‘I am just waiting for my time to die’

Hasifa Nabirye, a resident of Bukasero village, Bukatube Sub-county in Mayuge District, is one of the many women battling Breast Cancer in Uganda.
The 55-year-old mother of 10 whom I find seated in a grass thatched house, her left breast hanging out of a tattered gomesi - with pus dripping from it - says she has been battling cancer for three years.
“Three years ago, I felt a lump in my left breast but it was not painful. However, my breast was a little swollen.”
She decided to visit several hospitals in Mayuge. However, the situation worsened so she decided to visit Mulago.
“When I went to Mulago Hospital, the doctors checked me and said I had breast cancer and I needed an operation which cost me Shs300,000.”
However, she says, after the operation where the lump was removed, nothing changed. I even visited traditional healers whom I paid Shs300,000 thinking that I will be fine , but the pain still remained,” Nabirye explains with a sad look on her face.
Nabirye adds that in 2015, she went back to Mulago Hospital where she was told to look for money for another operation to cut off her breast.
“They also told me that I will cater for my transport, accommodation and food but I have failed to raise the money. I cannot afford any medication. It is now been three years but, I can no longer work. I used to till my land and get money to take care of my family but it is now impossible , I am just waiting for my day to die,” she says while wiping tears from her eyes.
Nabirye is worried that even when they cut off her breast, she will still die if she does not get required treatment.
The treatment, according to nhs.uk is surgery, followed by chemotherapy or radiotherapy or, in some cases, hormone or biological treatments. The treatment you’ll have will depend on the type of breast cancer.
Chemotherapy or hormone therapy will sometimes be the first treatment.

Financially constrained husband
“I don’t have hope of surviving because my neighbour also had breast cancer but even when they cut off her breast, she died. I am worried of leaving my little children behind.”
Nabirye’s husband, Habib Yusuf Isabirye, who used to support her is also financially constrained.
“I sold all my three cows to get money for my wife’s treatment but she has not improved. I first sold my first cow at Shs650,000, the second one at Shs350,000 and third at Shs185,000 but now I don’t have money to take her to Hospital. I just till other people’s land and get some money for survival.”
According to Dr Angel Yoven Akii, a senior consultant at Jinja Referral hospital, women of reproductive age should develop a habit of self-examination of their breasts.
“They should try to find out whether they have a lump or swelling. If this is detected early enough there is a chance to deal with the cancer cells before it reaches poor prognosis—difficult to control,” he says.
Once you detect the lump or swelling you must see a medical doctor as soon as you possibly can so that detailed biopsy (medical examination) can be done and remedies prescribed.
He also advised against a tendency by some women to object to cutting off their breast through surgical procedures once the cancer cells have been detected, saying the price for that is unbearable discomfort and pain till death.

