Odongo’s battle with breast cancer 

A  life threatening sickness can catapult you into a state of panic, confusion, anxiety and hopelessness. But to Florence Odongo, 52, cancer is not a death sentence, but rather a season in one’s life that needs to encountered with faith.  
As a family norm, Odongo and her family occasionally went for medical checkups.  However, of all the annual checkups she had carried out, going for cancer screening is something that had never crossed her mind, until September 2018.  When she learnt that AAR was offering free breast cancer screening services, she took advantage of the opportunity. 

After the diagnosis, results revealed she was healthy. But the worst was yet to come.  A week and days after the screening, Odongo felt a lump in her left breast.  “I was taking a shower and I felt a lump in one of my breasts.  This got me suspicious, and I decided to go back to AAR, Ntinda the following day for a checkup.”   

Medical examaniation
During the second examination, a gynaecologist asked Odongo to have an ultrasound done, which showed a lump in her breast. On October 2, 2018, she was sent to Kampala Imaging Centre for a mammogram- an X-ray picture of the breast. Doctors use a mammogram to look for early signs of breast cancer. Regular mammograms are the best tests doctors use to find breast cancer early, sometimes up to three years before it can be felt.

Results from a mammogram were not any different from those of the ultrasound. Odongo shared the news with her husband, who was away for a business trip. And when he returned, they decided go for treatment at Aga Khan University Hospital, Nairobi.

Coping with news 
With her medical reports, Odongo travelled to Nairobi on October 7, 2018 for further checkups.  It is here that more tests were carried out that indicated the lump was bigger.
A specimen from the lump was extracted for a biopsy test. And after a series of tests that lasted for a week, she was then called by Prof Ronald Wasike, a breast surgeon at Aga Khan Hospital, Nairobi to get her results. 

“When I got to hospital, Prof Wasike dropped the bombshell. I pretended I had not heard what he had said. So, he repeated.
“Mrs Odongo, we have diagnosed you with breast cancer,” she recounts.  “As I tried to come to terms with the bad news, I needed to know what stage it was.”  “It is at stage four,” the surgeon announced. 

Optimism and faith 
Lost in a sea of thoughts, Odongo never imagined she would suffer from breast cancer. “And I think that is the case for most people. They do not think it is going to be them until the diagnosis is done. Cancer does not have a face until it is you or somebody that you know and that was the situation I was in.”
Being Christian, Odongo says she had hope that God would heal the deadly disease. From that day, she decided to involve God at every step of her treatment and kept a positive mindset. 

Disclosure 
Telling children that you have cancer can be difficult because like any other person, the next thing running into their mind is death. However, Odongo felt the need to open up to her three children.  As a mother she says it was a trying moment, especially for her last born, who was a toddler. 

“Unlike my children, my husband received the news through Prof Wasike. He asked if he could break the news to him and I was okay with it.  
For the children, I first talked to the older children, but still I had to do a lot of explaining and assurance that by God’s grace, I was going to beat cancer.”
The news hit hard for Odongo’s first and the last born. Other than her husband and children, the rest of her family got the news in bits to avoid negativity, since many people look at cancer as a death sentence. 

Treatment
Odongo says according to Dr Asim Jamal, an oncologist who attended to her, cancer had spread to her lungs and other cells were in her lumbar vertebra. “He further explained that at stage four, I could no longer be treated and the best they could do was to manage the condition.”  
After the doctor’s analysis, she was prescribed treatment and her treatment plan included eight rounds of chemotherapy which was first administered on October 19, 2018.

“What is chemotherapy?  How is it administered?” These are some of the questions that ran through her head as the doctor took her through prescription and medical procedures. 
I remember on the first day, when the nurse was fixing my drip, she told me to enjoy my hair for the last time.  I did not grasp what she meant until after the second dose of chemo. My hair started falling off.”

Harsh side effects
She says among her medications was one that boosts immunity which was to be kept in cold temperatures at all times. And because of that, she had to get a portable cooler, which she carried all the time.
 “The treatment had very harsh side effects such as diarrhoea, nausea, lack of appetite, fatigue, hair and weight loss. My hair started falling off in patches. I could wake up in the morning only to find a mound of hair on the pillow. My skin colour started darkening, till now I am just recovering.”  
According to Prof Wasike, two types of chemotherapy- Adriamycin or Cyclophomamide and Taxane chom were to be administered to Odongo. 

