Doctors undertake stenting for a patient suffering from oesophageal cancer at Kyabirwa Surgical Centre in Jinja City. PHOTO/TAUSI NAKATO
What you need to know:
- Dr Kabweru urged people experiencing persistent or worsening difficulty swallowing to seek medical attention instead of relying on soft foods and liquids to manage the symptoms.
The shortage of specialists is limiting access to oesophageal cancer diagnosis and treatment in Uganda, with many patients seeking medical attention when the disease has advanced beyond the stage at which surgery is possible.
Dr Wilberforce Kabweru,Senior Consultant Thoracic Surgeon at Mulago National Referral Hospital, attributed late presentation to several factors, including limited access to specialised services and the high cost of diagnostic investigations.
“Only about 20 per cent of patients present at a stage when the disease can still be treated by surgical resection. The majority, 80 per cent, present in late stages when surgery is no longer an option,” he said.
Oesophageal cancer affects the oesophagus, or food pipe, which carries food from the mouth to the stomach. The disease can cause progressively worsening difficulty swallowing, eventually making it difficult or impossible for patients to eat or drink.
Dr Kabweru called for expanded access to diagnostic equipment and specialised treatment, noting that shortages of skilled personnel were limiting the management of patients.
He also cited the high cost of investigations, saying an endoscopy in Kampala costs between Shs300,000 and more than Shs1 million.
He raised concern about the disease affecting younger people, citing a case involving a 17-year-old patient.
Dr Kabweru urged people experiencing persistent or worsening difficulty swallowing to seek medical attention instead of relying on soft foods and liquids to manage the symptoms.
In extreme cases with blocked food passage, Dr Joseph Okello Damoi, head of surgery at Kyabirwa Surgical Centre, said patients should be enrolled on oesophageal stenting.
The procedure involves using endoscopy to guide a stent, a small tube, into the oesophagus to open the passage obstructed by the tumour.
“The tube is called a stent, which doctors carefully place inside where the tumour is, so that this tube opens up the way for food to pass,” Dr Damoi said.
Patients who cannot swallow often lose weight and become weak, making it harder for them to tolerate treatment.
However, Dr Damoi said restoring the ability to swallow improves patients’ nutritional status and may help them undergo further treatment, including chemotherapy and radiotherapy where appropriate.
Alternatives include creating an opening into the stomach for feeding, while providing nutrients directly into the bloodstream can be expensive.
Dr Damoi said Kyabirwa Surgical Centre treats about 100 oesophageal cancer patients annually and routinely provides stenting services.
He said misconceptions about cancer investigations also delayed treatment, with some patients refusing biopsies for fear that taking a tissue sample could cause the cancer to spread.
A biopsy helps doctors confirm a diagnosis and determine the appropriate treatment.
Dr Damoi advised people to avoid smoking, excessive alcohol consumption, and drinking extremely hot beverages.
According to the International Agency for Research on Cancer (IARC), Uganda recorded an estimated 2,438 new cases of oesophageal cancer in 2022, making it the country’s fifth most common cancer across both sexes.
The disease was also among the leading causes of cancer-related deaths in the country.
Oesophageal cancer affects the oesophagus, or food pipe, which carries food from the mouth to the stomach.