Up until 35, Doris had lived a full life. She was a science teacher who loved her job and away from work, she was a free spirit who loved the outdoors. She had just added another feather to her cap by scaling Mount Kenya at 34 and she felt very proud of herself.
Then her woes began. She noticed a persistent itch in her vulva (external genitalia).
At first it was mild, coming on and off, and she ignored it. As it persisted, she went to a pharmacy, where she was given a cream across the counter. She used it for a while with some relief while another two months flew by.
One day, after participating in a charity half-marathon, the itch overwhelmed her and she sought medical help.
The doctor prescribed antifungal capsules and a steroid cream. She faithfully used her medication but she did not get much relief. The discomfort was beginning to affect her life.
She lost interest in sex, which strained her relationship with her boyfriend. She spent all her time online trying to find solutions. She tried all manner of remedies. She discarded all her fancy sheer underwear in favour of cotton, she tried different types of sanitary towels, she ditched her denims and resorted to wearing dresses, to no avail. She adjusted her diet, went vegan, changed her soap and replaced her bathing flannel, but it was all in vain.
Repeated treatments for candidiasis did not help. She visited various outpatient clinics that her medical insurance permitted, but never quite got an answer.
She even attempted the old wives’ therapies of applying natural yoghurt to her vulva at bedtime, using aloe vera therapies purchased online and even traditional herbs. The itch soldiered on unperturbed.
Doris suffered in complete isolation, having grown up without sisters and having never formed strong bonds with her female friends. Due to her love for the outdoors, most of her close friends were men. She realised she did not have anyone to talk to. She suffered silently.
Her vulval skin was dry, flaky and was becoming hard. She failed to appreciate the developing mass underneath as she attributed these changes to the prolonged itch-scratch cycle that had become her life.
One day, Doris‘ church hosted a free cervical cancer screening camp. Doris decided to consult the screening nurse. By this time, Doris had developed an ulcer in her genitals. The nurse referred her straight to the teaching hospital where she had a biopsy done and a diagnosis of vulval cancer was made. Doris was devastated. She had no idea how to explain this to her loved ones. Yes she had cancer, but she could not even explain it to her mother. She could only show her the lesion. The fact that the vulva is a private body part that isn’t publicly discussed remains a hindrance to many when it comes to talking about this uncommon cancer.
She was grateful she had a female headmistress who was very understanding and allowed her time off work to seek medical care. The next week she was admitted to the ward and underwent surgery. No amount of counselling prepared her for the mutilation occasioned by the surgery. To fully excise the tumour, a large chunk of flesh had to be taken out of her vulva, extending all the way to the inguinal area (near the abdomen).
The healing was slow and exhausting. She spent her days sitting on her bed, legs together to prevent tension on the sutures and to prevent the wound from breaking down. She was on antibiotics for weeks to prevent infection and had to keep the dreaded urinary catheter (to help her excrete urine) for a month.
Her wounds healed but the scars remained as a testimony of what she had undergone. She survived the radiotherapy and despite the odds, Doris survived the cancer. Five years on, she has gotten her life back, but she hasn’t quite found the words to describe her experience.
Vulval itching is not normal. A majority of cases will be due to candidiasis (yeast infection), but this is a cardinal sign of vulval cancer. Stop rationalising it. No, it is not your underwear, it is not your tight jeans, it is not your sanitary towel. See your gynaecologist and get a proper diagnosis. It will save your life!