Cancer burden to rise by 40 percent in 2030

Patients and caretakers wait to be attended to at the Uganda Cancer Institute in Mulago, Kampala, in 2018. PHOTO/ FILE 

What you need to know:

  • Experts warn that the surge will knock Uganda sideways not least because there are limited facilities established by the government to care for cancer patients. 

The burden of cancers in Uganda will increase by around 40 percent in 2030 due to changes in risk factors and population growth, researchers at the Uganda Cancer Institute (UCI) have warned.
This information is contained in a 2022 report by nine researchers from UCI, Makerere University, America and South Korea.

In specific terms, the report, whose lead author is Judith Asasira from UCI, indicates that “cervical, breast and prostate cancer incidence was projected to increase by 35 percent, 57.7 percent and 33.4 percent, respectively.”
Experts warn that the surge will knock Uganda sideways not least because there are limited facilities established by the government to care for cancer patients. The UCI is the only centre in the country that offers comprehensive cancer care. The centre has recently made headline news over its failure to accommodate patients who are waiting for the next cycle of treatment.

Dr Nixon Niyonzima, the head of research and training at UCI, said they are registering increases in the number of cancer patients. 
The centre handles around 65,000 patients annually. The average number of new cases of children and adults with cancer registered at the facility increased from 3,500 in 2015 to 7,400 in 2021.
Uganda registered nearly 32,617 new cases and 21,829 cancer deaths in Uganda as per Globocan, which is compiled under the auspices of the World Health Organisation. Just this year, the country has lost hotshots such as former House Speaker Jacob Oulanyah and former Security minister Gen Elly Tumwine to cancer.

Not all doom, gloom
It’s not all doom and gloom as the 2022 report also indicates that the incidence rates of cancers like Kaposi sarcoma (KS) and non-Hodgkin’s lymphoma (NHL) in Uganda will decrease.
Aged eight, Moses Echodu was diagnosed with Burkitt lymphoma, a rare but fast-growing cancer, whose overall four-year survival rate in Uganda is only 44 percent. Echodu, who is now 32 years old, was, however, lucky to survive the disease after being treated with an experimental drug at Uganda Cancer Ward at Mulago hospital in 1999.

This was before UCI became an independent government entity. Back then, diagnosis and treatment options were scarce. For Echodu, who started experiencing the symptoms one evening after a football match with his friends, the future initially looked bleak.
“I was that young stubborn child, jumping around all over the place, and helping my grandmother in the garden, and taking care of the cattle,” he recalls, adding, “I would go out with friends, dive into rivers and wells, play football and the sorts.”

But after a particular football match, he was limping. 
He says: “I thought it was just fatigue.” 
The next morning, he still had the limp. So, he informed his grandmother, who almost immediately commenced malaria treatment.
“But there was no change,” Echodu remembers, adding, “So my mother was contacted and she brought me on the bus to St Francis Hospital Nsambya [in Kampala] and the doctor told me I had rotten vertebrae.”
After what should have been a routine operation, Echodu spent two weeks in excruciating pain at the hospital. Midway, he got paralysed.

“They had to put a tube in me to draw the pus in me, and after that, I went into paralysis. I tried to get up and I failed. My mother was in tears,” he said.
Nsambya hospital referred him to Uganda Cancer Ward at Mulago when his condition worsened.
“Here, they carried out a test and discovered that I had Burkitt lymphoma. At the hospital, lucky enough, they were in the final stage of the clinical trial for a drug. So my mother accepted that they test the drug on me. The treatment was successful,” he said.

Diagnose early
Dr Noleb Mugisha, a cancer specialist, who heads the prevention division at the UCI, said the burden of cancer among children and adults is on the rise. He said childhood cancer is highly curable. It usually presents in the form of swelling in body parts, persistent fever, difficulties in starting to walk, weight loss, bleeding easily or losing teeth.
“Cancers in children progress much faster, so if they are not treated early, they will die before an adult who developed cancer around the same time,” Dr Mugisha said.

The UCI currently registers an annual average of 700 new cancer cases among children at its facility. The overall survival rate for all types of cancers stands at 50 percent, which is below the 80 percent survival rate in developed countries. The survival rate for adults is much lower, according to experts.
The commonest cancer in Uganda is the cancer of the cervix. Kaposi’s sarcoma, which is cancer that manifests in the skin but it can also manifest in the lungs and intestines, places second. The third commonest is prostate cancer, which afflicts men. Cancer of the breast comes forth, and—contrary to commonly held views—men also suffer from it.

 Cancer causes
Besides genetic factors, cancer specialists say lack of physical exercise, tobacco smoking, alcohol consumption, and increased age at birth of a first child, are the leading causes of cancer in the country. 
The other common causes include treatment with hormone replacement therapy, family history of cancer, HIV/Aids infection, liver disease, and human papillomavirus (HPV).
Dr Henry Ddungu, a consultant at UCI, blames the increase in cancer cases on the adoption of lifestyles that predispose individuals to cancer risks.

“Globally, Uganda inclusive, cancer is increasing. The projection is that cases will increase even more than we are seeing now. We have factors like an ageing population, lifestyle issues where people are not exercising as much as they should yet they are eating foods that are easily absorbed and cause weight gain,” the expert said.
According to available scientific information, cancer can develop at any age. But as one gets older, most types of cancer become more common. This is because body cells can get damaged over time and this damage can then build up as we age. This can sometimes lead to cancer.
Information from www.cancer.org indicates that excess weight causes the body to make and circulate more hormones that can stimulate cancer growth.

Dr Ddungu also notes it is absurd that Ugandans are also avoiding vaccines that shield them from infection-related cancer.
Dr Noleb Mugisha, a cancer specialist told Saturday Monitor that “for all cancers, there is a genetic change that is responsible.”
He added: “Some of these can be inherited but the majority of them develop in an individual. There are risk factors that lead to genetic problems. So we call these risk factors as causes so that the public can appreciate.”

Treatment
Dr Joyce Balagadde Kambugu, the head of the Paediatric Cancer Unit at UCI, said although the machines and drugs are available at UCI, treatment abandonment is one of causes of a high number of deaths among patients.
“We provide free medicines, surgery, radiotherapy and all that, but that is just 50 percent of what the patient needs for a successful treatment. If you live in Katakwi [District, for instance], the transport costs are astronomical and you can’t keep coming back,” she said.

Alex Epedun, 55, a prostate cancer patient from Bukedea District, and his son Gilbert Okalebo, told this newspaper a couple of weeks ago that they decided to sleep outside at the UCI after the doctor advised them to travel back and return for surgery in October.
Okalebo said they cannot afford the transport fare. UCI established a care home three weeks ago for patients like Epedun, but the space is not enough.
 

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