Ocean Road Cancer Institute

BackgroundProstate cancer (PCa) is a leading cause of cancer-related morbidity and mortality among men globally. The prevalence is disproportionate among men of African descent and more specifically, in East Africa, where it is characterized by aggressive tumour biology and poor survival outcomes. Despite its high burden, the risk factors underlying its disproportionate prevalence remain understudied in this population. This study investigated lifestyle risk and protective factors among prostate cancer (PCa) patients, including demographic, dietary, lifestyle, and family cancer history, at Muhimbili National Hospital (MNH) and Ocean Road Cancer Institute (ORCI) in Dar es Salaam, Tanzania.MethodsThis case-control study compared PCa patients with non-PCa controls. Data on sociodemographic, lifestyle, diet, and family history were collected using a standardized questionnaire. Multivariate logistic regression identified significant risk and protective factors for PCa from each of these factors. Several statistical approaches were used to rank a Tanzanian urban population’s significant risk or protective factors.ResultsRanking of broad classes of factors revealed that diet, lifestyle, sociodemographic, family, and patient history of cancer and other disease factor groups, in order of importance, were associated with PCa in men. However, the single best model explaining the odds of being PCa had intake of red meat, coffee, alcohol, tomato, and marital status as independent variables. Specifically, increased intake of red meat (AOR = 5.248), and alcohol (AOR = 2.189) were associated with a high PCa incidence while increased intake of soya (AOR = 0.248), coffee (AOR = 0.603), tomato (AOR = 0.188), and not being married (AOR = 0.147) were associated with lower incidence of PCa in the Tanzanian urban population.ConclusionThe findings suggest that dietary and lifestyle factors have a significant association with PCa incidence in a Tanzanian population compared to sociodemographic, family cancer history, and exposure to infectious and other lifestyle diseases. We recommend further research, including prospective studies or randomized controlled trials with large sample sizes, to confirm these findings, as they suggest health initiatives for the prevention of PCa among high-risk populations, such as urban male populations.

Kaposi sarcoma is a malignant vascular neoplasm caused by human herpesvirus-8. It is mostly seen in immunocompromised individuals, particularly those with human immunodeficiency virus/acquired immunodeficiency syndrome or organ transplants. Cutaneous and mucosal Kaposi sarcoma manifestation is common; however, Kaposi sarcoma may involve the visceral organs. Iatrogenic or drug-induced Kaposi sarcoma may develop in immunocompromised patients undergoing immunosuppressive medication. It is quite uncommon for patients with inflammatory bowel diseases on immunosuppressive medication to develop intestinal Kaposi sarcoma. This case report describes the clinical presentation of steroid-induced disseminated upper gastrointestinal Kaposi sarcoma in a patient with underlying Crohn's disease and examines the management approach, associated challenges, and clinical outcome. We report a rare case of iatrogenic Kaposi sarcoma in a 39-year-old African male patient with Crohn's disease undergoing long-term corticosteroid treatment. Patient history, clinical examination, and investigations revealed mucosal Kaposi sarcoma with humanherpesvirus-8 positivity. This prompted discontinuation of corticosteroids with subsequent transition to infliximab a biologic agent. During the course of treatment with infliximab, the patient presented with extensive Kaposi sarcoma and was started on systemic chemotherapy with improvement. This case underscores the importance of maintaining a high index of suspicion for Kaposi sarcoma in patients on chronic immunosuppressive therapy who present with unusual skin or mucosal lesions.

Colorectal cancer (CRC) is one of the leading malignancies globally and chemotherapy forms the bulk of its management. Oxaliplatin is one of the standard drugs used for management of colorectal cancer. Oxaliplatin induced peripheral neuropathy (OIPN) is one of the most debilitating toxicities encountered which can lead to dose modification and premature treatment discontinuation with a great impact on quality of life. Therefore, we aimed to determine the prevalence, severity and factors associated with OIPN among colorectal cancer patients treated in Tanzania. This retrospective cohort study conducted at Ocean Road Cancer Institute (ORCI) of histologically confirmed CRC patients who were on oxaliplatin-based chemotherapy regimens. Data was collected using EORT-QLQ CIPN20 questionnaire and analysis was done using SPSS version 23 and p value < 0.05 was considered statistically significant. A total of 62 patients were recruited, the prevalence of OIPN was 71% and 59.7% for acute and chronic symptoms respectively. Obese patients were 21.66 times higher at risk of suffering from chronic OIPN compared to individuals who have normal body weight (p < 0.05). Cumulative Dose ≤ 780 showed a protective effect (p < 0.005) in development of OIPN. For the severity of acute OIPN, it was found that 4.8% had grade 4 symptoms, while 8.1% had grade 3 symptoms, and 69.4% had grade 2 symptoms, and 17.7% of the patients had grade 1. In patients with chronic OIPN, 13.5% had grade 3 neuropathies, 24.3% had grade 2 and 62.2% had grade 1 neuropathy. The prevalence of acute and chronic OIPN among colorectal cancer patients managed at ORCI was 71.0% and 59.7% respectively, with most patients developing grade 1 and 2 neuropathy for both acute and chronic symptoms. Number of cycles, cumulative dose and BMI were the major factors associated with the neuropathy.

