancer. The Ideal age for young girls to get HPV vaccine has always been around 9 to 13 years, provided they have not had any sexual exposure because the younger they are the higher the HPV risk,” underscores Dr. Odero.

Dr. Odero explains that when the cancer has advanced, women may experience abnormal vaginal bleeding (between periods, after sex, or postmenopausal), watery or bloody vaginal discharge with a foul odor, pelvic pain or pain during intercourse. Advanced disease may cause leg swelling, back pain, or difficulty urinating.

“Cervical cancer symptoms are only picked through a Pap smear, which is the abnormal cervical cells that later develop into cancer. When cancer advances a woman experiences post-coital bleeding which is bleeding after sex or abnormal foul-smelling discharge that may contain blood. The woman might also experience pain during intercourse,” he explains.

He also underscores that treatment for cervical cancer depends on the stage of the disease. For stages 1 and 2a, treatments include a combination of surgery (such as a hysterectomy) and radiotherapy. For locally advanced stages, chemotherapy and radiotherapy may be the primary treatment options. In more advanced stages, palliative care, chemotherapy, and targeted therapy may be needed.

“If it's stage 1 and 2a one can do a hysterectomy plus radiotherapy. If it has advanced locally, one may be forced just to do chemotherapy or radiotherapy. For more advanced stages, palliative care, chemotherapy, and targeted therapy may be needed,” he explains.

Dr. Odero advises women who are sexually active to go for regular Pap smear screenings to detect cervical cancer early. He further stresses that cervical cancer is preventable and that maintaining sexual health practices, such as being faithful to one partner or using condoms, can significantly reduce the risk of HPV transmission and consequently, cervical cancer.

“I encourage women who are sexually active to do Pap smear screening because early detection can save life. If you can be faithful, talk to your partner to be faithful or use a condom because this is purely a preventable disease and purely sexually transmitted,” urges Dr. Odero.