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Understanding cancer of the liver in Uganda
Uganda Cancer Institute ED Dr Jackson Orem.
What you need to know:
- While liver transplantation is effective for some, it remains limited in Uganda due to resource constraints.
Liver cancer, particularly hepatocellular carcinoma (HCC), has become a major health concern in Uganda. The Uganda Cancer Institute (UCI) plays a key role in addressing this challenge through prevention, diagnosis, treatment, and public education.
As cases continue to rise, understanding the causes and available interventions is essential to reducing the disease’s burden. Liver cancer originates in the cells of the liver, with HCC being the most common type. In Uganda, liver cancer is among the leading causes of cancer-related deaths. The UCI records an estimated 170 to 200 new cases annually, with aflatoxin exposure accounting for a significant portion.
Major risk factors
Aflatoxins, produced by moulds in improperly stored food such as maize and groundnuts, are a major cause. Some Ugandan crops contain aflatoxin levels 10 times higher than recommended safety limits, according to the National Agricultural Research Organisation. Chronic hepatitis B virus (HBV) infection is another major contributor. About six percent of the Ugandan population lives with HBV, which significantly raises liver cancer risk.
Nationwide vaccination, testing, and treatment programs are in place to curb the spread. Excessive alcohol consumption, common due to cultural practices and availability, can lead to liver cirrhosis and increase cancer risk.
Smoking is another factor, introducing carcinogens that damage liver cells. Unhealthy diets and cooking methods also contribute. Low fruit and vegetable intake, high red meat consumption, and charring food can increase cancer risk. Additionally, obesity and diabetes are linked to non-alcoholic fatty liver disease, which can lead to liver cancer.
Prevention strategies
Reducing aflatoxin exposure is critical. Public education on proper drying and storage methods, along with the use of products such as Aflasafe, helps lower contamination. Hepatitis B vaccination is a key preventive tool. UCI supports immunisation efforts, especially among newborns and high-risk groups.
Lifestyle changes are equally important. Reducing alcohol and tobacco use, eating a balanced diet, and staying physically active can significantly lower risk. Regular screening for high-risk individuals helps detect cancer early, when treatment is more effective.
Treatment options at UCI
UCI provides various treatment options, depending on the stage and nature of the disease. Chemotherapy is commonly used to shrink or control tumours. Surgery, such as partial liver removal, is an option for localised tumours, although many patients present at advanced stages.
While liver transplantation is effective for some, it remains limited in Uganda due to resource constraints. For patients with advanced cancer, UCI offers palliative care to manage pain and improve quality of life.
The writer, Dr Jackson Orem, is the executive director, Uganda Cancer Institute
