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How early breast cancer screening saved a nurse’s life

Beatrice Agik, Nursing officer Gulu University Health Center II

Gulu, Uganda | THE INDEPENDENT | In April 2018, Beatrice Agik, a nursing officer at Gulu University Health Center II decided to perform a self-breast examination for breast cancer together with her daughter out of curiosity at their home in Gulu City.

Agik was revising ahead of her exams, just a month after finishing a class presentation on breast cancer from Makerere University where she was pursuing a master’s course in midwifery. In her revision, she intended to demonstrate to her daughter how to conduct a self-breast examination for early detection of breast cancer.

“We all exposed ourselves, I said look at your breasts. First of all, see whether the sizes of your breasts are the same, and you should always be monitoring and following that the breast sizes are the same, and the skin color is consistent,” she said.

Adding “So we went on the palpation side of it. I demonstrated to her how she should be palpating her breasts periodically. So, she did hers, and it was natural,”

Agik later turned to conduct the same examination on her breasts unaware the outcome could turn upsetting.

“In the process, as I was demonstrating to her how to do it, that’s when I realized a mass in my breasts. It was a painless mass, so I requested her to try to palpate what I was feeling and that’s when she touched and found a mass,” said Agik.

According to Agik, the discovery of the mass on her left breast prompted her to conduct a further medical examination at the hospital.

Days later, Agik met a doctor at Mulago National Referral Hospital who recommended an analysis that included mammography, pancreas imaging, and fine-needle aspiration, in which a cell sample from a suspicious lump is removed for testing. According to Agik, the analysis all pointed she had stage one breast cancer.

Following the diagnosisAgik informed her family about her condition and prepared herself mentally to cope with the situation.

After starting treatment following referrals from Mulago National Referral Hospital to St Mary’s Hospital Lacor in Gulu City, Agik finally had a successful surgery that saw her left breast removed in June 2018. In September same year, Agik started Chemotherapy treatment at St Mary’s Hospital Lacor and later completed radiotherapy in June 2019.

She would later continue with oral chemotherapy and hormonal treatment while being monitored by doctors who considered the treatment successful since it was only at stage one.

However, in 2022, Agik realized an itching on her remaining right breast but when she went for a mammography test, no lesion was found in the breast. She notes that a fine needle aspiration test conducted at first turned out negative but on the second test, she was found positive for stage one breast cancer.

Considering cancer can spread fast, Agik accepted that her breast be removed for curative measures.

She says the surgery however didn’t go to plan after the wound developed infections leaving her hospitalized for eight months at St Mary’s Hospital Lacor. Agick says after healing, another test was conducted which turned out negative although she is continuing with oral treatment and scheduled appointments with her doctors.

According to Agik, while she didn’t suffer much psychologically and wasn’t affected by treatment effects, the treatment processes that went on for the past seven years took a toll on her finances.

She notes that she was forced to claim her savings from the National Social Security Fund (NSSF) after failing to meet some financial obligations and selling part of the family land to meet treatment costs.

Agik who is currently the acting in charge of Gulu University Health Center II says if it weren’t for the early detection of breast cancer, her situation would have been worse and encouraged women to embrace early screening for cancer.

“I encourage people to come for wellness diagnosis even if you are not feeling any symptoms once in a while, most especially for those who sit in offices. I would encourage people after three months to come and do a blood check, blood chemistry, ultrasound, do those various minimal screenings to check your wellness,” she said.

Agik is also the Uganda Women’s Cancer Support Organization (UWOCASO), an organization started by breast cancer survivors to fight cancer in the country. She is among the eight breast cancer survivors trained by the organization to offer psychosocial support to cancer patients and their families within the Acholi Sub-region.

Breast cancer remains among the top five leading cancer cases after cervical cancer registered among females within the Acholi Sub-region.

The Gulu cancer registry located at St Mary’s Hospital Lacor in its annual 2021/22 Financial year report shows over 4,008 cancer cases had been registered from 2013 to 2022.

The report shows that the top female cancer cases were Cervical Cancer which accounted for 39.5 percent, Breast cancer 17.5 percent, non-Hodgkin’s Lymphomas 6.7 percent, Liver 5.3 percent and Ovarian Cancers 2.9 percent.

Medics however say the fight against cancer is being hampered by the failure of the locals to conduct early cancer screening.

Dr. Moses Echodu, the program director of Uganda Child Cancer Foundation notes that late diagnosis among the majority of Ugandans remains a hurdle in reducing deaths from treatable cancer cases.

He says while women tend to embrace early screening for any health complications, the burden remains with men who most of the time shy away from screening a move that affects the survival rate of cancer patients.

According to a 2022 report from the Uganda Cancer Institute on the status of cancer, the country registers an estimated 30,000 cancer cases annually but loses about 21,000 patients. Out of the total number of new cancer cases registered, about 7,000 only make it for treatment at the cancer institute.

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