Qat and the Epstein-Barr virus: a deadly combination

Qat chewers who are infected with the Epstein-Barr virus are flocking to hospitals in large numbers complaining of symptoms including difficulty swallowing, tumor like lumps growing on their bodies, and neck pain.

Farming chemicals used to grow Qat and fruit have been found to be catalysts for nasopharyngeal cancer in people who have previously been infected with the Epstein-Barr virus, according to new medical findings. 

The National Cancer Center of Yemen is confronting this epidemic with medical treatment in clinics and educational seminars in the public school system. 

“Nasopharyngeal cancer is on the rise in Yemen,” says Dr. Faisal Abdullah Khurasani, a general physician at al-Jumhori Teaching Hospital. “I have seen approximately 120 patients per year with nasopharyngeal cancer. Qat farmers use chemicals to grow plants more rapidly, and it is these chemicals that cause the cancer,” says Dr. Khurasani. 

“[Nasopharyngeal] cancer is increasing in Yemen because a lot of carcinogenic chemical substances are sprayed on vegetables and fruits,” says Dr. Yahi Mogally, a cancer specialist. Dr. Mogally has seen about 100 cancer patients in the outpatient department. Those chemicals have been found to catalyze the development of cancer cells already encouraged by the Epstein-Barr virus. 

The Epstein-Barr virus, also known as EBV, is a herpes simplex that is widespread in all human populations. Many cases of nasopharyngeal cancer worldwide are associated with the Epstein-Barr virus, according to a document entitled ‘Infectious Agents & Cancer’ published by Cancer Research UK. 

EBV-induced nasopharyngeal cancer affects many Yemenis, and Farris Mohammed, 21, is one of its victims. 

“Mohammed lost weight and he was drenched in sweat when he came to us,” says Dr. Khurasani. Mohammed has been a patient for the past months. When Mohammed is asked how he is feeling, he simply says, “there is some improvement.” Mohammed has had EBV-induced nasopharyngeal cancer for six months, but Dr. Khurasani says that he was wrongly diagnosed as having tuberculosis, and took TB medicine for two months. That is why he came to Al-Jumhori Teaching Hospital five months ago. 

He was referred to have a biopsy of his lymph nodes and that is when the doctors realized he had cancer. Mohammed is one of the few patients expected to have a full recovery because his cancer was caught in the early stages, says Dr. Khurasani. 

Other Yemenis with nasopharyngeal cancer will not be so lucky. “I have been chewing Qat for 20 years,” says Saleh Ali Abdulrahman, 45, a farmer from a village on the outskirts of Sana’a. Eight months ago he knew he was sick when a mass grew on his neck and he had difficulty swallowing. “The mass was 80 centimeters wide, now it is 2 centimeters,” says Dr. Khurasani. Abdulrahman has been a patient for three months and is on his second cycle of Cisplatin, a medicine used to treat cancer patients, explains Dr. Khurasani. In addition, he will be treated with radiotherapy in the future.

Forty percent of cancers can be prevented by a healthy diet and physical activity, according to a document about cancer published by the World Health Organization. “Since I started treatment, I stopped chewing Qat, and I decided to stop chewing Qat all together,” Abdulrahman said. It is this new healthy path in life that will ensure that he remains cancer-free. 

Cancer-free is a goal that Yemen is striving for, and, like other countries, it is a goal that Yemen will probably never achieve. Because the chemicals used to grow Qat are linked to cancer, brochures about the dangers of chewing are handed out to patients at the NCCY. Also, those dangers are taught in the public school health curricula three or four times per year, according to Dr. Khurasani. 

Doctors from the medical clinic go to boys’ and girls’ schools in Sana’a, but because the National Cancer Center of Yemen “is suffering from a massive influx of patients, we don’t have time to do the full educational program,” says Dr. Khuransani. 

According to an American Cancer Society brochure called, General Information About Nasopharyngeal Cancer, nasopharyngeal cancer is relatively rare in most parts of the world. In the United States it occurs in seven out of every one million persons. This may add up to about 2,000 cases a year there. However, this cancer is much more common in areas of Asia and North Africa. Nasopharyngeal cancer most often affects people beginning at age 30 and older, but can be seen in children. About half of the world’s patients are less than 55 years old.  

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