What you need to know:
- A hysterectomy is a surgical procedure to remove the womb. That is what a doctor told the then 29-year-old Joyce Laker. On the day of the surgery, another specialist reviewed her case and recommended chemotherapy instead, writes Beatrice Nakibuuka.
Joyce Laker was diagnosed with cervical cancer in January 2011. The social worker and resident of Gulu is a navigator of Uganda Women Cancer Support Organisation (UWOCASO) in Gulu region, particularly Lacor Hospital.
In the beginning, she thought she was pregnant so she went to Gulu Independent Hospital for a scan.
The gynaecologist confirmed that she was expecting.
“He advised me to get as much bed rest or I would lose my baby. So I followed his advice religiously but two weeks later, I started bleeding. I immediately called my husband and told him I had had a miscarriage. The bleeding did not stop for the whole day,” she recalls.
She was taken back to the hospital because she had started feeling so weak. She was transfused and the doctors helped stop the bleeding. She was then advised to have a biopsy whose results she would pick two weeks later.
Husband breaks news
“When the results came, the doctor called in my husband and I was left in the waiting area. We thereafter went home and then, my husband started crying, he hugged me and asked me to be strong because I had cancer. I was so numbed with the news. I was only 29 years and had just graduated the previous year. I felt like the world had come to an end,” Laker says.
Like many other people who are diagnosed with cancer, Laker felt like it was a death sentence and for many days, denial, anger, fear, stress and depression took the toll on her life.
Disclosure was very difficult for her because her children were very young; the eldest was eight years and the youngest was four.
Their father did disclose to them because their mother was not going to be home for several days.
Her health deteriorated and she was rushed to Lacor Hospital where a doctor recommended new investigations. The results still showed a stage One cervical cancer.
“The doctor said that my uterus had to be removed. I refused so my husband had to call my relatives to convince me that it was for my benefit since I had two children already. I still did not want my uterus to be removed but I just agreed to it,” she says.
When she was taken to the theatre, her blood results went missing.
“The doctor said he could not do the surgery without knowing the level of blood in the body and the blood group so I had to go back to the ward and wait. When the director of the hospital was doing the duty round, he reviewed my case and said the cancer was still early and there was no need of removing the uterus,” she says.
She was referred to Uganda Cancer Institute and opened a file under the guidance of Dr Fred Okuku, who recommended several tests and confirmed a stage One cervical cancer which did not require a hysterectomy - a surgical procedure to remove the womb.
She thereafter, started chemotherapy on April 6, 2011 until September of the same year.
Her treatment plan was to get six cycles of chemotherapy which were three weeks apart and used to stay at her sister-in-law’s home in Kamwokya whenever she was on treatment then go back to Gulu rest and then return. Her husband was of great support because he came to visit all the time she was on treatment.
“On the first cycle,” she recalls, “I got diarrhoea, nausea, lost appetite, hair loss, darkening of my skin and nails, fatigue and wounds in my mouth. I was about to give up the treatment by the fourth cycle because the side effects were unbearable. I had lost a lot of weight.”
She then met Margret Okello, from UWOCASO who assured her that she would be able to survive if she completed the treatment. After chemotherapy, she did not require radiotherapy but had a quarterly review, went up to six months, one year, and now she is a 10 year-survivor.
Although her uterus was not removed, she did not have more children. She wanted to conceive again but failed because she stopped having her periods three years after receiving the chemotherapy treatment and when she sought medical attention, she was told that it was the effect of the treatment.
Laker remarks that, “Cancer comes with a lot of discrimination from people close to you and many isolate you. Some people still think that the disease is contagious. The long journey of treatment starts with acceptance. Once you stop being in denial, you are halfway cured. We can’t change what has happened but we can fight and beat cancer because we are survivors not victims.”
As a survivor, Laker maintains a healthy lifestyle.
“I no longer take things for granted; l try to eat a healthy diet including vegetables and fruits and get adequate rest in order to help me manage stress and fatigue and engage in physical exercise. Also, have faith in God, love yourself and don’t give up your life,” she says.
She also remarks that no one can fight cancer alone. You need help from friends and family and talking to other people with cancer or cancer survivors has a great impact because they share their experience and give you an insight into what you can expect during treatment.
Join support groups such as UWOCASO. Get the facts about your cancer diagnosis.
Try to obtain as much basic, useful information about the type of cancer you have. Visit a health facility as soon as you experience any abnormal body changes.
Types of hysterectomy
There are various types of hysterectomy. The type you have depends on why you need the operation and how much of your womb and surrounding reproductive system can safely be left in place.
Total hysterectomy – the womb and cervix (neck of the womb) are removed; this is the most commonly performed operation.
Subtotal hysterectomy – the main body of the womb is removed, leaving the cervix in place.
Total hysterectomy with bilateral salpingo-oophorectomy – the womb, cervix, fallopian tubes (salpingectomy) and ovaries (oophorectomy) are removed.
Radical hysterectomy – the womb and surrounding tissues are removed, including the fallopian tubes, part of the vagina, ovaries, lymph glands and fatty tissue.
Laparoscopic hysterectomy (keyhole surgery) – where the womb is removed through several small cuts in the tummy.
Vaginal hysterectomy – where the womb is removed through a cut in the top of the vagina.
Abdominal hysterectomy – where the womb is removed through a cut in the lower tummy