Undergoing surgery 
Odongo says when the lump in her breast shrunk, Prof Wasike suggested she undergoes a surgery instead of a mastectomy- cutting off the breast. 
The operation was slated for, April 24, 2019 and unlike other trips where she used to travel alone, this time round, she was accompanied by her husband and her youngest son.
“He was my greatest cheerleader. He reminded me that at one time I overcame meningitis and gave me assurance that I would beat breast cancer too,” she says. 

After the surgery, she woke up to a tube inserted in her breast draining blood into a small plastic container.  She says every morning, the fluid had to be drained out and measured to know the amount cleared out.  And the tube had to be removed once the fluid fell below 20mm. 
On May 6, 2019, the fluid had reduced to 12mm and the tube was removed. What remained was a bandage which I kept changing every after three days till the wound finally healed.

The final lap 
Radiotherapy is the last procedure in the finish line, the last push in a brutal series of her cancer treatment. Radiation therapy is cancer treatment that uses high energy beams to destroy cancer cells and shrink tumors. 
Radiation therapy may help meet different treatment goals. For instance, it may enhance the effectiveness of surgery, help prevent the spread of cancer or relieve symptoms of advanced cancer.
 “The therapy was one hour long, with a total of 30 sessions, five days a week for six weeks,” Odongo explains, adding that radiotherapy and chemotherapy came with side effects.
  
According to Prof Wasike, radiotherapy treatment planning with the patient is important because it helps to identify the exact area to be treated and the most effective dose of radiation. Treatment planning is usually done using a CT scanner to know the exact area to be treated.  This procedure destroys cancerous cells in the body.

Clinical remission
Odongo completed radiotherapy in 2019 and is currently in clinical remission. Remission means the signs and symptoms of your cancer are reduced. Remission can be partial or complete. In a complete remission, all signs and symptoms of cancer disappear. 
“Odongo is cancer-free. Her body has no cancer cells, but we are still monitoring her. From the very start, Odongo was courageous and had a lot of hope. I do not remember her breaking down at any time. She was optimistic and took her treatment and medication religiously. What kills most patients is living in denial,” Prof Wasike explains.

Reaching out  
 Having walked the journey of cancer, experience of pain and agony she went through, chemotherapy, surgery and raising money for treatment, Odongo has today decided to join the Uganda Women Cancer Support Organisation to encourage cancer patients to live positively. 
 “As a cancer patient you are expected to feed well, because of the strong medication. Every Monday, I reach out to cancer patients and together with my cell members, we take food to the haven, a place hosting cancer patients on Bukoto- Kisaasi Road.” 

Doctor’s remarks  
There are four types of breast cancer that affect women.  That is luminal A, luminal B, triple negative and her2/neu overexpression. Triple negative and her2/neu overexpression are very aggressive and tend to affect young patients between 35 to 50 years. 
The commonest type is lumial A at 65 per cent for all ages. This is slow growing and very forgiving. Advanced breast cancer can spread to another breast and one can have cancer on both breasts at the same time. 

Studies show that the risk of developing breast cancer increases with age. About eight out of 10 cases of breast cancer happen in women over 50.
“The early signs are lumps, but most women notice it when it is already late. Every woman should do a mammogram every year. Eat vegetables containing carotenoids to reduce the development of cancer cells and do regular exercises. Avoid hormonal contraceptives that contain estrogen and progestin and avoid over weight,”  Prof Wasike explains.

Statistics 
World Health Organisation data published in 2018 indicates that breast cancer deaths in Uganda reached 1,373 of total deaths. The age adjusted death rate is 15.35 per 100,000 of population, which ranks Uganda 101 in the world.  
Nearly one half of Ugandan women who are diagnosed with breast cancer die. 
These high mortality rates can be attributed to a late stage at diagnosis. Up to 89 per cent of women in Uganda present with stage III or stage IV disease, a time at which breast cancer is more difficult to treat and the outcomes are poor.