Uganda Cancer Institute Board Chairman Prof. William Bazeyo (in hat) addresses UCI board members during a monitoring visit to the Northern Regional Cancer Center in Gulu City.
By Brian Komakech
Gulu: The new Cancer Center in Gulu City is boosting the diagnosis of cancer, and revealing the increasing cases of the disease burden in the Acholi Sub-region.
The shs30bn regional cancer center constructed by the Health Ministry started partial Outpatient Department (OPD) services in July 2023.
The facility with state-of-the-art medical equipment is meant to offer services such as cancer awareness, detection, treatment, and palliative care to individuals all over Northern Uganda.
Statistics compiled within the past nine months since it started partial operations show a grim image of the cancer burden in Northern Uganda, with the Acholi sub-region leading in new cancer cases.
According to reports obtained by the Greater North News Agency (GNNA), the health facility received 377 clients in the OPD between July 2023 and April 11, 2024.
The reports indicate that out of the 377 clients screened, 221 were diagnosed with different types of cancer, 62% were females and 38% were males.
The top five leading cancer cases registered at the facility are cervical cancer, contributing 19% (48 patients), 32 patients (14.5%) were diagnosed with breast cancer, and 26 patients (11.8%) had cancer of the esophagus. Head and neck cancer had 19 patients (8.6%) and 19 patients (8.6%) had prostate cancer.
Amos Obote, in charge of the Northern Regional Cancer Center, told GNNA in an interview that the cases diagnosed were new and hadn’t yet been registered with the Uganda Cancer Institute (UCI).
Obote revealed the majority of those with cancer of the cervix were registered in the third quarter between January and March this year, apparently after information about the center opening its doors reached the community.
Statistics reveal that 91 of the confirmed cancer cases were from the Acholi Sub-region, 19 from the Lango Sub-region, 11 from West Nile, three from the Teso Sub-region, 6 foreign nationals, and five from other regions.
Why high Cancer of the Cervix cases?
Obote explained that whereas many health facilities have stock of the Human papillomavirus (HPV) vaccine, few girls and young women turn up for the vaccine or finish the second dose, leaving them vulnerable to cancer of the cervix.
The Health Ministry since 2015 has been targeting young girls between 6 and 14 and young women with the HPV vaccine for the prevention of cervical cancer, one of the leading cancer killers among women in the country.
“If they had a chance to get vaccinated at the time when they were girls, they were going to get immunity against the Human papillomavirus and the chance of developing cervical cancer would be low,” said Obote.
Obote said the current statistics of cancer cases are just the tip of the iceberg of the burden of cancer in the region, adding that once fully operational, the cancer center is expected to see a sharp rise.
“What you are seeing is just the tip of the iceberg. People have just walked there themselves. What if we had run camps here, what if we have run awareness here? You will see the numbers of people who are coming up,” he said.
Government focusing on prevention
Dr. Charles Olaro, the Director of Curative Health Services at the Health Ministry noted that the government’s focus at the moment is on preventive measures to ensure cancer cases especially cervix cancer are curbed.
Dr. Olaro said that although the government has established the cancer treatment facility, without preventative measures in place such as vaccination, the numbers will gradually overwhelm the facilities.
He called on the population, especially women, to embrace early screening for cancer to avoid the burden of showing up when symptoms have started presenting at late stages.
“Cancer of the cervix is prevented by vaccinating girls either at Primary, at Primary four, or at 10 years up to 14 and the vaccines are there. As a country, we have been using this vaccine since 2017. The vaccine has also been in use since 2006, it’s a safe vaccine,” said Dr. Olaro.
“Most cases we are seeing come at stage four. At stage four, what we can only do is palliation, and yet we can’t improve the outcome. We encourage early screening for women. At least every two years while HIV patients should conduct screening once every year,” he added.
Cervical cancer remains one of the commonest and leading causes of cancer morbidity and mortality in women in Uganda with an estimated 6,959 new cases and 4,607 deaths recorded in 2020, according to the April 2022 Journal of Global Health report.
Between 2012 and 2021, the Uganda National Institute of Public Health report for December 2022 indicated that the country had registered 14,257 cases of cervical cancer.
Ray of hope for northern Uganda
Dr. Jackson Orem, the executive Director of the Uganda Cancer Institute told stakeholders at a monitoring visit to the Northern Region Cancer at the weekend that the region will greatly benefit from timely diagnosis and reduced expenditure on cancer treatment.
Dr. Orem said that whereas the country registers up to about 30,000 cases of cancer each year, only between 7,000 and 8,000 turn up for treatment at UCI. He noted that 85 of the new diagnoses are from the countryside and can’t afford treatment costs adding that the regional center is now a beacon of hope for them.
“By having this center here, we shall reduce the percentage, because people will come and get their treatment near their homes. This means that treatment adherence will be better and the outcome will be better because people will get effective treatment for their cancer,” Dr. Orem said.
The Northern Regional Cancer Center will offer specialized cancer services to clients in the entire northern region, with some clients, also expected to come from parts of South Sudan.
The first phase of the facility, according to architects, is already 90% with board members expecting it to fully start operating by June this year.
The facility has already been equipped with a state-of-the-art digital x-ray machine, CT scan, mammography for early breast cancer detection, three functional theaters, a general ICU, Roche Cobas E411 and Cobas C311 machines for tumor and thyroid and liver, and kidney analysis respectively.
However, during a monitoring visit by UCI board members on Friday, numerous challenges were raised that could jeopardize the full operation of the facility come June and its anticipated expansion.
Limited land
Dr. Orem told board members that the government intends to establish a fully-fledged cancer hospital but noted that the facility currently occupies only 4.5 acres of land out of the needed 10 acres.
In its current phase, the government has so far established a mini OPD, a pharmacy, radiology, a small laboratory, and wards consisting of three private rooms, three theaters, a general ICU, a cafeteria, a laundry, and a mortuary.
According to Ddamulira Julius, an architect at UCI, the government has proposed to construct a four-story facility consisting of the main hospital, an extension of the radiology unit for the MRI suite, the main OPD, an emergency unit, a general infusion and administration unit, and private wards.
In the third phase of the project, the government has proposed the construction of the Radiotherapy facility, radiotherapy ward, pediatric ward, High Dependency Unit (HDU), and a fully equipped clinical laboratory.
This second and third phase of the proposed project according to UCI officials however hangs in balance due to a lack of land for the completion of the cancer center.
Staff shortage
Hellen Akello, the Human Resource Officer at UCI revealed that key positions at the Northern Regional Cancer Center remain vacant despite an application call recently issued to the public.
According to Akello, two positions for consultant oncologist, a medical officer special grade, and an anesthesiologist are vacant after no candidate applied for them recently.
Currently, the facility is operating with a skeletal team of 16 staff consisting of two medical officers, a nursing officer, a pharmacist, two laboratory technologists, and a medical imaging technologist among others.
In November last year, the Uganda Cancer Institute in partnership with Cincinnati University surgeons performed head and neck surgeries worth millions of shillings for free to over 13 cancer patients at the Northern Regional Cancer Center.
