Life is never the same after cancer treatment – Nassolo

By Beatrice Nassolo  

In 2019, Ms Faziira Nassolo felt a lump in her left breast, which she only realised after her breasts were engorged. 

The 33-year-old had not breastfed her baby that night so her breasts were swollen and painful. Her mother advised her to apply a warm compress to relieve the swelling.

She then continued breastfeeding her baby but she felt a little lump that had remained in the left breast.

“I thought it was milk that solidified. I continued breastfeeding my baby without any challenges and for three years, the lump was there and because it was not painful, I ignored it.”

One evening as she came from work in March 2021, she felt a sharp pain in the breast so she decided to seek medical attention the next morning.

“I went to Nsambya Hospital and upon the first examination with the nurse, I was referred to the cancer ward. I did not pay attention to it but while there, I really looked closely at the breast and it had the skin that looked like an orange peel, and the nipple had started dimpling. I do not know why I had not carefully observed these things,” she said.

Living in denial

These are clear signs of cancer and the doctor told her that it looked like cancer but she needed to do a biopsy but she declined. She did not know anyone in her family with cancer and she felt she was too young to have cancer.

“I always knew that cancer was a disease for older people. I was at the peak of my career and life and was where I always wanted to be. I was too young to have cancer. I was in denial and I refused to take the biopsy test. Many people offered herbs and I took them on.”

She searched the internet and just reading about the after effects of the treatment even made her feel horrible. Hearing failed stories of cancer treatment made her afraid even more. In her search for an alternative to conventional cancer treatment, she lost a lot of money and her finances crumbled.

Ms Nassolo after failing on herbs and having more pain than it was three months before, then opened up to a friend who counselled her and advised her to get out of the state of denial she was living in.

“She brought me two survivors; one was an older woman who had survived the cancer for several years and another had lived six years after the treatment. The women gave me a reason to live since I was a single mother of three. I got to understand that I had to be alive for them,” she recalled.

Seeking medical attention

She then went to the Uganda Cancer Institute and after a biopsy and several assessments, she was found to have stage III breast cancer in her left breast. She believes that her stage of denial escalated the disease and that if she had done the biopsy earlier, it would be an earlier cancer.

“I needed six cycles of chemotherapy, a surgery, and radiotherapy and hormone therapy. After the first cycle of chemotherapy, I went to work but I almost collapsed. I had not disclosed it to so many people because I thought I was a fighter. When I told people, many friends abandoned me. They thought I would be a burden to them financially.”

On the second cycle of chemotherapy, her long natural hair fell off and her children also offered to cut off their hair so they could look like her but she stopped them. A month after chemotherapy, she had a surgery to remove the breast and got radiotherapy.

Throughout her treatment process, Ms Nassolo remarked that she has learnt to be patient because you have to wait and stand in the long queues until your turn comes because there are many patients who are waiting to be served by the few doctors and nurses at the cancer institute.

Four months after the surgery, she had to return to work but there she faced stigma from fellow workers who would make hurting statements about losing her breast.

Emotional support

Ms Nassolo joined support groups for cancer survivors such as Bonus Moms who have supported her emotionally and there, she is free to share her joys and sorrows and many times they cover her up on parenting when she is not okay or has challenges.

“I am thankful that my mother has been my pillar of support. People should know that cancer patients and survivors need a lot of emotional support. I became depressed because I was not as productive as I was before falling sick and was not earning as much. My employer tried to help me but I also realised that she was straining.”

The doctors prescribed that she would take daily tamoxifen for five years and has done so for the past two and a half years. One of the side effects of treatment she may have to live with is her forgetfulness.

“It was not about money. I needed emotional support. Many people lose hope. Even if you are a fighter, if you do not have support, it becomes hard. People make it hard for us to come out to talk about cancer because of the stigma and careless statements they make about the situation,” she said.

Since many women lose their marriages, jobs and property during cancer treatment, Ms Nassolo thinks there is a need to support them by teaching them a skill that will sustain their lives after treatment.

She said: “Life does not remain the same after cancer treatment. I have lost jobs after my treatment. Extremes of weather affect me and there are some days when I do not have the energy to even walk out of my bed and it is hard to explain to an employer that you are not well all the time.”

BREAST CANCER AWARENESS MONTH

In a statement issued on October 1, The World Health Organisation said the theme for this year’s breast canncer awareness month is: No-one should face breast cancer alone

Background

Breast cancer is the most common cancer globally with around 2.3 million new cases every year. It represents one in eight cancer cases in both sexes and a quarter of all cancers in women, with 70 percent mortality occurring in resource constrained settings. Health system barriers and patient level factors with low levels of awareness and knowledge are contributing to low uptake of early detection services, with resultant late-stage diagnoses and poor outcomes. In many resource-constrained settings, breast cancer affects a relatively younger population significantly contributing to premature mortality. The WHO launched the Global Breast Cancer Initiative (GBCI) in 2021 to reduce mortality rates by 2.5 percent per year by 2040 to save 2.5 million lives through three key pillars of action on health promotion for early detection, timely diagnosis; and comprehensive breast cancer management. The breast cancer awareness month is celebrated globally every October. This year, WHO said it will highlight the importance of early detection, timely diagnosis, comprehensive treatment and the need to provide support for persons with lived experience including through patient navigation. It argues that the initiative also provides an opportunity for all stakeholders to review progress and to address challenges in access to breast cancer care.

Objectives

1. Raise awareness and drive behaviour change: Promote advocacy, awareness, and behaviour change communication to increase the uptake of breast cancer screening and early diagnosis, particularly in resource-constrained settings

2. Facilitate knowledge sharing and partnerships: Provide a platform for dissemination of breast cancer information, foster knowledge exchange, and strengthen collaborations and partnerships for breast cancer control.

3. Support national adoption of The Global Breast Cancer Initiative (GBCI): Encourage countries to adopt and implement the GBCI with a focus on early detection, timely diagnosis, and comprehensive care.

4. Promote patient support and address disparities: Highlight the importance of patient-centred care, including medical, emotional and social support while addressing disparities in access to breast cancer care