Low-cost alternative cancer treatment hailed a success
‘Burn off’ method pioneered in Scotland helps women in Malawi
A CERVICAL cancer treatment pioneered in Scotland has been hailed as a low-cost alternative to tackle the disease in developing countries after the success of a three-year screening programme in Malawi.
The Scottish Governmentfunded project used a thermocoagulation machine to “burn off” cancer cells in female patients instead of cryotherapy, which freezes the cells.
Thermocoagulation was pioneered in Dundee, but over time it has been gradually replaced by the more popular cryotherapy, leading to the NHS equipment to gather dust in hospitals.
However, it has been given a new lease of life as part of a groundbreaking screening project based at Nkhoma Hospital, Malawi, which sought to drive up testing and detection rates for the disease.
Professor Heather Cubie, an eminent Scottish virologist and expert in human papilloma virus (HPV) – the infection that causes cervical cancer – said it offered women in Malawi access to a cheaper and easier treatment.
Ms Cubie said: “Dundee has got more experience than anywhere else in the world in using thermocoagulation but many places would consider it old technology because it has been around for decades. We discovered the NHS was not using it; it is using newer technology, so the equipment was lying in cupboards.
“The World Health Organisation (WHO) recommends a treatment called cryotherapy. That’s like liquid carbon dioxide, which freezes the area to kill off the abnormal cells.
“But the problem with cryotherapy is it’s difficult to get hold of in Malawi – it’s very expensive, breaks easily and isn’t portable – whereas thermo-coagulation machine is a little instrument. You can almost hold it in your hand.
“We’ve taken it to tiny little clinics, we’ve used it in a tent, we’ve used it attached to a car battery instead of requiring electricity, and it’s very very cheap to deliver the treatment.
“Each treatment, after you’ve bought the instrument, costs pennies. So it has revolutionised what can be done and although the World Health Organisation has not yet recommended this as an alternative, Malawi is saying it can be used instead as a consequence of the work we have done.”
The African nation has the highest rates of cervical cancer in the world, with an incidence of about 76 cases per 100,000 population – about 10 times UK levels – and mortality of 50 per 100,000, according to the most recent data from WHO.
The screening programme headed by Ms Cubie has won the support of Malawi’s First Lady and Health Minister, and there is now a push to fund its introduction to 140 clinics nationwide. From 2013 to 2016 it screened 18,000 women – an uptake rate of about 20 per cent. The cancer is detected using acetic acid to turn abnormal cells white.
While neither radiotherapy nor chemotherapy are provided in Malawi, the programme has also trained surgeons to carry out radical hysterectomies as a potentially life-saving alternative.