Cancer happens when normal cells become cancerous cells that multiply and spread.  The top five cancers in Uganda inludes:

• Kaposis sarcoma (KS): Kaposi's sarcoma is a type of cancer that forms in the lining of blood and lymph vessels. The tumors (lesions) of Kaposi's sarcoma typically appear as painless purplish spots on the legs, feet or face. Lesions can also appear in the genital area, mouth or lymph nodes.

• Cervical cancer: A malignant tumour of the lower-most part of the uterus (womb) that can be prevented by PAP smear screening and a HPV vaccine. There may be no symptoms. In a few cases, there may be irregular bleeding or pain.

• Breast cancer: Breast cancer can occur in women and rarely in men. Symptoms of breast cancer include a lump in the breast, bloody discharge from the nipple and changes in the shape or texture of the nipple or breast. Treatment depends on the stage of cancer.

• Prostate cancer: A cancer in a man's prostate, a small walnut-sized gland that produces seminal fluid. A man's prostate produces the seminal fluid that nourishes and transports sperm. Symptoms include difficulty with urination, weak urine stream, frequent urination, intermittent stream, nocturia, urgency, hematuria, lower back pain but sometimes there are no symptoms at all. Some types of prostate cancer grow slowly.

• Non hodgkin’s lymphoma (NHL): Cancer that starts in the lymphatic system. The condition occurs when the body produces too many abnormal lymphocytes, a type of white blood cell. Symptoms include swollen lymph nodes, fever, stomach pain or chest pain.

Lung cancer is the leading cause of cancer related deaths in Uganda and the two groups hardest hit by cancer are the children under age of 12 and middle aged adult. Nearly one third of patients diagnosed with cancer are infected with HIV

Early detection and innovative treatments are curing cancer and helping people with cancer live longer.

What is cancer?
is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body.
 

What is the difference between a normal cell and a cancerous cell?
Normally, cells follow instructions provided by genes. Genes set down rules for cells to follow, such as when to start and stop growing. Cancerous cells ignore the rules that normal cells follow:

• Normal cells divide and multiply in a controlled manner. Cancerous cells multiply uncontrollably.

• Normal cells are programmed to die (apoptosis). Cancerous cells ignore those directions.

• Normal cells for solid organs stay put. All cancerous cells are able to move around.

• Normal cells don’t grow as fast as cancerous cells.

How does cancer start in your body?
Cancer starts when a gene or several genes mutate and create cancerous cells. These cells create cancer clusters, or tumors. Cancerous cells may break away from tumors, using your lymphatic system or bloodstream to travel to other areas of your body. (Healthcare providers call this metastasis.

For example, a tumor in your breast may spread to your lungs, making it hard for you to breathe. In some types of blood cancer, abnormal cells in your bone marrow make abnormal blood cells that multiply uncontrollably. Eventually, the abnormal cells crowd out normal blood cells.
 

How common is cancer?
It is predicted that the incidence rate of breast, prostate and cervical cancers will increase, and KS and NHL incidence rates will decrease as of 2030 (Judith et al, 2022).

What are cancer symptoms?
Cancer is a complicated disease. You can have cancer for years without developing symptoms. Other times, cancer may cause noticeable symptoms that get worse very quickly. Many cancer symptoms resemble other, less serious illnesses. Having certain symptoms doesn’t mean you have cancer. In general, you should talk to a healthcare provider anytime there’s a change in your body that lasts for more than two weeks.

First symptoms of cancer
Some common early cancer symptoms include:

• Unexplained weight loss.

• Chronic tiredness.

• Persistent pain.

• Fever that occurs mostly at night.

• Skin changes, particularly moles that change shape and size or new moles.

Left untreated, cancer may cause additional symptoms, including:

•  Bruising or bleeding more easily.

• Lumps or bumps under your skin that don’t go away.

• Difficulty breathing.

• Difficulty swallowing.

What causes cancer?

Cancer is a genetic disorder. It happens when genes that manage cell activity mutate and create abnormal cells that divide and multiply, eventually disrupting how your body works.

Medical researchers estimate 5% to 12% of all cancers are caused by inherited genetic mutations that you can’t control.

More frequently, cancer happens as an acquired genetic mutation. Acquired genetic mutations happen over the course of your life. Medical researchers have identified several risk factors that increase your chance of developing cancer.

