She had chemotherapy twice

Being a medical worker, Abwoch took good care of her herself, eating healthy foods and exercising a lot until January 2016, when she strangely started feeling pain in her joints.
Her knee and ankle joints would swell whenever she walked, or stood for a long time.
“At first, I thought it was because of old age. Since I had worked at Abim hospital, I contacted a doctor and after a physical assessment, he prescribed for me pain killers. But after a week, I went to the same hospital to tell the doctor that there was no change. The doctor kept changing the medicine to antimalarial and infections, but still there was no change,” she says.

Changing health facility
When she realised that she was not responding to the treatment, Abwoch went to another hospital, but still the doctors failed to diagnose her problem. Within no time, the problem had intensified. “I would get fatigued even when I was not doing anything. Bending and standing up was hard, walking became even harder for me,” she recalls.
Someone told her that she could have a bone problem, but she quickly disputed that because she had never been involved in any accident or had any trauma to the bones. The person still advised Abwoch to go to Kumi because most people with bone problems went to Kumi Orthopaedic Centre.
“I did several tests and then the doctor recommended that I do an X-ray test,” Abwoch recalls. The results showed that the bones in her neck, waist and knee joints were shapeless.
“The doctor said he would not manage my situation because he suspected that my bones were being eaten up by cancer. He then referred me to the Uganda Cancer Institute.”

Immediate intervention
The review examinations took about two weeks and all this time Abwoch slept under a white tent in front of the old cancer institute with her son and sister. She was found with stage III cancer of the bones and blood and the doctors recommended that she starts treatment as soon as possible because her type of cancer rare and aggressive.
The doctor prescribed for her six cycles of chemotherapy doses, which were three weeks apart. “They were very effective. I would go back home after receiving my dose and return after three weeks, but with a caretaker, transport alone would cost us about Shs200,000. The good thing was that I did not have to buy the medication because the doctors said it was available.”
After the second cycle, there was no more pain, Abwoch says. “I started eating and I tried to walk, except that I suffered the effects of the treatment. At the end of the cycle, my hair fell off. My palms, nails and soles of my feet turned black, but I was ready to do whatever it took for me to be better.”
After the third cycle, Abwoch asked a social worker if there was a place she would find shelter as she waited for the remaining three doses.
“I was then taken to Patient Relief Mission, which was then in Kawempe, a Kampala suburb, and would only come to hospital when I had an appointment. While there, my granddaughter, who is my caretaker, and I got a bed and free meals.
“Sometimes I would be so weak and my blood count would be too low since my cancer is in the blood. The doctors would postpone the dose to allow my body regain some strength and blood.
Upon completion of the six doses, Abwoch was given some oral tablets that the doctor said would boost the chemotherapy treatment. “I took them very religiously and the doctors said I go back after three months.”

Another chemotherapy cycle
But Abwoch started feeling pain again. When she returned to the Cancer Institute, the doctor said her cancer cells were not responding to the treatment.
“I had to start on a new combination of chemotherapy again. This time I was given four cycles that were four days apart. This time, I had to buy the medication and each dose costs Shs200,000. I still got through the after effects of chemotherapy.”
Abwoch completed the treatment and the pain has disappeared, except for being weak and extreme coldness in her feet. “I was told by the social workers that these are side effects of the chemotherapy drugs.”
Abwoch will be seeing the doctor again in a week’s time to know what her next treatment plan will be.

Doctor’s take
Dr Noleb Mugisha, an oncologist at the Uganda Cancer Institute, says: “Like in the treatment of any other diseases, there are times when people fail to respond positively to the chemotherapy combinations that have been prescribed for them.”
This means the cancer cells are still active and have the capacity to still multiply. The patients are then put on second line drug combinations that are usually a bit stronger and more effective.
“This is the reason we try to keep in close contact with the patients, do as many reviews and ask them if they feel any more pain just like they did before they started treatment,” Dr Mugisha says.

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