Throat cancer; Beware of the risk factors, Survivor sounds alarm bell

A throat cancer survivor has advised anyone who experiences persistent hoarseness of voice, swelling around the neck, difficulty in breathing and swallowing food to report to any health facility for investigation.

Mary Amankwah Fordwor, who is now championing efforts to prevent throat cancer, said recurring sore throat was also a risk factor.

The throat cancer survivor, who now lives on an artificial voice enhancement device with a pipe starting from his neck, explained that those might be signs and symptoms of throat cancer, therefore, going to the health facility for early diagnosis and treatment could help reduce the risk of the condition and also save lives.

"I wish we will stop self-medication. Do not wait until it’s too late. Early detection saves lives. Go to the doctor to tell you it’s nothing rather than staying at home and assuming it’s nothing," she advised.

Ms Fordwor mentioned other symptoms of the condition to be pains in the ear and noisy snoring when one was asleep.

Throat cancer awareness 

The month of April is throat cancer awareness month, and as part of marking it, Ms Fordwor, through a foundation she set up, Artificial Voice of the Voiceless, is creating awareness about the condition. 

She visited the premises of the Graphic Communications Group Ltd, publishers of the Daily Graphic, as part of the awareness creation where she also granted the interview.

Throat cancer develops in the throat (pharynx) or in the voice box (larynx). It often begins in the flat cells that line the throat. 

The voice box is made of cartilage and contains the vocal cords that vibrate to make sounds when one talks. 

People who smoke, take strong alcoholic drinks and those who have types 16 and 18 of human papillomavirus (HPV), sexually transmitted infection (STI) that causes small hard swollen skin on genitalia, are also prone to getting the condition. 

One of the major effects of the condition is that it makes one to lose their voice.

Ms Fordwor's condition 

Ms Fordwor was diagnosed of throat cancer on April 26, 2021 after which she had to undergo a number of surgeries, in addition to chemotherapy and radiation, to treat it.

She lost her voice because as part of the surgery, the area that links the throat and nose had to be cut off and her neck reconstructed for a hole to be created around the area in the neck where the nose, throat and mouth connect. 

From this hole in the neck, a tube has been fixed through to her lungs and the stomach. The tube has an artificial voice fixed inside that enables her to be heard when she speaks.

From this tube also, she is able to breathe because the nose has lost its functions. 

Ms Fordwor also carries with her an artificial feeding tube so that in case of any emergency of difficulty in swallowing, she could switch to the tube.

Whenever she wants to talk, she presses the tube in her neck to activate the speaking alternative, which does not allow her to breathe concurrently. When she wants to breathe, she releases the tube but that prevents her from talking at the same time.

How it started

Describing how the condition started, Ms Fordwor said for almost 10 years she experienced breakage or hoarseness of voice when she spoke, which made some of her old school mates to even tease her.

During those years, she explained, she did nothing about it because she thought it was due to stress from her busy schedule as a midwife, baker and travelling every weekend from her station in the Volta Region to Accra to be with her family.

She said it was in March 2021 that while bathing, she saw a swelling around her neck area and as a health worker, she concluded it was an infection and hence self-medicated with  antibiotics.

However, two weeks later she realised the painless swelling was still there, and that was when she reported to doctors for investigation.

After an initial investigation in Ho, she said she was referred to the Korle Bu Teaching Hospital (KBTH), Accra, for further investigation. 

At Korle Bu, Ms Fordwor said further investigations were conducted into her condition, including a biopsy, which unfortunately revealed that she had stage four throat cancer. 

"I didn't go to stage one, two or three but straight to stage four - very advanced stage. As a midwife, I've met a lot of cancer patients so I know how it is – the pain and the struggles. The first thing that came to my head was, why me? Because I know throat cancer is more for smokers and those who take strong alcoholic beverages. I'm a member of the Church of Pentecost and I don’t do these so why me?" she narrated how broken and sad she became after the diagnosis.

She wept at the news and imagined that death was closer to her than ever, the survivor said in a pensive mood.

Treatment 

However, the diagnosis paved the way for her to start treatment immediately, by visiting a psychologist for counselling as the first step. She later went through series of surgeries, chemotherapy and radiation. 

“It wasn't an easy battle. The side effects of the chemotherapy and radiation alone can even break you down but God gave me the strength to go through,” Ms Fordwor recounted.

During convalescence at the hospital three days after the surgery, she attempted to speak only to realise she was inaudible; her vocal cords had been severed, she recounted.

In another incident at home, she said she had forgotten that because of the device fixed on her neck, she could not pour water on herself while bathing as everybody did. 

She forgetfully did that and said she nearly killed herself because the water went straight through the tube into her lungs and choked her.

Ms Fordwor said while fighting for her health, she was also going through divorce. She is currently divorced and has two children.

Living with the device

Ms Fordwor has been fortunate enough to survive the tortuous disease which becomes fatal for many, but nonetheless has to make enormous changes to her way of life, especially her eating habit, mainly due to the device.

"I can’t eat with a tablespoon. I eat a teaspoon size because when the food becomes too bulky, there is a possibility of it locking up in my throat which would be disastrous. Everything I eat has to be gradual because my throat is not like everybody's, it has been reconstructed,” she explained.

She cannot eat or drink water in normal ways because in the case of water, after taking a sip, she is unable to gulp it down immediately, else she would choke. She now swallows in bits until she is full. 

Ms Fordwor also cannot swallow solid foods such as fufu and banku in morsels as they would block the tubes and choke her. Alternatively, she chews them into bolus or liquid before swallowing them, again in bits. She also has to swallow along enough soup or juice whatever she eats.

Again, because of the tube in her neck, she can never swim and as much as possible she must avoid being in the rain. She cannot bathe around the area of the device and therefore only uses wet towel to clean the neck area.

Ms Fordwor expressed happiness that in spite of the delicate lifestyle she now lives, she could still practise midwifery and do bakery on the side on weekends.

Indeed, she is the in-charge of the ANC Unit of St Anthony's Hospital in the Volta Regional capital, Ho.

Foundation 

Her challenging experience aside, Ms Fordwor said she was happy that she survived the condition that had left many dead, and many more in a state of depression. 

She said the experience and challenges associated with throat cancer in particular made her decide to start the foundation as a survivor to help people living with the condition and also let other people learn about it.

The foundation, which was started last year, is so far husbanding and supporting 10 people. 

She asked those who wanted to join to contact her through her Tiktok and Youtube social media handles.

Gratitude

She was very grateful for the support received from her family, the Church of Pentecost, the Nursing and Midwifery Council, old students of KNUST Midwifery Department, Mfantsiman Girls Senior High School and Seven Great Princes Academy, throughout her journey to rediscover hope.