Speciosa Kabwegyere
15 October 2007
opinion
Kampala — EVER imagined that life can be as normal as before after one has been diagnosed and treated for breast cancer? Did you know that given short intervals to rest during treatment, patients can even continue to work while undergoing breast cancer treatment?
The prevailing attitude when one is diagnosed with breast cancer, and indeed most cancers, is apprehension, despair, hopelessness and coming to terms with the prospect of quitting this world. Being diagnosed with cancer often evokes reality of death, bringing it closer and sooner.
Not surprising because statistics indicate that 75% of the women treated for breast cancer die within two to three years. The contrary occurs in the developed world, where the survival rates range between 70-90%. The major explanation for the Ugandan scenario, and indeed other less developed countries, is late diagnosis and treatment. This means that by the time the patient is diagnosed, the cancer cells have spread from the breast to other parts of the body such as the lymph nodes in the armpit, the lungs, the bones, the liver and other vital body organs.
In addition to the physical impact of breast cancer, there is the social dimension. The thought of being without a breast or breasts, the most important feature of womanhood, is devastating. But this is particularly intense in our setting, where breast reconstruction is done at a very small scale because of late reporting.
Coming to the quality of life
In countries where survival rates are high, life remains as normal as it was before treatment. At international breast cancer conferences, the topics covered are both medical and social such as childbearing after breast cancer treatment, sexuality, breast reconstruction, looking good and feeling better, supporting partners and family, and exercise as a way of decreasing the risk.
In Uganda, the situation is different - a life full of despair and resignation. This is mainly due to poverty, lack of awareness and inaccessibility to medical care.
Statistics show that breast cancer in Uganda is the third commonest cancer in women, coming only next to cancer of the cervix and Kaposi's sarcoma. Unfortunately, the cases are often seen in late stages thus the outcome of treatment is inevitably unsatisfactory. Since there is no effective primary prevention of the disease, it is imperative that efforts should be made to detect the disease in its early stages. Mammography has been found to be useful, but it is not applicable as a means of mass screening in Uganda, and, at sh550,000 per screening at Kampala Imaging Centre, sh30,000 (for general) and sh50,000 (private) at Mulago Hospital, it is quite unaffordable for the average Ugandan woman. Public education towards Breast Self Examination (BSE) should, therefore, be propagated because it is practical and affordable.Remember when diagnosed and treated early, breast cancer can be cured.
The writer is a breast cancer survivor and chairperson, Uganda Women Cancer Support Organisation
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