By Christine Namulindwa
MULAGO: Cancer has become a significant health concern in Uganda, as more and more cases are being detected.
The Cancer problem is not something that started yesterday. In 1958, a unique type of cancer, Burkitts Lymphoma was described in Uganda. The cancer was not seen anywhere in the world and it has the characteristics of growing very fast, which means it can also kill very fast.
There was therefore a lot of interest in trying to understand it. Everybody who was doing research of worth then packed their bags to come to Uganda. There was need to set up a base where this research should be done effectively. In 1972 the lead researcher Prof. John Ziegler together with the Uganda Cancer Institute, were nominated for
the prestigious Alaska award.
The Alaska Award is just one tier beyond the Nobel Prize. Up to now, some of the findings are still being put to use in various treatments of cancer. UCI as such became world renowned in cancer research to the extent that it became a WHO centre for research.
In this piece the Uganda Cancer Institute’s Dr. Jackson Orem answers FAQ’s from the public on the disease.
1. Is cancer an epidemic in Uganda?
There is a very different definition we can use instead of epidemic. However, if we are saying that there is a big health problem in Uganda, to that I agree entirely.
2. Why isn’t there a simple universal test for cancer?
Cancer comprises of 133 diseases which means that there are different types of cancer. It is really a difficult task. It’s better for us to identify each of them individually so that we can single them out and effectively control them. It’s both an advantage and a disadvantage. It’s an advantage in the sense that we can actually control them very effectively if we know each one of them.
3. Why does the diagnosis seem to be delayed in many cases?
One of the biggest problems we have is that there is lack of awareness. Patients come very late and they don’t know what to do by the time they come to Uganda Cancer Institute, they have gone to so many. We need to evolve a system where people can easily access care. This is what UCI is trying to do and if you come any day of the week, we can help you expedite your diagnosis.
4. Why are older people more prone to cancer in general?
One of the important things we should know about cancer is that, cancer develops as one ages. One of the systems in our bodies that mirror this is our immune system. Immunity is very important in the
fight against cancer. As one ages their immunity also goes down and that is why the risk of getting cancer is higher in older populations. However, in Uganda, we also see that cancer manifests early in children.
5. How is survival measured?
Survival is measured by what we call a rate. In that rate, we usually use five years. If for instance I treat you of cancer and you are able to live up to 5 years after treatment, then your 5 year survival is actually 100%. That is how we measure it. We measure survival by the duration one lives following a diagnosis or a treatment of cancer.
6. I need more clarity on HPV vaccination.
Human papilloma vaccination is a vaccine that has been developed against the cause of cervical cancer. This is given to young girls below the age of 12, but that doesn’t mean that it is only girls who can actually benefit from this. Even boys can actually benefit from it but [because of] the cost our policy prioritises young girls
7. How is passive smoking a risk factor for cancer?
What smoking does, whether it’s passive or active is that you get into your body nicotine which is carcinogen. This is a substance that can lead to causation of cancer irrespective of the means you get it into your body. However, carcinogens are very powerful and can easily lead to cancer. Shisha, cigarette or pipes can all lead to cancer.
8. Is there any screening done on lymphoma at the Institute?
Lymphoma is not one of the most popular cancers amenable to screening, but if you have anything that suggests that you have a swollen lymph node, you better check with the doctor. It could possibly be a lymphoma. Examining the swollen lymph node can help in early diagnosis of lymphoma.
9. When should we expect to have a fully functional cancer unit in Gulu, Arua, Mbale, Jinja and Fort portal?
We already have a functional cancer institute centre in Mbarara. We are in the process of setting up another functional cancer centre in Gulu; actually, it’s already in high gear. We are also planning to have another centre in Arua and we are doing the preliminary investigations for having designated land and the space that we need to set up that particular centre. The same is also for Mbale. Those
are the four centres that we want to start with and we are hopeful that in the next two years, we should be able to have some functionality in those centres.
10. What is the Cancer Institute doing about childhood cancers?
One of the best services we have at the UCI is [the treatment of] childhood cancers. The improvement and cure rate is now increasing dramatically. We are developing our human resource capacity. We are now training and next month we shall start graduating paediatric oncologists. A lot is being done. We have mounted programs of sensitization too.
11. What are some of the funding gaps?
The Uganda government is already doing a lot. In a year, at the UCI, we need up to 120bn in order to optimally carry out our functions. This financial year, we are getting up to half of that amount. If there are partners who can help with that we have mechanisms in which we can help bring them on board. We are already working with very many others and we expect many more other people to join.
12. Have you had any cases of people healed of cancer in Uganda?
This is something you need to see for yourself. There are very many people who have been cured of cancer in Uganda and here at the UCI. Next month we are going to have a survivors’ month you can come and meet people who have been cured of cancer. There will be many people who have finished university and had children; you should be able to meet them to see proof that cancer is a curable disease.
13. What causes Leukaemia and is there a chance to cure it?
Leukaemia is one of the easiest cancers to cure and in most cases our patients do not understand this and they come very late. If there are people who have any problem i.e. anaemia, weakness or loss of blood, they should suspect leukaemia and come to Uganda cancer Institute so that we can make a diagnosis.
14. Does Anal itching mean cancer?
Not necessarily. There are many causes of anal itching and of course it may be a result of anything. It does not necessarily mean that this is cancer.
15. The cost of cancer treatment is keeping away many patients who die in pain due to non- treatment, what is your take on this?
This is true; we are going to make sure that the people who come to us at the UCI get some of these drugs so that we remove this barrier to treatment. We should appreciate what our government is already doing because there is a specific budget that the government has given for procurement of anti-cancers and we are going to make sure that as much as possible people can get access to the treatment.
16. Is radiotherapy really working?
Yes, it’s! We closed down slightly because of maintenance; however, we are in the process of acquiring new machines. In the next few months we should be able to acquire a more advanced machine than the one we have currently.
17. What are the cancer risk factors?
The risk factors are many. It can be infection, environmental factors, it can be age, can be anything. There are many risk factors. Infection can also be through the HPV virus that can cause cervical cancer. Other infections can be cancer of the stomach by bacteria. Lifestyle factors can also be through tobacco which becomes a lifestyle risk factor. Alcohol also causes cancer of the liver.
18. How is UCI doing cancer awareness?
We have a whole deployment called the comprehensive community cancer program which goes throughout the country. On Sunday during the physical activity event, patients too can join us.
19. Is screening for cancer free?
At UCI screening for cancer is free.
20. What would it take for someone to escape?
Early screening helps detect the disease in its early stages. If you screen, even if it is just once, you reduce your risk of cancer, very considerably.
Ms Christine Namulindwa is the Public Relations Officer at the Uganda Cancer Institute (UCI)