Doctor shares experience as cancer patient

His passion in offering palliative care services to cancer patients in Uganda has made him a global figure.

Dr Jacinto Amandua stands tall amongst his peers for championing the integration of palliative care services into Uganda’s healthcare system.

Due to his experience with cancer patients, Dr Amandua, who is the commissioner clinical services at Ministry of Health, said he is also on palliation after being diagnosed with lymphatic cancer.

“I was diagnosed with cancer in 2011 at the Uganda Cancer Institute but as you can see, I look very well,” Dr Amandua said.

“I am glad that I got to know about my cancer early and started treatment in January 2012. I am currently on palliation so people should not get scared of cancer,” he added.
He says his cancer first manifested as small swellings in the armpits.

Upon undergoing chemotherapy, Dr Amandua said the cancerous cells were cleared but he relapsed in 2014 when the cancer manifested again.
“I am now on my second treatment but different from what I was given at first,” he said.

With a plan to retire in December, Dr Amandua says young people should avoid cancer risk factors such as tobacco and also start doing regular checkups for cancer.
He says the experience taught him the benefits of regular medical check up.

“The problem is we don’t check for these cancers yet young people must try everything possible to avoid risk factors. For those in my age bracket, it might now be hard,” he said.
The doctor, who is at the forefront of advocating for palliative care also referred to as pain relief, says patients in need of such treatment should be identified.

He says Uganda is the only African country after South Africa where palliative care services are integrated in its referral system. The initiative was introduced in Uganda in 1993 by the founder of Hospice Africa, Prof Anne Merriman.

Dr Amandua’s saying, “Palliative care must be as available as air,” dominated talks at the fifth International African Palliative Care Conference recently. The conference was held under the theme: “Hopice and Palliative Care: Resolution to Action.”

It was aimed at discussing action required to meet targets on palliative care set by the World Health Assembly resolution passed in 2014.

Dr Amandua was recognised by the African Palliative Care Association (APCA) for his leadership and pioneering palliative care in Uganda.
Dr Amandua started offering palliative care to patients in 1995 while serving as medical superintendent of Arua Hospital.

He was also recognised with the Road to Hope award. In his acceptance speech, Dr Amandua pledged to continue advocating and attending to patients who need care. He is the first Ugandan to train in palliative care boasting of a Masters degree in Palliative Care from the King’s College London.

Experience
Dr Amandua says his most challenging day as a medical doctor is handling a cancer patient in pain.

As a doctor, he says it is challenging when you cannot solve problems for patients battling cancer. This he attributes to the fact that they are always in pain yet majority are poor.
“They have no money and as you know cancer is an expensive disease to treat,” he added.

He advises doctors to be empathetic to patients and continue to offer service to all patients without discrimation.

According to APCA, palliative care is the service that is provided to improve the quality of life of patients and their families facing problems associated with life-threatening illness such as; cancer, HIV/Aids, diabetes, hepatitis and tuberculosis.

It is provided through prevention and relief by means of early identification, through assessment and treatment of pain and other complications including physical, economic, psycho-social and spiritual.

Profile

Dr jacinto amandua, commissioner clinical services, ministry of health
Age. 60
Background. Born on December 22, 1956 in Bombo, Dr Amandua is a father of five and a grandfather of two.

Education. He attended Ndirea Primary school between 1966 and 1972. He then joined St Charles Lwanga College in Koboko District in 1973 for his secondary school education. Between 1979 and 1984, he pursued a Bachelor’s degree in Medicine and Surgery at Makerere University. He also holds a Master’s in Business Administration from the Eastern and Southern African Management Institute.

Work experience. He worked in Yumbe Hospital between 1986 and 1988 as a medical officer. In 1988, Dr Amandua went back to Makerere University for his post graduate degree. He served as physician and medical superintendent to Arua Hospital from 1995 up to 1999 when he moved to the Ministry of Health headquarters to serve as the commissioner clinical services, a position he holds to date.

Lymph nodes and cancer

According to Dr Nicholas Asiimwe an oncologist at Uganda Cancer institute, the lymphatic system is the body’s drainage system that consists the neck area, armpits and the lower abdomen. Anything that affects the lymph nodes causes swelling of the lymph nodes.

All types of cancers can affect the lymph nodes and they can appear as masses invading the lymphatic system but the lymphomas which are commonly known as liquid tumors or tumors of the circulatory system commonly affect the lymph nodes. These include; Leukemia, Burkitts’ Lymphoma, Hodgkin and non-Hodgkin lymphomas.

These cancers normally affect the lymph nodes but are metastatic as they do not originate from the nodes but rather from somewhere else in the body. Dr Asiimwe says some of the cancers present with symptoms such as unexplained swelling of the lymph nodes and loss of weight, evening fevers, night sweats and cough for more than two weeks.

The carcinomas on the other hand are solid tumour cancers that have their masses affecting particular body parts but not the lymphatic system. They include but not limited to breast, cervical, prostate, mouth cancers.

Everyone is at risk of catching a lymphoma and their cause is not known but a few are linked to genetics. In Uganda, t lymphomas are more pronounced in children although an adult can as well get the cancer.

The lymphomas can be treated with surgery and chemotherapy only once detected early without the use of radiotherapy unlike the carcinomas.

Compiled by Beatrice Nakibuuka