The Ugliness With Adrenocortical Cancer [analysis]

Deceased TV presenter Rosemary Nankabirwa’s picture, where she was still in ill health, was circulated over social networking sites such as Facebook and WhatsApp, eliciting a number of reactions.

Her mother Rebecca Kibirige, in a recent New Vision interview, said she was unhappy that another patient’s caretaker had snapped and circulated the disturbing picture. Wendy, a Ugandan student based in Norway, said the picture made her cry.

Zahra, a trader at Container Village, resolved to donate towards the fund aimed at raising Shs 100m for Nankabirwa’s treatment. Rosemary (not the patient) on her part could not believe that was Nankabirwa other people expressed their disbelief in the picture being that of Nankabirwa.

Racheal perhaps had the reaction of reactions. She could not understand the type of cancer that makes a person gain weight.

“That is a weird disease,” she said.

CORTISOL AND CUSHING SYNDROME

The “weird disease” that killed Nankabirwa, the disease that makes people gain weight, is adrenocortical carcinoma, also known as cancer of the adrenal cortex. Adrenal glands are made up of an outer layer, the adrenal cortex and an inner layer, the adrenal medulla.

“It is true, adrenocortical carcinoma results in abnormal weight gain. We call the weight gain Cushing syndrome,” Dr Fred Okuku, an oncologist at the Uganda Cancer Institute, says.

Adrenocortical carcinoma or adrenal tumours release cortisol. The hormone, which is made in the adrenal glands, is important to the body, helping in stress management, blood sugar regulation and in controlling salt and water balance. It also influences blood pressure, acts as an anti-inflammatory agent and helps in memory and foetus formation.

However, too much of the hormone, results in Cushing syndrome, a flushed and round face, high blood pressure and mood swings, according to Internet sources.

ADRENOCORTICAL CARCINOMAS RARE

Dr Jackson Orem, the director of the Uganda Cancer Institute, says adrenocortical carcinomas, also known as adrenal cortical carcinormasor adrenal cancer, are rare in Uganda.

“We see about a case a year,” he says.

He adds that the cancer is symptomised by a mass in the adrenal glands. Other symptoms, according to www.cancer.gov include pain in the abdomen or back – Kibirige said Nankabirwa complained of backache – and a feeling of fullness in the stomach.

Adrenocortical cancer is curable when caught in Stage 1, Okuku says.

STRANGE AFFLICTIONS

Adrenocortical carcinomas do not only result in the overproduction of cortisol. They may also result in the excess production of hormones such as aldosterone, testosterone and oestrogen.

Excess production of these hormones could result in symptoms that would shock Racheal, who was ‘weirded’ out by a cancer that makes one gain weight. Growth of hair on the face, balding and a deepened voice could occur in a woman if she had a cancerous tumour producing testosterone.

Impotence and an expansion in breast tissue could be the result in men whose tumours produce oestrogen, www.cancer.gov says.

Excess production of aldosterone results in frequent urination, feeling thirsty, high blood pressure and muscle weakness or cramps.

CHEMOTHERAPY SIDE EFFECTS

Juxtaposed with her long and healthy hair from before the illness, Nankabirwa’s short hair in the picture that was circulated on April 4 was heartbreaking. It surprised some people too, with one commentator saying her hair had grayed. What could have happened to her?

One of the well-known side effects of chemotherapy is hair loss.

“Chemotherapy does not cause hair to gray, however,” Okuku says.

But it will darken fingernails and toe nails, cause nausea, loss of appetite and general malaise. It may make it difficult to pass stool and urine and may make urine darker, Peter Genza, who worked with children with cancer at Bless a Child Foundation, says.

Nankabirwa’s workmates at NTV Uganda where she was working before going to the UK for her master’s degree, started a fundraising drive for her specialised treatment. Well-wishers had raised Shs 110m to save the former news anchor’s life, but unfortunately she died on Sunday soon after arriving at the hospital in Nairobi.

Source : The Observer

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