Could cooking smoke be the silent killer behind lung cancer in women?

A jiko fitted with gas valves bringing in the biogas used for cooking at Chuka Boys high school in Tharaka Nithi County (Dickson Mwiti, Standard)

Most women battling lung cancer, the leading cause of death among cancers, have done nothing more than cook for their families, according to a doctor.

The gastroenterologist warns that smoke from firewood and other traditional fuels may be causing lung cancer, contributing to deaths, especially as patients face the high cost of treatment.

Many women with lung cancer have not been exposed to common risks like tobacco smoke, radioactive gases, or asbestos, leaving them unaware of the disease’s cause. Even their doctors are still unsure of the triggers.

A long-standing tradition—cooking for their families—might be exposing these mothers to lung cancer, which kills 92 per cent of those diagnosed, according to hospital records.

Linet Mulaya, in her 50s, is one such patient. She’s never smoked or encountered any known risks for the disease. In 2019, a persistent cough led her to a private clinic in Eldoret, where tests ruled out tuberculosis and other diseases, but her symptoms persisted.

“After many unsuccessful visits, I went to Moi Teaching and Referral Hospital (MTRH) for further tests in 2021. A biopsy confirmed I had lung cancer. My condition worsened, and I spent two weeks in the ICU. I contracted Covid-19, but survived. Doctors have been managing my case with chemotherapy,” Mulaya shares.

She describes battling lung cancer as the toughest struggle of her life, with harsh symptoms, such as vomiting, nausea, sleeplessness, and aching bones, especially after chemotherapy.

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She hasn’t won the battle yet and claims the Social Health Authority (SHA) has been a letdown throughout her six-year fight. Many patients can’t afford chemotherapy under SHA, she says.

“The Government of Kenya isn’t prioritising cancer treatment. Many lung cancer patients are poor, and SHA offers minimal support. They can’t afford chemotherapy and often resign to fate,” she explains.

Mulaya is one of many women doctors suspect might have developed cancer simply from cooking for their families. After spending hours in a smoky kitchen, a persistent cough followed, leading to a diagnosis that felt like a death sentence.

At MTRH, where Mulaya and others are treated, 54 lung cancer cases were detected last year, and 28 patients died, according to Dr Murunga. “Nearly all those diagnosed alongside me in 2021 have passed away. If SHA is facing challenges now, what happens to those of us who need help immediately? Will we still be alive?” she asks.

Another survivor, Mercy Katam, adds that it takes too long for lung cancer patients to get appointments and treatment, with some dying while waiting for their next chemotherapy.

The Kenya Hospices and Palliative Care Association (KEHPCA) in Eldoret has been informed that traditional cooking methods may now be overtaking smoking as the leading cause of lung cancer.

According to the Kenya National Control Strategy’s 2017-2022 report, 794 lung cancer cases were diagnosed during that period, with 729 fatalities—a 92 per cent mortality rate.

Doctors are warning that traditional cooking methods could be pushing more Kenyan women to their graves.

Dr Lawrence Murunga of Moi Teaching and Referral Hospital (MTRH) stated that oncologists strongly suspect indoor pollution as the main cause of the disease. He finds it puzzling that most lung cancer patients have not been exposed to known risks like tobacco smoke.

Dr Murunga explains that many patients with lung cancer symptoms, often persistent coughs, decline biopsy tests, only seeking help when the cancer is advanced, making treatment challenging. “We have many patients diagnosed with lung cancer with no known exposure to common risks. We suspect various triggers, but we are especially concerned about indoor pollution,” he says.

He urges the use of modern cooking methods and proper ventilation in homes to reduce harmful smoke inhalation. “Most of our patients, especially women, have simply cooked for their families,” Dr Murunga adds.

While cigarette smoking remains a known risk, he stresses the need for support to help people stop inhaling smoke. “We need to be more vigilant in fighting lung cancer. People over 50 are at higher risk, but we’ve had patients as young as 30,” he says.

Dr Murunga notes that lung cancer is difficult to detect, with diagnosis being both meticulous and costly. “Many patients fear that a biopsy will worsen their condition, so they avoid finding out,” he explains.

He also mentions that medical experts are working to incorporate artificial intelligence for earlier detection.

In 2022, 2.5 million people were diagnosed with lung cancer worldwide, and 1.8 million lost their lives.

KEHPCA Executive Director David Musyoki noted that lung cancer rates have been rising since 2017. Surveys from recent years show that high agricultural potential areas are seeing increasing cases of lung cancer and other non-communicable diseases, prompting calls for further research into whether agrochemicals are contributing to the rise in cases.

“Lung cancer is often diagnosed at later stages. We’re working to raise awareness among caregivers,” Musyoki added.

He also pointed out that lung cancer screening is rare due to the disease’s difficulty in detection.

The Kenya National Control Strategy’s 2017-2022 survey shows a prevalence rate of 1.75 per 100,000, though experts believe this reflects only diagnosed cases.

A lung cancer care toolkit launched in Eldoret on March 20, outlines common risk factors, including smoking, second-hand smoke, genetics, a history of chronic obstructive pulmonary disease, and radiotherapy.

It also highlights symptoms to watch for, such as persistent coughs, chest pain, coughing up blood, unexplained weight loss, recurrent lung infections, shortness of breath, and fatigue.