30 FACTS ABOUT BREAST CANCER

Breast cancer remains a leading cause of cancer death in women, second only to lung cancer. So, in the spirit of heightening awareness – and screening, here are fact bout breast cancer:
1. The leading risk factor for breast cancer is simply being a woman. Though breast cancer does occur in men, the disease is 100 times more common in women than in men and women are at 200 times the risk of developing the disease compared to risk in men.
2. Most breast cancer – about 85 percent – occurs in women who have no family history of breast cancer.
3. About 5 to 10 percent of breast cancers can be traced to specific, inherited gene mutations, such as the BRCA1 and BRCA2 gene mutations.
4. Men can also get breast cancer. About 2,150 are diagnosed annually – or about 1 in 1,000 men.
5. A woman born today has about a one in eight chance of being diagnosed with breast cancer in her lifetime, according to the National Cancer Institute.
6. While much progress has been made in breast cancer treatment and research, more work remains: Breast cancer remains the second-leading cause of cancer death after lung cancer. Overall, cancer deaths are the second most-common cause of death after heart disease.
7. Simply getting older – 79 percent of new cases and 88 percent of deaths occurred in women age 50 and older, according to the American Cancer Society. Just fewer than 11,000 invasive cases occurred in women younger than 40, and just under 49,000 in women under 50. In women ages 50 to 64, invasive breast cancer was even more prevalent with more than 84,000 cases. Women over age 65 accounted for more than 99,000 cases last year.
8. Breast cancer accounts for 29 percent of newly diagnosed cancers.
9. In the 1970s, breast cancer lifetime risk was one in 11 – compared to today’s one in eight. The good news is part of the reason is due to longer life expectancy and more detection through screening. Other factors include menopausal hormone use, changes in reproductive patterns and the increased prevalence of obesity.
10. The oft-repeated one in eight statistic may mean something different than you think. The lifetime risk for women born today of being diagnosed with breast cancer is one in eight. But lifetime risk reflects an average woman’s risk over her entire lifetime, including the possibility that she may die from another cause before she would have been diagnosed with breast cancer.
11. While non-Hispanic white women have higher rates of breast cancer incidence, African-American women have a higher incidence rate before age 40 and are more likely to die from breast cancer at every age.
12. Women who are diagnosed with cancer before age 40 have a nearly 4.5-fold increased risk of developing another breast cancer.
13. Women of Ashkenazi Jewish heritage are at higher risk of having BRCA mutation.
14. Not everyone needs genetic screening for breast cancer. Only about 2 percent of women meet the guidelines for screening.
15. Fewer than 1 percent of the general population have a BRCA mutation.
16. Research suggests breastfeeding for a year or more slightly reduces overall risk of breast cancer – about a 4.3 percent reduction for every 12 months of breastfeeding. Why? One possible explanation: Breastfeeding often interrupts periods, meaning fewer menstrual cycles and less estrogen exposure. Others suggest that the reduced risk can be credited to structural changes in the breast after lactation and weaning.
17. The risk of overweight women developing breast cancer after menopause is 1.5 times higher than in lean women. Obese women are at twice the risk of lean women.
18. Herceptin, a breast cancer “smart drug,” can trace its roots to City of Hope: Scientists here developed engineered human proteins that led to monoclonal antibodies, the basis of multiple cancer drugs.
19. The movement away from one-size-fits all screening doesn’t mean you should skip your mammogram. Talk with your physician to evaluate your personal risk of breast cancer. Yearly mammograms beginning at age 40 are recommended.
20. Exercise reduces breast cancer risk for women of all body types – even lean women.
21. While 150 minutes of moderate intensity exercise per week to manage risk are recomended, for some, even 30 minutes per week has been found to be beneficial.
22. Minimize alcohol intake to control risk. That means one glass of wine, one beer or one hard liquor drink per day. (Drinking seven drinks in one day and none the rest of the week is not OK.)
23. The discovery of the BRCA mutation and its link to breast cancer celebrates its 20th anniversary this year – the same year scientists reported in the New England Journal of Medicine the PALB2 mutation and its link to breast cancer.
24. Only about 42 percent of women who undergo mastectomy choose to have reconstructive surgery, according to a recent JAMA Surgery study.
25. With eight out of 10 breast lumps discovered by women themselves, don’t underestimate the importance of a monthly breast self-exam. By becoming more familiar with your breast tissue and appearance, you will be more likely to notice changes should they occur.
26. If you’ve been diagnosed with breast cancer, you’re up to four times more likely to develop a new cancer in the same breast or in the other breast.
27. Quit smoking to control risk of many diseases, including breast cancer. Younger women who smoke have a higher risk of breast cancer than their nonsmoking peers.
28. According to the National Institutes for Health, breast cancer survivors are at an increased risk of osteoporosis. Estrogen has a protective effect on bones, and reduced estrogen levels can trigger bone loss.
29. Exercise is beneficial to breast cancer survivors. A June study in Cancer found only a third of survivors meet recommended activity levels.
30. If you are diagnosed with breast cancer, a second opinion could save your life.

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