As Uganda launched in earnest into the battle against HIV/AIDS, Jackson Orem, M.D., was preparing for the next assault on the nation’s public health: cancer. “We must fight cancer, particularly HIV- and infection-related malignancies, with equal vigor as HIV/AIDS,” said Orem, director of the Uganda Cancer Institute in Kampala.
Uganda has among the highest cancer rates in the world, yet limited resources for patient diagnosis and care. As a result, Uganda’s cancer survival rate is just 10 percent. Orem is well known among Uganda’s cancer patients. In 2008 he was the only oncologist in the country and he treated more than 10,000 cases annually. To improve this situation, that same year Orem joined forces with Fred Hutchinson Cancer Research Center in Seattle, Wash., USA, to form a unique collaboration for cancer research, treatment and training called the Uganda Program on Cancer and Infectious Diseases, or UPCID. Orem is co-scientific director of UPCID alongside Corey Casper, M.D., M.P.H., an associate member of the Hutchinson Center’s Vaccine and Infectious Disease Division.
Orem’s research in infection-related cancers and his groundbreaking role in advancing the understanding and treatment of HIV-associated malignancies have raised his profile in the cancer research community.
In 2009 he participated in the first successful clinical trial ever conducted on the African continent to explore the utility of dose-modified oral chemotherapy for AIDS-related non-Hodgkin lymphoma. Researchers found that dose-modified oral chemotherapy is safe, efficacious and pragmatic in sub-Saharan Africa and outcomes are comparable to those in the United States. Such research is particularly significant in countries like Uganda that have high numbers of people with HIV and are therefore disproportionately affected by infection-related cancers. While many HIV-positive individuals are benefitting from programs that have improved access to antiretroviral therapy, they are succumbing to malignancies such as Kaposi sarcoma and Hodgkin and non-Hodgkin lymphomas.
The trend threatens to undermine the young and productive segment of Africa’s population, Orem notes. “Improving cancer survival rates, especially among children, is essential to secure the next generation and Uganda’s future.” Nearly 1.2 million people there are living with HIV/AIDS. Non-Hodgkin lymphoma is the fifth most common cancer and one of the most common to develop in HIV-infected individuals.
Orem has been at the helm of the Uganda Cancer Institute, the site of several landmark cancer discoveries, since 2005. On Oct. 4, 2011, the UCI/Hutchinson Center Cancer Alliance will reach a new milestone: the groundbreaking for the Uganda Cancer Institute/Fred Hutchinson Cancer Research Center Clinic and Training Institute.
“We are developing critical clinical, research and training infrastructure,” Orem said. “Building a state-of-the-art facility for care, training and research especially focused on infection-related cancer will also support AIDS-associated malignancy research.”
Orem is an internist and specialist in hematology and oncology and an honorary lecturer at Makerere University in Kampala. He completed additional training in medical oncology at Case Western Reserve University in Cleveland, Ohio, USA.
His interests and published studies are focused on the development of novel oral chemotherapy combinations to improve the delivery of cancer care in resource-poor settings, the treatment of viral-associated malignancies, and infections in cancer patients with compromised immune systems.
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