Cancer risk factors you can control

• Smoking: Smoking cigarettes and cigars and using e-cigarettes increases your chance of developing lung, pancreatic, esophageal and oral cancer.

• Diet: Eating high-fat or high-sugar foods can increase your risk for many types of cancer. You’re also more vulnerable to disease if you don’t get enough exercise.

• Environment: Exposure to toxins in your environment - such as asbestos, pesticides and radon - can eventually lead to cancer.

• Radiation exposure: Ultraviolet (UV) radiation from the sun significantly increases your risk of developing skin cancer. Over-exposure to radiation treatment can also be a risk factor.

• Hormone therapy: Women and people AFAB taking hormone replacement therapy may have an increased risk for breast cancer and endometrial cancer.

How can I reduce my risk of developing cancer?

You can reduce your risk by changing some of your lifestyle choices:

• If you smoke or use tobacco, try to stop. Ask a healthcare provider about smoking cessation programs that can help you quit tobacco.

• Follow a diet plan that’s healthy for you. If you want help managing your weight, ask a healthcare provider about nutritional guidance and weight management programs.

• Add exercise to your daily routine. Exercise may boost your immune system so it provides more protection against cancer.

•  Avoid toxins, including asbestos, radon and pesticides.

• Protect yourself against sun damage.

• Have regular cancer screenings.

How do healthcare providers diagnose cancer?

• Healthcare providers begin a cancer diagnosis by doing a comprehensive physical examination. They’ll ask you to describe your symptoms. They may ask about your family medical history. They may also do the following tests:

• Blood tests.

• Imaging tests.

• Biopsies.

• Genetic testing.

Blood tests for cancer may include:

• Complete blood count (CBC): A CBC test measures and counts your blood cells.

• Tumor markers: Tumor markers are substances that cancer cells release or that your normal cells release in response to cancer cells.

• Blood protein tests: Healthcare providers use a process called electrophoresis to measure immunoglobulins. Your immune system reacts to certain cancers by releasing immunoglobulins.

• Circulating tumor cell tests: Cancerous tumors may shed cells. Tracking tumor cells helps healthcare providers monitor cancer activity.

Imaging tests may include:

• Computed tomography (CT) scan: CT scans check for cancerous tumors’ location and impact on your organs and bones.

• X-rays: X-rays use safe amounts of radiation to create images of your bones and soft tissues.

• Positron emission test (PET) scan: PET scans produce images of your organs and tissues at work. Healthcare providers may use this test to detect early signs of cancer.

• Ultrasound: An ultrasound uses high-intensity sound waves that show structures inside of your body.

• Magnetic resonance imaging (MRI): MRIs use a large magnet, radio waves and a computer to create images of your organs and other structures inside of your body.

• Iodine meta-iodobenzylguanidine (MIGB): This nuclear imaging test helps detect cancer, including carcinoid tumors and neuroblastoma.

Biopsies

A biopsy is a procedure healthcare providers do to obtain cells, tissue, fluid or growths that they’ll examine under a microscope. There are several kinds of biopsies:

• Needle biopsy: This test may be called a fine needle aspiration or fine needle biopsy. Healthcare providers use a thin hollow needle and syringe to extract cells, fluid or tissue from suspicious lumps. Needle biopsies are often done to help diagnose breast cancer, thyroid cancer or cancer in your lymph nodes.

• Skin biopsy: Healthcare providers remove a small sample of your skin to diagnose skin cancer.

• Bone marrow biopsy: Healthcare providers remove a small sample of bone marrow so they can test the sample for signs of disease, including cancer in your bone marrow.

• Endoscopic or laparoscopic biopsy: These biopsies use an endoscope or laparoscope to see the inside of your body. With both of these methods, a small cut is made in your skin and an instrument is inserted. An endoscope is a thin, flexible tube with a camera on the tip, along with a cutting tool to remove your sample. A laparoscope is a slightly different scope.

• Excisional or incisional biopsy: For these open biopsies, a surgeon cuts into your body and either the entire tumor is removed (excisional biopsy) or a part of the tumor is removed (incisional biopsy) to test or treat it.

• Perioperative biopsy: This test may be called a frozen section biopsy. This biopsy is done while you’re having another procedure. Your tissue will be removed and tested right away. Results will come in soon after the procedure, so if you need treatment, it can start immediately.