Getting tested at Uganda Cancer institute, Mulago

Above president Museveni opens the Uganda Uganda Cancer Institute - Fred Hutchinson Cancer Research Center, Mulago in May. FILE PHOTO

The suggestion that I should test for prostate cancer, was exciting but as the likelihood of testing positive for a disease with no cure but painful therapy drowned on me, the excitement evaporated like thin air.
It is 10am on a Monday morning at Uganda Cancer Institute, Mulago. There are several people seated under a tent, on the veranda and others spread in the small compound. They are cancer patients and caretakers.
Past the tent, inside the building, a one Kalungi mans the Inquiry desk. “I want to test for prostate cancer.” Kalungi looks at me, a young small bodied man, seemingly wanting to say something but chooses not to, at least not now. “It is a wrong day, sir,” he says instead. “Please come back on Friday that’s when we do cancer screening.”
Kalungi’s desk is busy so he must attend to the other persons. “Hey,” he calls as I turn to leave. “As if you don’t qualify for prostate cancer screening,” he says. Careful not to offend me, he asks, “How old are you?” Before I answer, he offers an explanation. “We screen men who are 40 years and above. That’s the age prone to prostate cancer.”
By all accounts, there is no way I can allege I am 40 years. But I insist I want to do the test anyway. “Well, you see..,” he tries to dissuade me. “Men below the age of 40 can’t get prostate cancer. But if yours is a special case, then you may need to be assessed first, fine, come back Friday. You will undergo counselling first. Make sure you are here by 6am in the morning. We work on first-come-first-serve basis and we screen only about 20 people a day.”

Braving Mulago hill coldness
It is Friday, the day of my appointment and I am at the Institute 13 minutes before 6am. The tent, the veranda and the compound are all filled with people. The ward being too small to accommodate the large number of patients and caretakers, they sleep out in the open, in the cold. Except a few with thin blankets, majority cover themselves with all they have, light clothes that serve as bed sheets and blankets. Mulago hill, literally, pours its coldness on them. You cannot imagine what happens when it rains.
You sympathise most with the children. One mother struggles to give warmth and comfort to her little boy, a cancer patient. He is about three years old. He is coughing and crying. The cold plantain the mother tries to feed him on does not help matters.
About 33 minutes, the first member of staff of the outpatients department arrives, opens the reception and switches on the lights. But even an hour later, the screening has not started. I begin to wonder why Kalungi, told me to come so early.

Women try to forget their fears
By 7am, more people have arrived, about 60. There are more women than men here for breast and cervical cancer screening. We assemble in the order of arrival but when nothing happens for about 10 minutes, people abandon the queue. The women begin conversing, bringing up all sorts of topics. One woman tells her colleagues how they cannot rely on “safe days” to avoid getting pregnant. A debate for and against family planning ensues. No one is taking about cancer. Maybe they don’t want to discuss their fears. Towards 8am, anxiety sets in yet not until 8.10am does one gentleman turn up with sheets of paper in his hands. Knowing he has come to register, all the people rush towards him, surrounding him in the process. He lectures us first on who is and not eligible for cancer screening. Pregnant and breastfeeding mothers and those in menstrual periods are disqualified. “You may come back seven days after your periods or two months after breastfeeding,” he announces. Braving the morning cold of Mulago hill has been in vain for them.
Those of us who are neither pregnant, breastfeeding nor anything stay but anxious and weary. The last thing anyone would want to hear is confirmation of their fears!

Screening starts
At 8.25am, registration begins. But who came first, for people have long abandoned the queue. Luckily, everyone can affirm I was the first to arrive. But as the registration continues, it’s hard to ascertain the order of people’s arrival. Late comers squeeze their names on the paper faster than some early comers. That is how unfair life can be!
Forty two people have been registered. The rest are advised to try next time. “Please don’t shed tears,” one female nurse pleads. “Remember you’re not sick, you only suspect you might have cancer. Even if we registered all of you, the truth is we are unable to screen you all in a single day. Please understand our situation.”
She turns to us. “One by one you will see the doctor,” she says. “Ask him or her all the questions you have. The doctor will examine you and carry out the test. If you are negative, rejoice and if positive, please come back for treatment. It’s free. Some people have a tendency of resorting to witchdoctors for treatment, I hope you don’t.” Her remarks attract a hefty laugh as we momentarily rest our fears and anxiety.

After all I didn’t have cancer
I get into the Consultation Room at 9.15am. “Why do you suspect you have prostate cancer, what signs do you have?” the medical officer asks me. He would confirm I do not have cancer. I was below the age 40, that is prone to prostate cancer. “It is good you came, though,” he comforts me.
At 9.21am, I leave Uganda Cancer Institute not sure how to react – should I be sad for having waited long in the queue only to find out I did not have to or rejoice for being cancer free? Maybe the latter. One thing I know though, at the Uganda Cancer Institute, anxiety, fear and pain reign.

Preventing prostrate cancer

Choose a healthy diet
There is some evidence that choosing a healthy diet that’s low in fat and full of fruits and vegetables may contribute to a lower risk of prostate cancer, though this hasn’t been proved concretely.
If you want to reduce your risk of prostate cancer, consider trying to:
•Choose a low-fat diet. Foods that contain fats include meats, nuts, oils and dairy products, such as milk and cheese.
•Eat more fat from plants than from animals. In studies that looked at fat consumption and prostate cancer risk, fats from animals were most likely to be associated with an increased risk of prostate cancer. Animal products that contain fats include meat, lard and butter.
•Increase the amount of fruits and vegetables you eat each day. Fruits and vegetables are full of vitamins and nutrients that are thought to reduce the risk of prostate cancer, though research hasn’t proved that any particular nutrient is guaranteed to reduce your risk.
•Eat fish. Fatty fish — such as salmon, tuna and herring — contain omega-3 fatty acids, a type of fatty acid that has been linked to a reduced risk of prostate cancer. If you don’t currently eat fish, you might consider adding it to your diet.
Another way to add omega-3s to your diet is by eating flaxseed.
•Reduce the amount of dairy products you eat each day. In studies, men who ate the most dairy products — such as milk, cheese and yogurt — each day had the highest risk of prostate cancer. But study results have been mixed, and the risk associated with dairy products is thought to be small.
Maintain a healthy weight
Men who are obese — a body mass index (BMI) of 30 or higher — may have an increased risk of prostate cancer. If you are overweight or obese, work on losing weight. You can do this by reducing the number of calories you eat each day and increasing the amount of exercise you do.
If you have a healthy weight, work to maintain it by exercising most days of the week and choosing a healthy diet that’s rich in fruits, vegetables and whole grains.
Exercise most days of the week
Studies of exercise and prostate cancer risk have mostly shown that men who exercise may have a reduced risk of prostate cancer. Exercise has many other health benefits and may reduce your risk of heart disease and other cancers. Exercise can help you maintain your weight, or it can help you lose weight.
Source: mayoclinic.org