Important note: Information in this article was accurate in 2009. The state of the art may have changed since the publication date.
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New Vision (Kampala) - November 15, 2009
Chris Kiwawulo
On November 4, Enock Ssebbanga died of Hodgkin's lymphoma. He has for a long time, been battling for his life getting treatment at the International Hospital Kampala (IHK) and Hospice Uganda in Makindye since 2007.
Ssebbanga, who as a child, was tortured and starved nearly to death for over two months by his parents, had got a new life when he was adopted by a Mukono-based charity, African Foundation, headed by Rev. Kefa Ssempangi.
At IHK where he was being treated, Dr. Helena Nam says by the time Ssebbanga was taken to IHK, it was a little late because the cancer had already recurred.
"The prognosis from recurrent Hodgkin's lymphoma is poor. It had heavily infiltrated his bone marrow, making him anaemic and prone to bleeding," she reveals.
She urges members of the public to report any lump on their bodies for medical examination, urging that if diagnosed and treated early enough, Hodgkin's lymphoma can cure.
A lump is an irregular shaped thickening that grows in any part of the body and can be felt by fingers.
Asked whether the cancer could have been as a result of Ssebbanga being starved during childhood, Nam says: "Malnutrition does not directly cause Hodgkin's lymphoma but a good diet, helps to strengthen the immune system." Each person should have a balanced diet rich in fruits and vegetables.
What is Hodgkin's lymphoma?
Previously known as Hodgkin's disease, Hodgkin's lymphoma is a type of cancer that originates from the white blood cells (lymphocytes).
It was named after Thomas Hodgkin, who first described abnormalities in the lymph system in 1832. It is characterised by the orderly spread of systematic symptoms with advanced disease and the presence of Reed-Sternberg (RS) cells on microscopic examination.
It a type of cancer which can be treated using radiation therapy and combination chemotherapy.
Nam says there are no guidelines for preventing the disease because the cause is unknown.
Symptoms
Hodgkin's lymphoma can start with a lump that is not painful, night sweats, fevers and weight loss.
Treatment
Once detected early, Hodgkin's lymphoma can respond well to chemotherapy and the patient can cure.
A 1-2 centimetre lump that has been growing for more that six weeks should be assessed by a healthcare worker, even if it is not painful. Many lumps are not cancerous, but if it turns out to be, it can be treated early.
Hodgkin's lymphoma in Uganda
Although there are no exact records about Hodgkin's lymphoma at the national data base, Dr. Victoria Walusansa, an oncologist, says there are approximately 80 to 100 new Hodgkin's lymphoma cases coming up every year at Mulago.
She says many patients go to the hospital when the disease has reached advanced stages while others do not go at all. "Most of the cases we get are associated with HIV/AIDS.
Many people mistake it for other diseases and get treated at the local level until they die. Some even go to witchdoctors," Walusansa observes.
According to Dr. Jackson Orem, the director of the National Cancer Institute at Mulago Hospital, the facility handles an average of 1,000 new cancer cases every month, 600 of which are children. There are also about 9,000 continuing adults with about 4,500 children.
Most of the patients are from the eastern region, particularly Pallisa, Budaka, Kumi, Soroti and Mbale. Patients from northern Uganda can be handled at Lacor Hospital, West Nile-Kulva Hospital and western-Mbarara Hospital.
Orem says the challenge is that the bed capacity at Mulago is small and the place is overcrowded. There are only two wards with 60 beds, which makes some patients sleep in the corridors.
Risk factors
You are at risk if your body has a history of infection with Epstein-Barr virus, which causes mononucleosis.
A weakened immune system, including HIV infections.
Prolonged use of human growth hormone.
More prone in males than females. Mostly attacks those aged between 15-35 and those over 55.
When there is a family background of the disease.
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