‘I found out I had cervical cancer while I was pregnant’

Dorothy Masasa walks happily down a dirt road on a sunny afternoon, her baby strapped securely to her back.

Just six months ago, the 39-year-old, originally from southern Malawi’s Thyolo district, was in Kenya for life-saving radiotherapy.

Malawi only recently received its first such machines, so other women with cancer may no longer have to travel abroad for treatment.

“I was registered as an emergency after doctors discovered I had cervical cancer when I was 13 weeks pregnant. They told me these two things don’t go together,” the mother-of-three told the BBC.

She says doctors in Malawi told her she could have surgery to remove the cancer, but this would end the pregnancy, or she could have chemotherapy, but that would risk the baby being born with a disability.

She opted for chemotherapy until the baby was born via caesarean section – without any disability.

Her uterus was removed in the same operation.

Before the diagnosis, Ms Masasa experienced abdominal cramps, bleeding and a foul-smelling vaginal discharge that just wouldn’t go away. At first, doctors thought it was a sexually transmitted infection.

But despite the chemotherapy and surgery, she still needed further treatment to cure the cancer – treatment that was not available in Malawi until earlier this year.

She joined a group of 30 women brought to a Nairobi hospital in Kenya by the aid organization Doctors Without Borders (MSF) to undergo radiotherapy to kill the cancer cells.

It was her first time traveling by plane so she was quite apprehensive and also reluctant to leave her newborn baby behind.

“But because I had to go there for treatment, I encouraged myself that I really should go and get treatment and that I will come home healthy and happy.”

When the BBC visited her in hospital, Ms Masasa was still weak from the effects of the treatment as she had lost weight and lost her hair.

She is one of 77 patients transported from Malawi to Kenya since 2022 for cervical cancer treatment.

Sixty years after gaining independence from Britain, Malawi first installed its first radiotherapy machine at the privately owned International Blantyre Cancer Center in March this year, marking a major step in the country’s healthcare system.

More machines arrived in June and will be placed at the National Cancer Center, which is still under construction in the capital Lilongwe.

Although Malawi still has a long way to go to provide comprehensive cancer treatment, it is ahead of many other countries in the region.

In Africa south of the Sahara more than 20 countries have no access to radiotherapy, which is essential to fight cancer.

This means that patients are forced to make expensive and exhausting treatment journeys.

Cancer of the cervix it is the fourth most common cancer among women worldwidewith an estimated 660,000 new cases and 350,000 deaths reported by 2022, according to the World Health Organization (WHO).

All but one of the 20 countries with the highest rates of cervical cancer in 2018 were in Africa, according to the World Health Organization.

This is due to a lack of access to preventive human papillomavirus (HPV) vaccines, adequate screening and treatment, which means many women are treated late.

Queen Elizabeth Central Hospital (QECH), Malawi’s oldest and largest government-owned treatment center, receives a large number of cervical cancer patients from all over the country.

An obstetrician and gynecologist at the hospital, Dr. Samuel Meja, says that cervical cancer is a major problem for most countries in the region.

“Poor access to screening and the HIV scourge that has ravaged most parts of sub-Saharan Africa have worsened the situation,” he says.

In 2018, Malawi was second only to Eswatini in southern Africawhich had the highest incidence of cervical cancer in the world.

Outgoing WHO Regional Director for Africa, Dr. Matshidiso Moeti, says that globally a woman dies of cervical cancer every two minutes. Africa accounts for 23% of the deaths.

To reverse these grim statistics, Africa has seen massive campaigns to vaccinate girls against HPV, which causes cervical cancer.

Lesotho has been reached an exceptional coverage of 93% after vaccination of 139,000 girls against HPV.

But stigma around cervical cancer in various African countries has affected the number of people getting vaccinated.

In Zambia, for example, talking about anything gynecological is frowned upon.

In Malawi, says Dr. Meja that cervical cancer screening has been introduced.

“This is a very simple strategy that identifies women at risk and treats them before they become cancer patients. This investment is what we need to make as a nation before it gets out of hand,” he says.

As for Ms Masasa, she is now back in her home in Malawi.

The treatment she received in Kenya has given her a new lease of life. Her hair has grown back, she can walk around with her baby on her back, look after her cow and work in the fields.

She says she now knows that cervical cancer is treatable and that the vaccine can help other women avoid the disease, so she has no doubts about vaccinating her daughter.

“Cervical cancer took me through a tough phase and I didn’t want my daughter to go through the same thing,” she says.

“There is a huge difference between how I was then and how I am now. I feel so happy that I am cured.”