Study uncovers rare condition among women

KAMPALA - As Uganda struggles with high cervical cancer rates, many women in the advanced stages of the disease are also battling cancer cachexia, a severe condition characterised by extreme weight loss and weakness. 

The latest recent study conducted by the Uganda Cancer Institute (UCI) revealed that over 60% of women who seek care at UCI suffer from cancer cachexia. 

Dr Martin Origa, the head of gynaecology at UCI, revealed that on average, about 20 to 25 new patients with cervical cancer visit the facility every week. 

Overall, the World Health Organisation (WHO) had about 6,700 new cervical cancer cases, with an estimated 4,200 deaths. 

Over 50% of cervical cancer patients in the country are diagnosed at an advanced stage, which is stage three or stage four. 

“When a patient is diagnosed at stage three or stage four, our focus shifts to palliative care, which means we aim to prolong life rather than provide a cure. If over 80% of our patients present at this late stage, it is a major concern,” Origa added. 

Impact on quality of life 

Experts warn that cancer cachexia reduces patients’ quality of life, making treatment even more challenging. 

The study assessed the impact of cancer cachexia and its prevalence among women with cervical cancer. Presenting the preliminary study findings at Skyz Hotel on Friday (March 28), Innocent Atuhe, the study co-investigator, revealed that 64% of women with advanced cervical cancer are at risk of malnutrition. 

Experts recommend nutritional assessment, counselling, and interventions to prevent malnutrition, which worsens the burden of cancer and chemotherapy. 

Studies have also indicated that 50% to 80% of women with advanced cervical cancer suffer from cancer cachexia, and causes death in 20% to 60% of these cases.

Mirembe speaking during the release of preliminary study findings at Skyz Hotel. (Credit: Violet Nabatanzi)

Diagnosing cancer cachexia

 Experts diagnose cancer cachexia using internationally recognised criteria. 

“We evaluate the patient’s weight over the past six months, measure their height, and assess their nutritional status. Additionally, we determine whether they have experienced muscle loss to confirm a diagnosis of cancer cachexia,” Atuhe explained. 

The study, titled Impact of Cachexia on Physical Activity, Performance, and Functional Measures in Advanced Cervical Cancer Patients at UCI, found that 44.2% of patients with cancer cachexia experience chronic pain. 

Dr Henry Ddungu, a senior consultant of haematology oncology, emphasised that the best way to prevent cervical cancer is through vaccination against the human papillomavirus (HPV), the primary cause of the disease. 

“Screening is crucial because it allows for early detection. When cancer is detected early, it can be treated and cured. If cancer is cured, cachexia also disappears. Weight loss is often a direct result of cancer, so effective treatment by qualified specialists is essential,” Ddungu said. 

HPV vaccination challenges 

The health ministry has an HPV vaccination policy targeting girls aged nine to 13 years. However, Origa noted that vaccine uptake has been suboptimal. 

“We administer two doses of the vaccine, and while the first dose has an uptake of about 70%, many girls do not return for the second dose,” he explained.

Transition to a single-doze 

The WHO has revised its policy, recommending a single-dose HPV vaccine, a move the Ministry of Health has adopted. Origa reassured the public about the vaccine’s safety. 

“There are fears that the vaccine affects fertility, but this has not been scientifically proven. I strongly encourage young girls to get vaccinated. For those who miss the vaccine, screening should begin at age 25,” he said.

Need for action 

Prof. Florence Mirembe, the study advisor, noted that early sexual activity, defilement, and rape contribute to HPV infections among young girls. 

The ongoing study, which began in January 2023, involves patient assessments by a multidisciplinary team, including gynaecologists, study nurses, physiotherapists, nutritionists, and social workers. 

The study recommended urgent screening for cancer cachexia in all cervical cancer patients and calls for evidence-based care, nutritional screening, and counselling. 

It also highlights the need for adequate nutrition to support cancer treatment and reduce the burden of malnutrition.