Fighting Cancer in Africa - Voices of doctors and patients (IAEA) April 2006
Which cancers are on the increase?
Dr Joseph Kigula: Senior Consultant Radiotherapist
Summary:
In Uganda cancer is on the increase. While this may be partly explained by an increasing population, Dr Joseph Kigula, Senior Consultant Radiotherapist at Mulago Hospital in Kampala explains that the incidence of breast cancer has doubled over the last 20 years and women who are developing cancer of the cervix are increasingly younger and suffering more aggressive forms. With only one treatment unit in Uganda, he estimates that there are 20,000 cancer suffers who could be diagnosed and treated if Uganda had more equipment and treatment units.
Suggested introduction:
In Uganda, as elsewhere in Africa, the rate of cancer is increasing. In Uganda in 2005 it was estimated that there were 21,000 new cases due, in part, to an increase in life expectancy. However, about 60% of these cases would benefit from treatment with radiation. Currently the only place for treatment is the Mulago Hospital in Kampala where Senior Consultant Radiotherapist Dr Joseph Kigula has been working since the unit was set up with the support of IAEA (the International Atomic Energy Agency) a decade ago. As the number of patients rises he would like to see more treatment units available throughout Africa.
Susie Emmett met Dr Kigula at the beginning of another busy day in the department and began by asking how much is understood about why cancers start?
Tape in:
We understand the process but why...
Tape out:
...this is where we hope to go.
Closing Announcement:
A media toolkit for reporting on cancer and its treatment. This pack has been produced for the International Atomic Energy Agency (IAEA)
Transcript
Dr Kigula
We understand the process but why it does take place is much more difficult. Because all the time cells are dying and new cells are being formed and this process is very well controlled normally. But for some reason something goes wrong with that control, normal control by the body and the cells now just continue dividing without control. That is when they become cancerous.
Emmett
Are you seeing an increase in the number of cases of cancer?
Dr Kigula
Yes we are, we are seeing an increase but of course the population has been growing. When we started in 1988 Uganda had a population of about 15-20 we are now at about 26 million. The commonest cancer in the radiotherapy department is cancer of the cervix. Almost 40% of all the patients that we treat have cancer of the cervix.
Emmett
Can you explain what cancer of the cervix is? Where is it, what is it?
Dr Kigula
The cervix is the opening of the womb, this is where the cancer starts, it is in women. It usually comes in the age between 40-50 and above, but of recent we are seening much younger women in their twenties and in their thirties, and a very aggressive, very rapidly developing cancer. But even other cancers like cancer of the breast, the incidence over the last 20 years has more than doubled, cancers in the throat, that is another relatively common cancer that we are seeing.
Emmett
So how do people suspect, what are the symptoms that people can notice if cancer is a possibility?
Dr Kigula
Yes, that is a good question. Unfortunately, it is very difficult for me to describe because unlike HIV/AIDS which is one illness, cancer is not really one illness. Depending on where the cancer is starting, the patients do get symptoms get signs, related to that cancer.
Emmett
But with early diagnosis cancer can very often be treated successfully?
Dr Kigula
Yes, cancer can be cured. Not just treated but you give the treatment and you know that this patient has got a cure. Unfortunately for us in Africa, 80% of our patients come late, the chances of getting a cure become much less.
Emmett
Cancer may be treatable but the treatment, the equipment, radiation therapy, is quite an expensive business. The equipment is expensive and health departments, hospitals like this one here in Kampala, health ministries have lots of things that they need to be spending their health budgets on?
Dr Kigula
Completely and maybe the story in Kampala illustrates what is happening in many African countries. The department was actually started with a grant from the International Atomic Energy Agency. They gave us a grant worth one million dollars. They gave us treatment planning facilities and put a lot of us back to school to gain skills and knowledge which we did not have. And that was 1990-1995. Last year we treated more than one thousand, one hundred patients which was the highest we have ever treated. But we want to do more because in our estimate there are twenty thousand patients where if we had the facilities we would be able to diagnose and treat. So we are making a very ambitious plan to expand facilities all over the country. First in Mulago to get more equipment, right now we have one equipment and if it fails, breaks down for some reason it means that treatment cannot be given. We need at least three, one as a back up and another one with more facilities than the one which we have and the money is not there. We hope this money will be somewhere; we do pray it does come. But in the next 5-10 years this is where we hope to go. End of track
