​What kinds of symptoms do patients experience before receiving treatment?

Patients in need of a thyroidectomy often present with a small thyroid growth (nodule or cyst), a thyroid gland that is so overactive it is dangerous (thyrotoxicosis), cancer of the thyroid, noncancerous (benign) tumors of the thyroid that are causing symptoms, or thyroid swelling (nontoxic goiter) that makes it hard to breathe or swallow. Patients in need of thyroid surgery often present with nervousness, anxiety, rapid heartbeat, hand tremor, excessive sweating, weight loss, and sleep problems, among other symptoms.

​What is the impact on patients’ lives of living with these conditions?

The thyroid gland is an organ located in the front of your neck. It releases hormones that control your metabolism (the way your body uses energy), breathing, heart rate, nervous system, weight, body temperature, and many other functions. When the thyroid gland is overactive (hyperthyroidism) the body’s processes speed up and you may experience nervousness, anxiety, rapid heartbeat, hand tremor, excessive sweating, weight loss, and sleep problems, among other symptoms.

What cultural or regional factors affect the treatment of these conditions?

Thyroid disorders are relatively common in the African continent. Iodine deficiency, although still the commonly documented cause of thyroid disorders in Africa, is not as rampant as it used to be. There is a compelling need to set up thyroid disorder registries in order to determine not only the scope of the burden of these disorders, but also to document changing trends, if any, especially given the background of widespread iodization programs. Thyroid cancer is the most common endocrine cancer, and its incidence has continuously increased in the last three decades all over the world. This trend is present on every continent except Africa, where detection is possibly insufficient.

What does the treatment process look like?

Thyroid surgery takes approximately three to eight hours depending on the patient. Patients will stay in the hospital for a maximum of six to eight weeks or as needed for recovery. A patient will usually have one follow-up appointment in six weeks.

What is the impact of this treatment on the patient’s life?

In case of thyroid cancer, the surgery is the patient’s best chance of preventing the spread of cancer and saving the patient’s life. In cases of hyperthyroidism, the treatment help stabilize the hormones that regulate metabolism and effectively treat some of the patient's symptoms, such as rapid heartbeat, anxiety etc.

What potential side effects or risks come with this treatment?

Thyroid surgery is often 90% curative should diagnosis be done early. For benign tumors and hyperthyroidism, the surgery is more than 90% curative. The surgery comes with few risks.

How accessible is treatment in the area? What is the typical journey like for a patient to receive care?

The accessibility of the treatment is fairly easy in this region. Due to the high numbers of patients flocking to the government facilities, most patients opt to seek care in missionary and private hospitals which are slightly more costly. In Kijabe, we have an average of 80 to 100 thyroidectomies in a year (three to four cases a week).

What are the alternatives to this treatment?

In Kenya, surgery is the only treatment offered for thyroid cancer and hyperthyroidism. This is because radiotherapy and medication alternatives are not easily accessible. Also, the cost of treating with radiotherapy and medication is higher than that of surgery.