In spite of the fact that cancer is not a foreign concept in Tanzania, there are still myths surrounding the disease alongside its treatments. Chemoradiation for example. This is a type of cancer treatment that combines chemotherapy and radiation at the same time. There are patients who had heard the myths and yet they chose to give the treatment a chance in the quest to rid their bodies of the cancer cells. There are also those who chose to believe the myths, avoided chemotherapy and sought alternative treatments instead.
One of the people whose life before and after she found out about her cancer status was surrounded by the different notions formed in the society about cancer treatments is Swalha Mohammed*.
In December 2021, she felt some swelling in some parts of her vaginal entrance when she was taking a shower. Being aware of her body parts too well, Swalha knew something was not right but she could not put her finger on it. Swalha had lost her grandmother to cervical cancer and this scared her.
She visited the Ocean Road Cancer Institute for checkup and the doctor assured her nothing was wrong after examining the swollen parts.
After a short while, she travelled to Mombasa where she visited another hospital for a second opinion. The doctors there told her the same thing she was told at the Ocean Road hospital, ‘It’s nothing you should be worried about, there is absolutely no problem’.
When she came back to Dar es Salaam, Swalha went back to Ocean Road for another checkup hoping whatever was making her worried could finally be found. The doctors advised her to return after six months, (she wasn’t checked this time) a period in which they believed there would be changes that could be easily detected.
During the first days of her ‘waiting time’, Swalha started experiencing an abnormal discharge that was accompanied with an unusual odour. This made her even more worried than she was during the checkups. ‘Could this be the same disease as my grandmother’s?’ Swalha asked herself.
Around the same time, she travelled to Tanga for work. While there, she started feeling unwel.She went to a nearby hospital called Bombo. She took several tests and the results showed she had ulcers. While she was still at the same hospital, Swalha thought this was a chance to confirm her worries on the abnormal discharge that she was still experiencing. She told the doctor she wanted to confirm her worries through an actual test.
A short while after conducting the tests, the doctor informed her that cancer was detected. As much as she believed the doctor’s words and checkup results, Swalha decided to test again at another hospital in Moshi Region.
“I had travelled there for work and I used the opportunity to do another checkup there. The test came back positive. It was confirmed that I had cancer although they could not pin the stage at which it was clearly. I was afterward given a referral to Ocean Road hospital,” she recalls.
When she arrived at the cancer institute, the doctors requested a sample of tissue taken from the cervix to be tested at the hospital in Moshi. The final results showed Swalha had stage one cervical cancer and she started treatment right away.
“In the beginning, I started with five chemotherapy treatments in five weeks’ time as well as three external radiations and three internal radiations. Later on I took on other means of treatment including herbal treatments because I thought this would mean faster recovery.”
She adds; I had also heard that the herbal treatment was far more effective than medical ones. After a while I decided to go back to the Ocean Road hospital after realising that I was losing a lot of money in herbal treatment. The herbs were not working and my health was only getting worse,” she narrates.
At the hospital, she was made to restart treatment. Fast forward, Swalha is currently in remission, which means all signs and symptoms of cancer have disappeared.
“Honestly, I was more terrified of chemotherapy than radiation because I heard how it makes you feel and look and I absolutely did not want my body to experience the stories I had heard. I was also afraid the struggles of cancer treatment would resemble the struggles my grandmother went through during her treatment,” she says.
According to Swalha, the treatment myths are sometimes linked to the side effects of cancer, which she says are manageable once the patient follows the doctor’s instructions.
“When I started radiotherapy, I was instructed to use soaps like Jamaa to avoid irritation because the radiation had made the skin fragile to other kinds of soap. I was also told not to scratch myself whenever it itched because that would cause more irritation on the skin,” she explains.
Swalha further says; “Both chemotherapy and radiation truly wore me out but in the end, they both helped me get better and I am now in remission.”
Doctor Harris Mapande, an oncologist at the Ocean Road hospital defines chemoradiation as the treatment that brings together chemotherapy and radiation treatments to rid the patient’s body of cancer cells.
“For a patient to undergo both treatments, it depends on the type of cancer. The most common types of cancer that require both treatments are colon cancer, cervical cancer and thyroid cancer,” he explains.
Dr Mapande unveils that in chemoradiation, chemotherapy acts as the sensitiser that helps radiation to work in a perfect manner.
“Many people are terrified of this treatment because of the side effects that emerge during treatment. These include hair loss, mouth sores, diarrhoea, skin colour change and feeling nauseous,” he details.
Dr Mapande further explains that there are myths lingering in Tanzanian societies and that such myths have set barriers for some of the patients to seek the right treatment when they get sick.
“Surviving cancer starts from the patient’s mind. It takes longer than a day, a month and sometimes even years. With the existence of a variety of myths, it’s up to the patient to believe them or to seek information that will guide them to make the best decisions for their own health,” he says.
He further hints that one of the common myths is that radiation is a painful procedure since it uses beams in the process to stop cancer cells from growing. This, he says is not true.
“I once met this patient from Mbeya who was undergoing chemotherapy. As she was preparing for her first radiation treatment, she seemed terrified. Once I was done, she asked ‘Is that it?’ apparently she was told that the beams would cook her skin as she watched,” Dr Mapande narrates.
Many people believe that cancer treatments are tickets to death. This, again, the doctor says is a misconception. The truth is that early treatment saves lives. Also getting well after treatment depends on the stage that the cancer is.
“There is an approach called ‘palliative care’ or ‘comfort care’ which is aimed at reducing suffering for people with terminal or complex illnesses whose outcome is death. When such patients die, people think it is because of the medications.” The doctor adds; “It is due to this myth that some people choose herbal treatment and when that treatment does not work, they seek medical treatment while their health has already deteriorated or when the disease is already in the final stage.”
According to Dr Mapande, another myth that sums up cancer in its totality is that it is a contagious disease.
“Cancer cannot be transmitted by holding hands, touching or even breathing the same air as the cancer patient. This is why patients are not restricted to interact or share space with other people,” he says.
However, there are rare cases where precautions must be taken.
“In cases such as thyroid cancer, whenever a patient receives one of their treatments called radioactive iodine treatment, the patient is immediately quarantined from three to five days to prevent the beams from affecting other people. When the level of the radiation goes below tolerance level, we let the patient out of quarantine.” Dr Mapande says for such myths to end, the society must be made aware of the truth as this will guide them to make decisions based on accurate information.
“It is about time people understoodthat cancer does not mean death. Its treatments should give people hope to live instead of taking that away. When society becomes aware of all these, people will give cancer treatments a chance-for betterment and relief,” Dr Mapande details.
According to him, medical practitioners too should be educated as they have the responsibility to take care of patients and give them hope to get better.
“There are medical practitioners who create fear in patients due to their ignorance and own perspectives of cancer treatments without knowing that they play a vital role in the patients’ treatment journeys. This is because some of them have little or no knowledge of cancer as well as its treatments,” the doctor says.
*Not their real name.