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Cancer Institute struggles on 50 years later

Poor funding undermining cancer research and treatment

Kampala, Uganda | FLAVIA NASSAKA | Dr. Jackson Orem, the Executive Director at the Uganda Cancer Institute (UCI) was still a student in August 1967 when the facility opened at Mulago Hill North of Kampala city.

Founded with an aim of researching and eventually finding best treatments for cancer, UCI was initially named Lymphoma Treatment Center because at the time there was this unusual tumor that mostly affected children around the jaw and abdomen area– experts call it Burkitt’s lymphoma.

Five years after its formation, the institute was already a hub of cutting edge research and won a popular Lasker award an equivalent of the Nobel Prize now for excelling in handling lymphoma cases.

“Ugandan researchers under the leadership of Prof. Charles Olweny were the first group to show that liver cancer could be treated by chemotherapy successfully,” Orem said before quickly adding that that good start was short lived owing to a funding crisis and the loss of interest by medical students in the specialty following the departure from Uganda of international researchers in President Idi Amin’s era.

Funding for the facility has increased over the years from Shs. 10.4 billion in 2013/14 to Shs. 45.44 billion in 2017/ but Orem says this is like a drop in the ocean given the institute’s mandate. “It is not even enough for treatment and the day to day operations,” he told The Independent.

Yet because of the nature of cancer, research is everything– the cancer they knew in the 70’s, Orem said, is quite different from what doctors are realizing today. Because cancer is always evolving, the oncologist’s main puzzle is stopping cancerous cells from growing out of control. Many fight a losing battle that even with treatment, 78% of those diagnosed still succumb. This is at the heart of why the institute was founded in the first place.

“We now understand that cancer is not simply about cells growing out of control but about one’s personal characteristics and many other diseases” Orem told The Independent, “Researchers previously focused on treating tumors. We have now enlarged our scope to focus on other critical features such as an individual’s genetic makeup.  We have found that even if both individuals have the same cancer say of the breast, they may need different treatment interventions”.

Focus on personalized care

A study on molecular characterization of some cancers is currently on going. Dr. Noleb Mugisha an oncologist at the Institute says they are moving into personalized cancer care where they want to treat the disease according to the biology of the person having it.

“We get a tissue from a cancer swelling and analyze it genetically to determine which genetic mutations are in that tumor,” Mugisha said, “We have already realized breast cancer here is not the same as that in the US”.  He added that they are now discovering this even in lymphoma – cancer that affects the lymph nodes, cancer of the cervix and that of the vulva.

“If we analyze this we will be able to know which drugs will work,” he said, “We will have information to conclude that majority of our breast cancer cases for instance have these characteristics”.

In other two studies – that of cervical cancer and Omega-3, they have had interesting findings that could reduce the burden. Mugisha says they have found that omega -3 fats greatly reduce the incidence of Kaposi Sarcoma that commonly affects people living with HIV because the cancer develops on blood vessels and these oils make blood vessels healthier. In cervical cancer, they have found girls who start sex early at 17 are three times more likely to present with cancer of the cervix than those who begin late. The good news in this study is they have found that the incidence of the disease is on a decrease especially in urban areas.

Orem says these studies are guiding them on which way to go to defeat the tumors now that the disease is increasingly becoming the country’s biggest health scare where out of every 100,000 people, 300 have newly diagnosed cancers yet in 2008 the figure was 199 out of every 100,000 people.

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