How to survive some of the lethal cancers

Dr Moses Galukande 

In Uganda, where access to specialised healthcare is limited for many, early detection of cancer can mean the difference between life and death. 

Some cancers are particularly elusive, showing no clear signs until they reach advanced stages. This makes treatment expensive, outcomes poor and survival rates low. 

In Uganda, nearly seven to eight out of 10 people with cancer will have advanced disease by the time they reach a facility capable of managing it. 

Recently, a colleague came to see me due to persistent chest pain, which he assumed was a result of a seatbelt injury from a recent accident. 

When the pain persisted for three weeks, we decided to do a CT scan to rule out rib fractures. To our surprise, we detected an early-stage lung cancer that had otherwise been silent. 

He underwent surgery and is now doing well. Around the same time, another colleague presented with a bowel obstruction, which tragically turned out to be late-stage pancreatic cancer. 

Unfortunately, he did not survive. So, which cancers are the most elusive? Why are they caught late? Why is treatment so expensive? Who is at risk and what can you do to improve your chances of early detection? 

Pancreatic Cancer Pancreatic cancer is often called the “silent killer” because it exhibits almost no symptoms in its early stages. 

By the time signs such as yellowing of the eyes, weight loss, and severe abdominal pain appear, the cancer is usually in an advanced stage. 

Both men and women are equally at risk, with cases peaking between the ages of 65 and 80. However, although rare, younger individuals under 50 can also be diagnosed with it. 

Those with a close family history of pancreatic cancer are at a higher risk. The late detection of pancreatic cancer is primarily due to its location deep within the body, making tumours difficult to detect through physical examination. 

Early symptoms are vague and easily mistaken for common digestive issues. Furthermore, there are no readily accessible routine screening tests for pancreatic cancer in Uganda. 

While an MRI scan can offer early detection, the few available in public hospitals are overwhelmed with routine diagnostic cases. Additionally, patients are required to pay for the service. 

Surgical removal of pancreatic tumours is highly complex, requiring skilled specialists and expensive surgical supplies. Chemotherapy and radiotherapy — essential for advanced cases — are costly, require multiple sessions, and necessitate new diagnostic tests before each treatment cycle. 

For those with access and the discipline to undergo regular check-ups, early detection is possible through advanced imaging such as CT scans and MRIs. 

After the age of 60, it is advisable to have at least one MRI scan every two to three years. 

In the private sector, this test costs sh800,000 per scan. Preventative measures include maintaining a healthy diet and avoiding smoking, which is a major risk factor. 

Anyone experiencing persistent abdominal pain, jaundice, or unexplained weight loss should seek immediate medical advice.

Your health is in your hands 

Early detection significantly improves survival rates. Paying attention to your body, undergoing regular medical check-ups, and seeking prompt medical attention for unusual symptoms can make all the difference. Act early — it could save your life. 

Ovarian cancer

Ovarian cancer symptoms include bloating, abdominal discomfort, and frequent urination. 

These symptoms closely mimic common conditions, making early detection difficult. Because they are mild, they are often ignored. 

There are no routine screening tests readily available in most Ugandan hospitals. 
While pelvic exams and ultrasounds are accessible in many facilities, they are not commonly performed unless a patient presents with symptoms. 

Treatment for ovarian cancer requires surgery, chemotherapy, and sometimes targeted therapy. 

Specialised tests to confirm the diagnosis are costly. Women with a strong family history of ovarian or breast cancer should consider genetic testing. 

Regular check-ups with a gynaecologist are also recommended. Persistent bloating, changes in urination or pelvic pain should not be ignored. If you have a family history of ovarian or breast cancer, seek medical advice promptly. 

The writer is a professor of surgery.