Komugisha's battle with breast cancer

Sherah Komugisha Kaganzi, a vibrant 50-year-old mother of four from Entebbe, never imagined that a simple discovery in July 2022 would dramatically alter the course of her life. What started as a small lump in her breast soon spiralled into a harrowing journey filled with uncertainty and fear.

“The doctor told me that I should return after three months saying that there was a high chance that it would become cancerous. I returned to hospital in November 2022 and did another scan but the doctor said he did not understand what it was so he sent me to do a mammogram at Kampala Imaging Centre," Komugisha says.

Although the lump was labelled benign at the imaging centre, the looming threat of cancer was ever-present. Komugisha was then referred to Mulago Hospital for a biopsy. However, her case took a frustrating turn when the person handling her results misplaced them, leaving her in limbo for three months.

Confusion about diagnosis

In search of clarity, Komugisha reached out to a friend working at Aga Khan Hospital in Kenya about her dilemma. The doctors there advised her to undergo another biopsy. The second biopsy, done at Mulago, came out negative, but Komugisha was asked to open a file at the Uganda Cancer Institute.

“I went with my husband and he endured the long hours with me throughout the tedious process of file opening and undergoing various tests to get a proper diagnosis. At this point, I was still optimistic knowing that I only had a lump although its size kept increasing with time,” she recalls.

Doctors convened a tumour board to discuss her rare case, advising her to undergo a third biopsy. Fear began to take hold as Komugisha suspected that the doctors were trying to confirm a cancer diagnosis. The pathologist then recommended a mastectomy to prevent the potential spread of cancer.

“At first, I thought they would only remove the lump and reconstruct my breast,” she says. But when she consulted a surgeon at Platinum Hospital, she was told that the entire breast had to be removed.

“I was devastated. I wasn’t prepared to lose my breast. Until then, I was in denial because all the results had been negative, except for one that even the doctors were uncertain about,” she recalls.

The turning point and treatment

Komugisha, still in disbelief, declined the surgery, despite her husband’s insistence. On the way home, they argued about her reluctance to start cancer treatment. Distraught, Komugisha disappeared for three days, unable to face her family and friends. During this time, she found solace in prayer and solitude, finally accepting her situation.

After three days, Komugisha scheduled an appointment with another doctor, hoping he could reconstruct her breast. However, after examination, he confirmed that it wasn’t possible. This became the turning point in her journey. She returned home ready to begin treatment.

In October 2023, Komugisha underwent surgery to remove her breast at Platinum Hospital. She went home after a day but five days later, her wound became septic because her caretaker was scared of nursing it.

The delay in healing pushed back her next phase of treatment. After analysing the tumour cells, doctors confirmed that Komugisha had stage III breast cancer, but fortunately, it had not spread.

Breaking the news to her children

One of the hardest parts of Komugisha’s journey was explaining her diagnosis to her young children. “They would often break down and cry at school,” she says. Fortunately, their teachers were understanding and supportive, and the school administration was considerate, even allowing delays in school fees due to the financial strain of treatment.

Throughout her journey, Komugisha received all kinds of unsolicited advice. Some people urged her to abandon chemotherapy for herbal remedies or starve the cancer by avoiding solid foods.

“I even ordered herbal medicine from Nigeria. The idea was that the cancer would have disappeared by the time I completed the herb but all was in vain,” she says.

In November 2023, Komugisha opened a file to begin chemotherapy. “When I arrived, Dr Victoria Walusansa hugged me and said, ‘We’re in this together.’ I felt like I was home and knew that I was going to be handled well,” she recalls.” Although Komugisha was prepared for physical changes like hair loss, she wasn’t prepared for the frustrations she encountered with the overworked nurses and long wait times at Mulago. On the days she had to get a dose, she would leave Entebbe at 5am and arrive at Mulago by 6am to catch up with the queue early enough.

“I got frustrated by the nurses who were helping us get the treatment but I later learnt that they are overwhelmed by the big number of patients and sometimes, a little money motivates them,” she says.

Radiotherapy: A new challenge

After waiting two weeks, Komugisha finally began her radiotherapy sessions. Patients who had gone through the process before advised her to pay the radiologist to speed up her treatment. She was asked to pay Shs1.2 million, which she agreed to after hearing stories of others who had paid up to Shs5 million.

“On the radiotherapy bed, the doctor pulled out an injection and started the process without explanation of what was going on. Honestly, I did not have the time to make any kind of decision because many people were waiting in the queue,” she says.

However, things didn’t go as planned. Komugisha was scolded by doctors for not following the correct procedure.

“But how was I to know the right procedure if they had not explained it to me? I am sure there are so many patients that are naïve, the way I was," she says.

Komugisha was prescribed 15 days of radiotherapy, with appointments starting as early as 5am. She completed this phase in April and has been undergoing monthly reviews since then. Her next review is scheduled for December.

Through her journey, Komugisha’s outlook on life has changed. “I’ve learnt to take one day at a time. I’m grateful to God and now understand that one may not necessarily die from cancer—it could be anything else. Just like my sister.”

KEY FACTS ON BREAST CANCER

Breast cancer caused 670,000 deaths globally in 2022. Roughly half of all breast cancers occur in women with no specific risk factors other than sex and age. Breast cancer was the most common cancer in women in 157 countries out of 185 in 2022. Breast cancer occurs in every country in the world. 

Approximately 0.5–1 percent of breast cancers occur in men. Chemotherapy is a medication given to treat cancer that’s designed to kill cancer cells. It’s usually taken by mouth or given through an infusion into a vein or medication port. Side effects of chemotherapy You may experience side effects. Some include nausea and vomiting, hair loss, fatigue infection, mouth or throat sores, anaemia, diarrhoea, weakness, pain and numbness in limbs (peripheral neuropathy) Radiotherapy. With radiation therapy, beams of radiation are focused on a specific area in your body. 

The radiation changes the DNA makeup of the tumor, causing the cells to die instead of multiplying and possibly spreading. Sometimes, one of these treatments can be more effective than the other in treating a particular type of cancer. Other times, chemo and radiation can actually complement each other and be given together