Battling the cancer scourge

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Cancer has increasingly become one of the most deadly diseases confronting Nigeria and the world. With about 10,000 new cancer cases recorded in Nigeria in the last one year, according to a latest report by the National System of Cancer Registries (NSCR), the Federal Government can no longer afford further complacency in the fight against cancer, writes Ifeoma Onuoha.

Mrs. Tonia Uzor, an auditor with one of the blue chip companies in Lagos used to regard cancer as a disease of the wealthy, the elderly and the developed societies until she was diagnosed of cervical cancer in early 2013. Following the shocking discovery that she had cancer, largely viewed as ‘being on death row (sentence)’, Mrs Uzor began a frantic and expensive treatment of the disease.

She went to one of the few tertiary health institutions in the country that have cancer treatment facilities (CTF) and was booked for radiotherapy in six months time. Unfortunately, she did not live up to the time of appointment, as her condition deteriorated afterwards, culminating in her death.

Suzzy Ibitoye, a 34-year-old banker was treated for stomach ulcer for over three years, but her condition did not get any better. Eventually, she was diagnosed of cancer of the cervix when the disease had reached an advanced stage. Disappointed with the misdiagnosis of the past three years coupled with the lack of facilities in the country, her family members opted to fly her abroad for treatment. Sadly, Ibitoye died before she could reach the destination, after the family had sold property and even borrowed money for the medical trip.

The sad experiences of Uzor and Ibitoye are similar to what many Nigerians afflicted with cancer have been passing through.  Indeed, there are many flashpoints of losing the battle against cancer in the country.  According to the World Health Organisation (WHO), Nigeria has the highest cancer death rate in Africa, and this has been compounded by the fact that there is shortage of functional cancer control plans, diagnostics and treatment facilities, essentially a major debilitating factor in combating the disease. Many Nigerians have died of cancer due to late detection and diagnosis, poor diagnosis and lack of fund to cater for expensive therapy. To this end, it has become an ugly trend, making it uncommon to see someone who has been cured of cancer in the country.

What is cancer?

Cancer is a malignant tumour or growth which occurs when cells multiply uncontrollably, destroying healthy tissues. It can occur in the pancreas, breast, colon, lung, prostate, skin, blood, cervix and other parts of the body. Like other non-communicable diseases (NCDs), cancer has many possible causes such as; genetic factors; lifestyle factors such as tobacco use, diet, and physical activity; certain types of infections; and environmental exposures to different types of chemicals and radiation. According to Professor Clement Adebamowo, principal investigator for National System of Cancer Registries (NSCR), “smoking is associated with lung cancer, colon cancer, and breast cancer. Also infections like hepatitis, HIV and human papilloma virus increase the risk of certain cancers.”

Failure to manage the scourge

One of the major steps towards the control of the disease is early detection, but unfortunately before most patients in Nigeria could be diagnosed, the sickness has reached an advanced stage which makes it difficult to manage. Sadly too, there are inadequate facilities to ensure early detection of the disease, the worst situation being the absence of facilities for the treatment of the disease in the country even when it has been detected.

Nigeria with over 160million population is said to have only six radiotherapy centres whereas the WHO recommends one radiotherapy centre per 250,000 persons. Also, only six doctors train in nuclear medicine each year in efforts to provide anti-cancer manpower in the country.

The scourge continues to increase

The cancer scourge in Nigeria has continued to rise unabated. A recent report of the NSCR during the World Cancer Day celebration on February 4, 2014, show that over 10,000 new cases of cancer have been recorded in Nigeria in the last one year.  This excludes cases that were not registered in the hospitals.

Of this total, breast cancer accounts for 40 percent of new cases, cervical cancer accounts for 26 percent  and both combined affected more than 6,600 women across the country. For prostate cancer which affects men, 16 percent of the total was recorded while cancers of the colon, rectum and less malignant lymphoma accounted for the remaining 16 percent.

