Early breast cancer detection saved me

At the end of a summer vacation in Virginia, USA, in 2004, a cancer diagnosis was the last thing on Rebecca Mayengo’s mind. “I was feeling good. My employer in Sierra Leone had sponsored the holiday. I had had a good time with my sister and other friends who lived in Virginia and Maine. I was looking forward to returning to work.”

A year before, Mayengo had been studying for a PhD in Developmental Psychology at Howard University in Washington State, USA.
However, when she got a consultancy at The Center for Victims of Torture (CVT), at their Sierra Leone office, she put her studies on hold for a while.

A week to the end of her holiday, she checked into Inova Alexandria Hospital for a routine medical checkup. It was a standard regulation that employees in her organisation had medical checkups at least once a year.

“I was not ill. In fact, I had not been sick in a long time. As I lay on the examination table, the things I had planned to do that day were running through my mind.”
When the doctor got to her left breast, he took a particularly long time probing around it.
“How long have you had this lump?” the doctor asked suddenly.
Mayengo was shocked. She thought the doctor had not checked properly. “He sent me to the next room to have a mammogram done on the breast,” she recalls.

Confirming suspicions
Having had a mammogram years before, with clear results, Mayengo entered the room hoping the doctor had made a mistake. To be sure, he made an appointment for her to have a biopsy, the next day.

As she recalls the procedure, Mayengo’s tone of voice lowers. Unconsciously, her left hand goes up to the affected breast. The biopsy confirmed it was a malignant tumour.
“I had breast cancer. I looked at those results and I started praying to God. I had no alternative,” she says.

A history of the disease
Mayengo believes that breast cancer is hereditary in her family.
“Many women on my father’s side have died of breast cancer. Some die young; others get it in their old age. One of our grandmothers died a very painful death because the affected breast was not removed,” she explains.
Early this year, Mayengo lost a cousin to the disease.

Tackling the tumour
With results in hand, Mayengo returned to her doctor who recommended a surgeon.
Given medical insurance from her employer, the operation could take place immediately.
“That was the first blessing. I was living with my sister at the time. When I got home, I called my bosses and informed them. Then I called my family members. They were devastated. My sons thought I was going to die.”

However, Mayengo no longer felt that she was going to die and she attributes this to the psychological atmosphere in the hospital.
Her surgeon’s examination found that one lymph node in her armpit had been eaten up, and another was half destroyed.
“The fact that only two lymph nodes had been destroyed so far was good news. The surgeon recommended a lumpectomy.”

Lumpectomy is the removal of the breast tumour and some of the tissue that surrounds it.
The operation went well and after recovery, Mayengo was placed on chemotherapy. Her sister drove her to the clinic, making sure she kept all her appointments.
“I was going once a week to the hospital for the drugs to be infused into my blood system. The drugs were very strong. Now there are better, milder drugs on the market because of continual research,” she says.

After the second session, Mayengo’s oncologist informed her that her hair would fall out, as a side effect. Her sense of taste also disappeared. “I had to force myself to eat to maintain my blood count.
I was mostly drinking Chinese and tomato soup, and plenty of water to wash the drugs out of my system.”
At the same time, a new breast cancer drug—Herceptin—was on trial in the US. The oncologist asked Mayengo if she was willing to try the drug, as part of the research.
She agreed and was chosen to receive the expensive drug, free of charge.

After chemotherapy, the next stage was radiotherapy. This uses carefully measured and controlled high-energy x-rays to destroy cancer cells.
“As I walked into the hospital for my first session, a beautiful black woman was coming out. Her makeup was perfect. She asked why I looked frightened. She asked if it was my first time and I nodded. She laughed and told me not to worry. She had been through radiotherapy three times in her life.”

Encouraged, Mayengo stepped into the reception.
“When the radiologist came out, he introduced himself and asked if I was from Uganda. Of course he had read my file beforehand, but I was surprised that he was playing East African music in the background. I think it was African Safari. It just soothed me.”
The sessions happened daily, and lasted a month, after which, she was placed on hormonal therapy treatment for five years.

Mayengo’s breast cancer was ER-positive, which meant that the cells contained oestrogen, a female sex hormone. The hormonal therapy treatment was to stop the growth of the tumour by blocking the production of oestrogen.

In 2008, with one year left on her treatment schedule, Mayengo returned to Uganda. Her husband had been supportive, but her co-wife told people that no one survived cancer and Mayengo would soon die.

“The irony of life is terrible. She developed a lump in her throat. Tests confirmed that she had throat cancer. Even with specialised treatment but there was nothing the doctors could do. She died in 2012. It was a terrible experience for my husband. I think he worries that I will also die soon,” she adds.

However, for a 70- year-old woman, Rebecca Kiziri Mayengo looks fit.
“I attribute this to the fact that I jog every day and because of that, I have been cancer-free for eleven years,” she says.

Mayengo is the chairperson, Uganda Women’s Cancer Support Organisation (UWOCASO), an organisation she joined when she returned to Uganda in 2008.
When cancer is in remission, patients are advised to have medical checkups every year, to detect if the cancer is recurring.

Due to immigration laws, Mayengo was unable to return to the USA. Her checkups are now done at the Cancer Institute in Mulago hospital.
“The bone scan is quite expensive and recently, the scanner broke down. I have to go to Nairobi. The radiation machine is on and off. It is terrible for patients who cannot afford other alternatives. Any pain in my body sends me into a panic. My first thoughts always go to cancer, wondering if it has recurred through another organ,” she explains.
After the panic passes, Mayengo reminds herself by God’s Grace, the cancer will not come back.

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