Silent pain: Late cancer diagnosis cost man voice box

Wednesday July 03 2019
Raymond Njeru

Mr Raymond Njeru points to where he was operated on after losing his voice to cancer during an interview on June 19, 2018. PHOTO | FRANCIS NDERITU | NATION MEDIA GROUP


When it was his turn to speak, he whipped out a pen and notebook.

On it, he wrote “I am Raymond Njeru from Embu. A pleasure to meet you.”

At 60, Mr Njeru, is learning a new language after losing his voice to cancer two years ago.


In 2017 he was diagnosed with laryngeal cancer, a disease that starts in the voice box (larynx) and mostly affects people over the age of 40.

“I first walked into Embu Tenri Mission Hospital with difficulty in breathing after using too much over-the-counter medicine to treat what I thought was a common cold. When I got there, doctors nebulised me to decongest my chest and throat,” he recounts.


But his diagnosis, he also recalls, was that he developed breathing problems due to an allergic reaction to something in his environment. Nebulisation is a method of converting a medicine or solution into an aerosol, which is inhaled directly into the patient’s lungs.

Never in his wildest thoughts would he have imagined cancer was rapidly multiplying in his body. This is because the initial diagnosis did not indicate there could be an underlying problem.

When the “cold” persisted, Mr Njeru, on his son’s advice, went to a different hospital, five months after his first visit. This time, he was given medication to soothe his “burning throat”.

“Besides the drugs, I was also told what to eat and what to avoid,” he says.

Unfortunately, the symptoms grew more aggressive, compelling him to go to a third hospital before going back to Tenri where further tests revealed he had laryngeal cancer stage four. “When I woke up from sedation, I realised I no longer had my voice. A gadget was fitted on my neck,” he recalls.

In order to allow air to get into the lungs, a new opening must be made on the front part of the neck to create a permanent opening called a stoma.


Mr Njeru underwent a total laryngectomy, a procedure in which the voice box was removed. It also involved separation of the airway from the mouth, nose, and oesophagus.

One important function of the larynx is to protect the airway by ensuring that swallowed foods and liquids pass down the oesophagus instead of going into the lungs. Vocal folds, responsible for sound generation in speech and singing, are also located in the larynx. As air is exhaled past the vocal folds, they vibrate and produce the sounds heard in voiced speech.

If the larynx is removed, air can no longer pass from the lungs into the mouth. The connection between the mouth and the windpipe no longer exists.

Every year, about 423 Kenyans are diagnosed with laryngeal cancer, which develops when cancer cells form in the tissue of the larynx. Of these, it is estimated that 75 per cent succumb to the disease. “If it weren’t for my children who were tired of hearing me clear my throat every now and then, I probably would still be on the over-the-counter-cough medicine,” he says.

As many as 133 people are diagnosed every day, as the scourge of cancer grows in the country. Every day, about 90 Kenyans die from cancer, with many having been diagnosed when the disease was too advanced to treat.

According to doctors, cancer of the larynx is fast becoming one of the most common types of cancers in the country.

“Something as simple as a persistent common cold should not be ignored,” said Dr Andrew Odhiambo, an oncologist.


While cancer treatment has improved and survival rates have gone up, so has the number of people afflicted with the disease.

And there is probably no bigger battle fought as bravely as that by cancer patients. On Monday, the disease claimed Safaricom CEO Bob Collymore. And it comes at a cost too. “I was thinking, had I not been a Safaricom or Vodacom employee, it would have been difficult for sure,” Mr Collymore had said during an interview.

The cost of diagnosing and treating cancer, however, varies depending on the type and stage of the disease, Dr Odhiambo says.

Many new cancers are as a result of our new dietary preferences while other causes are unknown, adds Dr Odhiambo.

“Our healthcare system is not responsive to how cancer behaves. For instance, if a patient is seen at the same hospital repeatedly, the system should alert the care provider of the same. Due to lack of synchronisation, a patient can go to a hospital up to 13 times with stomach complaints, given the same medications repeatedly without anyone realising it,” explains Dr Odhiambo.

Last year, the World Health Organisation’s International Agency for Research on Cancer recorded 9.6 million cancer deaths.