According to the WHO, it is feared that by 2020, cancer incidence for Nigerians may rise to 91 patients in every 100,000 males and 101 patients in every 100,000 females. It is also estimated that by 2020, death rate from cancer for males and females may reach 73 deaths in every 100,000 and 76 deaths in every 100,000 respectively.

Need for urgent actions

This pathetic and disturbing picture calls for urgent actions by all stakeholders. Many are still not aware of this disease and fail to adopt healthier lifestyles which experts say can prevent the sickness by 30 percent, let alone going for medical check up to detect the disease early enough. On the part of government, aside its failure to provide adequate cancer screening and treatment centres, it has failed in formulating and enforcing law that will reduce some of the disease’s risk factors such as prohibiting smoking in public places,  checking industrial pollution among others. There is also nothing like health insurance cover for the sickness despite its high cost of treatment which can hardly be affordable to many sufferers.

On the need for government support for the treatment of cancer, Dr. Kodjo Soroh, medical director at Pfizer Nigeria East Africa Region, noted that there are new and better drugs for cancer treatment, but very expensive for individuals. “One course of treatment costs $4,000 and you need minimum of four courses in a month. How many individuals can afford it.  In other countries,  health insurance takes care of this but in Nigeria it is not so,” he said.  He therefore called on government and corporate organisations to assist cancer patients in the country.

Remi Ajekigbe, a professor of Radiotherapy & Oncology, and Head of Oncology Unit, Lagos University Teaching Hospital (LUTH) Idi Araba Lagos said that 15 new cancer cases are diagnosed daily at the LUTH. He cautioned that cancer has assumed epidemic level in the country and urged the federal government to invest more in its management.  According to him, no fewer than two million people are currently suffering from cancer and not less than 100,000 new cases are recorded in Nigeria every year.  Of the 100,000 new cases, only few have access to treatment because there are just three functional cancer centres for the over 160 million people even as the treatment is expensive.   “LUTH has a linear accelerator, but what we need in Nigeria is at least, one machine for each geopolitical zone.   There should be at least two machines in each hospital so that when one breaks down you turn to the other,”he said.

Ajekigbe however explained that the scourge of cancer is the price Nigerians are paying for civilisation.  “We are all over-civilised now. We eat chemicals and apply them on our body. Some of these chemicals, especially the ones applied on the body and armpit, touch the breast and cause cancer of the breast.  This explains why more people have cancer in the left breast than the right breast because most of us are right handed when we apply these chemicals in the left axis they cross more in the left breast. These chemicals contain what we call parabens.   We are defiling the environment; we are eating and rubbing chemicals all in the name of civilisation and that is the price we are seeing,” he said.

Can the poor survive cancer?

Professor Ajekigbe believes that even though it is expensive to manage cancer,   even the rich may not survive the disease. “It is nice to have money to treat cancer.  Poor people will not survive as much as the rich and this is why we are telling the government that health insurance should include cancer because the treatment is very expensive. The drugs, radiotherapy, and chemotherapy are all very expensive. Everything about cancer is very expensive. Government should be involved in treatment and also invest more. The National Health Insurance Scheme (NHIS) should cover cancer even if it is only 25 per cent  of the cause of cancer treatment,” he said.

Breast Cancer on the rise

Breast cancer is still the leading cancer in Nigeria. Professor Ajekigbe therefore advised women to form the habit of examining their breasts for early detection of breast cancer. According to him, cancer is genetic; hence ladies whose mothers had breast cancer have the tendency of suffering from the disease too. Such ladies should always examine their breasts so as to ensure early detection of the disease.

Message on World Cancer Day

You owe yourself every day, if you notice anything unusual about yourself see your doctor. Any lump, any thickening, anywhere in your body particularly your breasts, your lips and tongue, see your doctor. If there is any bleeding from any natural openings like, your private part, nose, mouth, anus etc, report to your doctor. If you are up to 40 and your bowel habit has changed; for instance; you are going to toilet once a day normally, then, it becomes thrice a day, something is wrong with your gastro intestinal system.

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