Abstract Purpose: Timely diagnosis is one of the core pillars of the World Health Organization’s Global Breast Cancer Initiative. This study explored the experiences of Tanzanian women in securing a breast cancer diagnosis and gathered their recommendations for enhancing the diagnostic process in a resource- constrained setting. Methods: We conducted a qualitative study involving 14 women who completed breast cancer treatment at Ocean Road Cancer Institute in Dar es Salaam, Tanzania. Purposive sampling was used to recruit the participants to ensure cancer survivors who are active as patient advocates were also represented. Data were collected through in-depth, semi-structured interviews. Interview prompts focused on the participant’s experiences related to obtaining a breast cancer diagnosis. Data were analyzed using the Model of Pathways to Treatment framework alongside a rapid analysis approach to identify healthcare system strengths, barriers to diagnosis, and suggestions for improvement. Results: Participants had a median age of 50 years (range 40–60 years). All participants were cancer survivors, with 71% (10/14) being active patient advocates. Identified strengths within the health system included the availability of primary care and specialized cancer care services, some health insurance coverage, and social welfare support from various healthcare facilities. Barriers to timely diagnosis included financial and logistical constraints, insufficient resources in healthcare facilities and limited breast cancer knowledge among non-specialized healthcare providers. Participants also reported challenges in navigating the health system, complicated referral pathways, delays in receiving biopsy results and poor patient-provider communication. Recommendations for improvement included enhancing patient-provider communication, improving training for primary care providers, reducing costs for diagnosis, strengthening pathology services, and incorporating psychological support in breast cancer care. Conclusion: This study highlights the strengths and weaknesses of Tanzania’s healthcare system for breast cancer diagnosis. By preserving the strengths while addressing existing challenges, access to breast cancer diagnostics could be improved. Initiatives aimed at improving breast cancer care should prioritize the implementation of patient suggestions, such as enhancing patient-provider communication and strengthening pathology services including lowering diagnostic costs. Citation Format: Zainab Illonga, Summaiya Haddadi, Kija Luhuti, Beatrice Mushi, Pendo Ibrahim, Msiba Selekwa, Godfrey Philipo, Ryan Fodero, Asteria Kimambo, Nanzoke Mvungi, Edda Vuhahula, Jaime Gilliland, Katherine Van Loon, Elia Mmbaga, Dianna Ng. Barriers to Breast Cancer Diagnosis in Tanzania: Patient Perspectives and Recommendations for Improvement [abstract]. In: Proceedings of the 13th Annual Symposium on Global Cancer Research; 2025 Sep 16. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(12_Suppl):Abstract nr 52.

BackgroundLocally advanced cervical cancer (LACC) can result in obstructive uropathy (OU). Urinary diversion (UD) is the treatment of LACC patients with OU. This study assessed the benefits of UD before or during radiotherapy by examining its effect on improving kidney function and survival in patients with LACC.Materials and methodsThe study retrospectively analysed the clinical data of 119 women with LACC treated from January 2020 to December 2021. The treatment intention (radical or palliative) was decided by a multidisciplinary team based on the disease stage, Karnofsky performance status and degree of renal derangement. Treatment and outcome details were retrieved from electronic records. This included obtaining serum creatinine levels before the UD, 7 days after, 21 days after and 1 month after the UD. Time to normalisation of serum creatinine, feasibility of delivering planned treatment and overall survival were determined. The impact of various prognostic factors on outcomes was determined using univariate or multivariate analysis. The significance level was set at 0.05.ResultsThe mean age was 51.1 ± 9.9 years. Approximately a third of patients underwent UD. Percutaneous nephrostomy was the most frequently performed type of UD (92%). About 85% of patients had hydronephrosis, and 56.3% had unilateral hydronephrosis. The mean baseline serum creatinine level was 662 µmol/L for the entire cohort. There was a 53% reduction of serum creatinine from the baseline to 30 days post-UD (p = 0.001). The median equivalent dose in 2-Gy (EQD2) for the whole cohort was 86 Gy. The median survival time for the entire cohort was 20 months. In the multivariate analysis, UD resulted in a 40% decreased mortality risk (aHR 0.6, p-value = 0.03). Patients who did not receive brachytherapy had 5.9 times more risk of mortality compared to those who had brachytherapy (aHR 5.9, p-value = 0.001). EQD2 ≥72 Gy was associated with 40% less mortality risk than those who had EQD2 of <72 Gy (aHR 0.4, p-value = 0.005). Patients with a maximum tumour diameter of more than 5 cm had 2 times higher mortality risk than those with a tumour with a maximum tumour diameter of less than 5 cm (aHR 2, p-value = 0.005). Patients who were treated with concurrent chemoradiotherapy had 60% less risk of mortality compared to those treated with radiotherapy alone (aHR 0.4, p-value = 0.048).ConclusionUD was associated with a 53% reduction in baseline serum creatinine levels 30 days post-UD, reducing mortality risk by 40%.

