By Aulah Najjuuka
Did you know that out of 100,000 women in East Africa, 29.9 will be diagnosed with cancer, and of those, 15.4 will pass on? According to Breast Cancer Hub, breast cancer remains a critical health issue in the region, with rising incidence and high mortality rates due to late-stage diagnoses and limited treatment access. The numbers reflect significant barriers in early detection and healthcare accessibility. Uganda, for instance, has seen a 4.5% annual increase in cases, as urban lifestyle changes heighten risk factors. Though awareness is improving, only 37.7% of women survive past five years post-diagnosis, largely due to inadequate screening and the scarcity of diagnostic and treatment facilities, especially in rural areas.
Last month, which was Breast Cancer Awareness Month, saw the stories of survivors like Jane Nakaayi take centre stage, offering valuable lessons in courage, early detection, and self-care. For women and young girls across the country, Nakaayi’s journey is a powerful reminder that breast cancer, when caught early, can be treated successfully. Through lifestyle changes and a profound faith, she triumphed over a diagnosis that many find overwhelming.
Nakaayi first realised she had breast cancer in July 2011 when she decided to do a self breast examination and she noticed a lump in her right breast which grew twice in size in just two weeks. After a “biopsy” the results turned out positive for an aggressive type of breast cancer.
“This diagnosis challenged me, but it also strengthened my relationship with God and reminded me of the power of positivity. I was very prayerful and had a positive mindset,” Nakaayi explained, describing how her faith served as an anchor during her darkest days.
A critical diagnosis
Nakaayi’s diagnosis at stage one, the earliest stage of invasive breast cancer, was pivotal in her recovery, allowing her to start treatment immediately. “It was stage one,” she recalls, “which gave me a fighting chance and made all the difference.”
Nakaayi underwent a series of treatments. She underwent three cycles of chemotherapy which were followed by surgery and then three more cycles of chemotherapy. Later she underwent 16 cycles of radiotherapy. “Since the cancer type was aggressive, all the cancer armoury was used in the treatment,” she said.
For Nakaayi, learning her diagnosis early was both frightening and a blessing. She immediately embraced a range of lifestyle changes. “I eliminated sugar, dairy, and meat products from my diet,” she shared. “It was a commitment to my body and my health, one I knew would help me through this journey. I wanted to give my body the best possible chance,” she explained.
When asked about the condition she went through during treatment , she says it was one of the toughest moments of her life and really took a toll on her. “It was a roller-coaster ride. The chemotherapy was really tough! I had wounds in my mouth, my skin darkened, I lost all my hair, lost appetite and vomited quite a lot. The surgery was managed well, the drainage tubes were used for 1 month and removed. For radiotherapy, I had no major side effects. I had low self-esteem when my breast was cut,” she candidly shares.
Nakaayi went for her first cancer treatment known as chemotherapy at Uganda Cancer Institute, Mulago hospital where the three cycles of chemotherapy were provided for freee and then Nakasero Hospital for her surgery and later Aga Khan Hospital Nairobi. “The crowds at Uganda Cancer Institute even in the private wing were quite large, the oncologists were overwhelmed with the numbers, they seldom had time to even eat meals,” she said.
The power of support and positivity
“I had a very strong support system. My husband was there for me throughout the treatment. He got leave whenever I had a chemotherapy cycle, got leave when I had surgery and was with me in Nairobi for one month during radiotherapy,” Nakaayi said. She continues to explain that her mother traveled all the way from Rukungiri to nurse her. Her children, although young then, were also there for her emotionally. Her biggest worry during her treatment was her job but she says her employer was “such a darling” and allowed her to get treatment and recover for close to a year. Nakaayi’s friends and other cancer survivors gave her overwhelming support too and she believes they made her journey a little easier. “Cancer survivors from Uganda Women’s Cancer Support Organisation (UWOCASO) were such a blessing,” she says.
Prayer became a source of strength, allowing her to feel grounded and hopeful amid the uncertainties of her treatment. “I healed very quickly; the doctors were amazed at how fast I healed. I was very health conscious during treatment,” she says.
A call to action
Nakaayi’s story is a timely reminder of the importance of awareness, education, and self-advocacy. Health professionals and awareness campaigns encourage practices such as self-examinations, regular health screenings, and understanding one’s family medical history. Knowing what to look for and acting quickly can be life-saving, as Nakaayi’s early-stage diagnosis exemplifies.
Nakaayi’s message to young women is simple yet profound: be vigilant, take ownership of your health, and believe in the possibility of recovery.
Facts on breast cancer
Q. What is breast cancer?
A. Breast cancer is a type of cancer which begins when abnormal cells in the breast (ducts or lobules) start growing in an uncontrolled way.
Q. How common is breast cancer in Uganda?
A. A total of 2,999 women in Uganda were estimated to have developed breast cancer in 2022. It ranked second among all cancers in women in Uganda.
Q. What are the causes of Breast cancer?
A: There are many causes of breast cancer. These include:
– Lifestyle factors: being overweight; drinking alcohol; not being physically active; eating a high fat diet and not eating a balanced diet.
– Reproductive factors: starting your first period younger than 12 years; being older than 30 years at the birth of first child; not giving birth; not having breastfed; going through menopause after 55 years.
– Family history factors: a family history of breast cancer and/or a particular type of ovarian cancer in first-degree relatives (e.g. mother, sister) on the same side of the family, especially if diagnosed at a young age.
– Personal factors: older age, dense breast tissue, and inherited genetic fault.
– Medical factors: using menopause hormone therapy (MHT), taking the contraceptive that contain hormone oestrogen or progestogen or both for a long time, and having radiation therapy to the chest.
Q. What can I do to reduce breast cancer risk?
– Eat a balanced diet, with adequate fruits and vegetables, and less fat;
– Engage in regular physical activity such as walking, jogging, domestic chores, etc for at least 30 minutes daily.
– Avoid drinking alcohol
Q. What is Breast cancer screening?
A. Breast screening is the process of looking for precancerous breast changes or cancer in women who don’t have any symptoms
Q. At what age should I start to screen for breast cancer and how frequent should I screen?
A. It is recommended that women aged 25 years and above get screened once every year using a clinical breast exam. Women aged 40 years and above should get a mammogram once a year (if the mammogram is available). All adult women are advised to practice for the self-breast exam.
Q. What is a self-breast exam?
A. Checking your breasts yourself once a month to look for signs and symptoms of breast cancer. The best time to examine your breast is at least 7-10 days after completing your menstrual period.
Q. What are the signs and symptoms of breast cancer?
A: In its early stages, some people have no symptoms and the cancer is found during a screening mammogram (a low-dose x-ray of the breast) test. If signs or symptoms occur, they usually include:
– A lump, lumpiness or thickening, especially if it is in only one breast
– Change in the size or shape of the breast
– A change to the nipple, such as a change in shape, crusting, sores or ulcers, redness, a clear or bloody discharge, or a nipple that turns in (inverted) when it used to stick out
– A change in the skin of the breast, such as dimpling or indentation, a rash, a scaly appearance, unusual redness or other colour changes
– Swelling or discomfort in the armpit
– Ongoing, unusual pain that is not related to your normal monthly menstrual cycle, remains after your period and occurs in one breast only.
Note: Most breast changes are not caused by cancer. If you have symptoms, visit your nearby hospital without delay.
Provided by Dr Alfred Jatho of Uganda Cancer Institute
