MULAGO: Uganda Cancer Institute in senstisation drive Cancer has become an important health problem in Uganda, as more and more cases are being detected.

1. In thispiece the UgandaCancerInstitute’s Dr. JacksonOrem answersFAQ’s from the publiconthe
disease.
1. Is cancer an epidemicinUganda?
There isa verydifferentdefinition we canuse insteadof epidemic. However,if we are sayingthatthere
isa bighealthproblemin Uganda,to thatI agree entirely.
2. Whyisn’t there a simple universal testfor cancer?
Cancer comprisesof 133 diseaseswhichmeansthatthere are different typesof cancer.Itis reallya
difficulttask.It’sbetterforusto identifyeachof themindividuallyso thatwe can single themoutand
effectivelycontrol them.It’sbothanadvantage anda disadvantage. It’sanadvantage inthe sense that
we can actuallycontrol themvery effectivelyif we know eachone of them.
3. Whydoes the diagnosisseemto be delayedin many cases?
One of the biggestproblemswe have isthatthere islackof awareness. Patientscome verylate andthey
don’tknowwhatto do by the time theycome to Uganda CancerInstitute,theyhave gone tosomany.
We needtoevolve asystem where people caneasilyaccess care.ThisiswhatUCI is tryingto do and if
youcome anyday of the week,we canhelpyouexpedite yourdiagnosis.
4. Whyare olderpeople more prone to cancer in general?
One of the importantthingswe shouldknow aboutcanceristhat, cancer developsasone ages.One of
the systemsinour bodiesthat mirrorthisisour immune system.Immunityisveryimportantinthe
fightagainstcancer.As one agestheirimmunityalsogoesdownand thatis whythe riskof getting
cancer ishigherinolderpopulations. However,inUganda,we alsosee thatcancer manifestsearlyin
children.
5. How is survival measured?
Survival ismeasuredbywhatwe call a rate. Inthat rate,we usually use five years.If forinstance Itreat
youof cancer and youare able tolive upto 5 yearsaftertreatment,thenyour5 year survival isactually
100%. That ishow we measure it.We measure survival bythe durationone livesfollowingadiagnosisor
a treatmentof cancer.
6. I needmore clarity on HPV vaccination.
Human papillomavaccinationisa vaccine that hasbeendeveloped againstthe cause of cervical cancer.
Thisis giventoyounggirlsbelow the age of 12, but thatdoesn’t meanthatit isonlygirlswhocan
actuallybenefitfromthis.Even boyscanactuallybenefitfromitbut[because of] the costour policy
prioritisesyounggirls
7. How is passive smoking a risk factor for cancer?
What smokingdoes,whetherit’spassiveoractive isthat yougetinto your body nicotine whichis
carcinogen.Thisisa substance that can leadto causationof cancer irrespectiveof the meansyougetit
intoyour body.However,carcinogensare verypowerful andcaneasilylead tocancer.Shisha,cigarette
or pipescan all leadtocancer.

2. 8. Is there any screeningdone on lymphomaat the Institute?
Lymphomaisnot one of the mostpopular cancersamenable toscreening, butif youhave anythingthat
suggeststhatyou have a swollenlymph node,youbettercheckwiththe doctor.It could possiblybe a
lymphoma.Examiningthe swollenlymphnode canhelpinearlydiagnosis of lymphoma.
9. Whenshouldwe expectto have a fullyfunctional cancer unitin Gulu,Arua, Mbale,Jinja and
Fort portal?
We alreadyhave a functional cancer institutecentre inMbarara.We are in the processof settingup
anotherfunctional cancercentre in Gulu;actually,it’salreadyinhighgear.We are alsoplanningto have
anothercentre inArua and we are doingthe preliminary investigations forhavingdesignatedlandand
the space thatwe need tosetup that particularcentre.The same isalsofor Mbale.Those
are the fourcentresthat we wantto start withand we are hopeful thatinthe nexttwoyears,we should
be able to have some functionalityinthose centres.
10. What is the Cancer Institute doing about childhoodcancers?
One of the bestserviceswe have atthe UCI is [the treatmentof] childhoodcancers.The improvement
and cure rate is nowincreasing
dramatically.We are developingour humanresource capacity.We are now trainingand nextmonthwe
shall start graduatingpaediatriconcologists.A lotisbeingdone.We have mountedprogramsof
sensitizationtoo.
11. What are some of the fundinggaps?
The Uganda governmentisalreadydoingalot.In a year,at the UCI, we needupto 120bn inorderto
optimallycarryoutour functions. Thisfinancial year,we are gettinguptohalf of that amount.If there
are partnerswhocan helpwiththatwe have mechanismsinwhich we can helpbringthemonboard.
We are alreadyworkingwithverymany othersandwe expectmanymore otherpeople tojoin.
12. Have you had any cases of people healedofcancer in Uganda?
Thisis somethingyouneedtosee foryourself.There are verymany people whohave beencuredof
cancer inUganda and here at the UCI. Nextmonthwe are goingto have a survivors’monthyoucan
come and meetpeople whohave beencuredof cancer.There will be manypeople whohave finished
universityandhad children;youshouldbe able to meetthemtosee proof thatcancer isa curable
disease.
13. What causesLeukaemia and is there a chance to cure it?
Leukaemiaisone of the easiestcancerstocure and inmostcases our patientsdonot understandthis
and theycome verylate.If there are people whohave anyproblemi.e.anaemia,weaknessorlossof
blood, theyshouldsuspectleukaemiaandcome toUganda cancer Institute sothatwe can make a
diagnosis.
14. Does Anal itchingmean cancer?
Notnecessarily.There are manycausesof anal itchingandof course it maybe a resultof anything.It
doesnotnecessarilymeanthatthis iscancer.

3. 15. The cost of cancer treatment is keepingaway many patientswho die inpain due to non-
treatment,what is your take on this?
Thisis true;we are goingto make sure that the people whocome tous at the UCI getsome of these
drugsso that we remove thisbarrierto treatment.We shouldappreciatewhatourgovernmentis
alreadydoingbecause there isaspecificbudgetthatthe governmenthasgivenforprocurementof anti-
cancers andwe are goingto make sure that as much as possible people cangetaccessto the treatment.
16. Is radiotherapy reallyworking?
Yes,it’s!We closeddownslightlybecause of maintenance;however,we are inthe processof acquiring
newmachines. Inthe nextfewmonths we shouldbe able toacquire a more advancedmachine thanthe
one we have currently.
17. What are the cancer risk factors?
The risk factorsare many.It can be infection,environmentalfactors, itcanbe age,can be anything.
There are manyriskfactors. Infection canalsobe throughthe HPV virus that can cause cervical cancer.
Otherinfectionscanbe cancerof the stomach bybacteria.Lifestyle factorscanalsobe throughtobacco
whichbecomesalifestyle riskfactor.Alcohol alsocausescancerof the liver.
18. How is UCI doingcancer awareness?
We have a whole deploymentcalledthe comprehensive communitycancerprogramwhichgoes
throughoutthe country.On Sundayduringthe physical activityevent,patientstoocanjoinus.
19. Is screeningfor cancer free?
At UCI screeningforcanceris free.
20. What wouldit take for someone to escape?
Early screeninghelpsdetectthe disease initsearlystages.If you screen,evenif itisjustonce, you
reduce yourriskof cancer,very considerably.
CompiledbyChristine Namulindwa,
PublicRelationsOfficer
Uganda Cancer Institute