Cancer care involves disclosing difficult information, making treatment decisions, and advance care planning. Communication practices and preferences are strongly influenced by sociocultural context. This scoping review aims to identify, map, and appraise the available evidence on clinical communication in cancer care in Africa and recommend priorities for future work. A search strategy was developed to identify studies conducted in Africa with a primary focus on patient-clinician communication in cancer care and performed in PubMed, Embase, Web of Science, CINAHL, African Index Medicus, and PsycINFO. Two reviewers independently screened titles and abstracts, full texts, and cited references. Study characteristics were analyzed using descriptive statistics and content analysis. Critical appraisal was performed using the Mixed Methods Appraisal Tool. Our search yielded 58 articles from 19 countries. Study designs were quantitative survey (53%), qualitative (38%), non-randomized experimental (5%), and mixed methods (3%), with no randomized trials. Populations included patients with cancer (n = 25), doctors (n = 24), nurses (n = 16), family/caregivers (n = 16), and/or others. Seven studies (12%) focused on pediatrics. Most studies (60%) focused on clinicians' disclosure of information, often framed as "breaking bad news" or "truth-telling." The remainder focused on information preferences (14%), advance care planning (10%), illness understanding (5%), shared decision making (5%), and communication training (3%). Critical appraisal demonstrated higher quality among qualitative than quantitative studies. Future work should explore underexamined research areas such as patient-centered communication, translate observational findings into intervention development and testing, implement communication skills training, and evaluate outcomes related to communication in cancer care in Africa.

The rising global burden of cancer disproportionately affects low- and middle-income countries (LMICs), which account for over half of new patients and cancer deaths worldwide. However, LMIC health systems face profound challenges in implementing comprehensive cancer control programs because of limited health care resources and infrastructure. This analytical review explores contemporary evidence on barriers undermining cancer control efforts in resource-constrained LMIC settings. We conducted a comprehensive literature review of peer-reviewed evidence on cancer control challenges and solutions tailored to resource-limited settings. We provide a conceptual framework categorizing these barriers across the cancer care continuum, from raising public awareness to palliative care. We also appraise evidence-based strategies proposed to overcome identified obstacles to cancer control in the published literature, including task-shifting to nonspecialist health workers, strategic prioritization of high-impact interventions, regional collaborations, patient navigation systems, and novel financing mechanisms. Developing strong primary care delivery platforms integrated with specialized oncology care, alongside flexible and resilient health system models tailored to local contexts, will be critical to curb the rising tide of cancer in resource-limited settings. Urgent global commitments and investments are needed to dismantle barriers and expand access to prevention, early detection, diagnosis, treatment, and palliation services for all patients with cancer residing in LMICs as an ethical imperative. The review elucidates priority areas for policy actions, health systems strengthening, and future research to guide international efforts toward more equitable cancer control globally.

BackgroundConcomitant invasive ovarian mucinous adenocarcinoma, unilateral renal agenesis and bicornuate uterus is a rare combination. Unilateral renal agenesis has been associated with genital anomalies, such as unicornuate and bicornuate uterus. Furthermore, a wealth of studies has reported the association between unicornuate uterus and ovarian anomalies, such as the absence of an ovary or ectopic ovaries, but rarely has there been a combination of the three to the best of our knowledge. The present case report is the first case presentation with a combination of the three syndromes: ovarian mucinous tumor, unilateral renal agenesis, and bicornuate uterus.Case presentationWe report the case of a 17-year-old who presented with abdominal distension. On examination, a CT scan revealed a large multicystic abdominal mass on the right side, with an absence of the right kidney while the left kidney was normal in size, appearance, and position. Intraoperatively, massive blood-stained ascitic fluid was evacuated. Additionally, a large whitish polycystic intra-abdominal mass with mucus-like materials and solid areas was attached to the midpoint of the colon and the right ovary, with visible metastasis to the omentum. The uterus was bicornuate. The mass and omentum were taken for histopathology and a diagnosis of invasive ovarian mucinous cystadenocarcinoma with metastasis to the colon and omentum was made after a pathological report.ConclusionsThe presence of these conditions in the same individual could potentially complicate medical management and fertility considerations. Thus, a need for a multidisciplinary medical team, including gynecologists, urologists, and oncologists, to address their unique needs and provide appropriate treatment and guidance. Further research and case studies are needed to better understand the possible association and implications of these rare co-occurring conditions.