After losing her breast, Mbabazi fears she might not have children

Carol Mbabazi, 32, a health worker with the Uganda People’s Defence Force (UPDF) was diagnosed with breast cancer in April 2019. Prior to the diagnosis, she had not experienced any pain. However, one day as she carried her sister’s baby, she could feel a lot of pain every time the baby exerted pressure on her left breast. 
“At first I thought the pain was being caused by the baby’s weight but I noticed that days later, it was persistent. Worried, I went to Nsambya Hospital for a checkup. At the hospital, a scan revealed that I had a lump in the left breast and I was advised to do a biopsy,” Mbabazi says.

She then made her way to Platinum Hospital in Kampala where a biopsy (involves extraction of sample cells or tissues for examination to determine the presence or extent of a disease) was performed. A mammogram (an X-ray imaging to detect for presence of tumour or lump in breast) was also taken. Confident and still believing that she did not have cancer, Mbabazi returned to the hospital three days later for the results. 

“I made my way to the laboratory where the technician handed me an envelope with the results and told me to take it to the doctor for interpretation. However, I was anxious to know the results so I opened the enveloped. I was shocked to read that I had cancer. At first, I thought I had been given the wrong results but after carefully reading my name, I accepted that they were mine. Deflated, I left the hospital and boarded a boda boda home,” she remembers.

At home, she kept the results a secret at first, thinking that she had not read the documents well. She woke up in the night and read again. Unable to keep the diagnosis a secret anymore, she sent a message to a friend but cautioned her not to inform anyone, especially her parents.

Accepting the results
After sometime, she made the decision to go back to the hospital so that the doctor could guide her on the next course of action. At the hospital, the doctor revealed she had stage II cancer and needed a mastectomy or a surgery in which the entire breast is removed, including all of the breast tissue and sometimes other nearby tissues.
“At the time, I was pursuing my bachelor’s degree and was to sit for my exams in May. I told the doctor that I would come for the surgery after sitting my exams. I also informed the registrar that I would not be able to carry out my research on time and asked for more time,” she says.

Mbabazi then travelled to Mbarara in western Uganda to inform her parents about her ailment and the treatment plan ahead. Her parents were worried and concerned, especially after knowing many friends and family who had succumbed to the disease.
“I was very strong and told them that I was going to live. At the Uganda Cancer Institute, the doctor asked me to find a way of preserving my ova since there was a possibility of the chemotherapy affecting my fertility. However, at the fertility clinic, the doctor asked me to pay Shs5m for the procedure, which I did not have,” she says.

Treatment
Without preserving her ova, Mbabazi went ahead with the treatment and started chemotherapy a month after the surgery. The chemotherapy and its side effects took a toll on her, causing loss of appetite, diarrhoea, hair and weight loss, black nails and pale skin, among others.

Throughout the six cycles of chemotherapy,  Mbabazi would look out for any organisation that could offer counselling and a listening ear during this time. With time, she heard about the Uganda Women’s Cancer Support Organisation (UWOCASO) and since they were located near her home in Ntinda, Kampala, she one day walked into their offices for help. The women at UWOCASO were of great help to her and would visit her all the time she was in hospital.

“I also suffered other effects due to the chemotherapy such as damage to the heart. I have, therefore, had to go to the Uganda Heart Institute for radiotherapy and hormone therapy. My immunity and blood levels are also very low which makes me prone to infections,” she says.

Fears about the future
Fortunately, Mbabazi says, the UPDF has been paying her hospital bills and she has received full support from her boss. Her fear is being unable to conceive since even other methods such as in vitro fertilisation (IVF) are costly. 
“The doctor says I can try to conceive four years after treatment but there is no guarantee that I will become pregnant. My worry is being childless for the rest of my life,”  she says.

Mbabazi says it is also a challenge to continue living a normal life after cancer treatment, especially when a number of people in her community still believe that cancer is contagious and survivors are isolated. 
“Prosthetic bras are also very expensive and so many of us cannot afford them yet we need them. I wish they were a bit cheaper,” she says.
Mbabazi is glad that the treatment is so far working and is hopeful that in future, she can live a normal life, probably married with children.

Benefits of early detection
According feminstyle.africa, breast cancer is the topmost cancer among women. It is also among the top women killers. The incidence of breast cancer is higher in Africa and other low-income countries than their more developed counterparts. 
Africa bears about half of the worldwide cancer burden. More than half the women who are affected by breast cancer in Africa go on to die of the disease.
Breast cancer can be cured if detected early. Early breast cancer is mostly asymptomatic (show no symptoms) and can go undetected. But periodic breast examinations will go a long way to aid early breast cancer diagnosis. 

Screening for breast cancer is easy. A self-breast examination can be done with the guidance of a health worker, or a health personnel can perform it.
The early signs that are looked out for include lumps, change in size, change in nipple appearance, nipple discharge, changes in the appearance of the skin of the breast; whether pinched, dimpled or wrinkled. 
If the colour of the skin has changed, reddened and has increased temperature, among others. Hardening of the breast and appearance of prominent veins have also been listed as some of the signs.