Sunday, February 6, 2011

Experts make case for cancer care and management in Nigeria

…as the World makes ‘World Cancer Day’

For two years, Yinka Craig, an ace broadcaster, battled to stay alive. But on September 23, 2008, Craig who made his mark with the Nigerian Television Authority (NTA), died at the Mayo Clinic, Rochester, Minnesota, United States of America, where he was receiving treatment for cancer of the immune system.
For Sonny Okosun, one of Nigeria’s great musicians, his story isn’t different. He died May 24, 2008 aged 61, in the U.S after a prolonged battle with cancer. He had also gone to seek medical advice on his deteriorating health. Going further, Yusuf Jibo, former Zonal Director of NTA, who would have turned 55years of age today (February 4th, 2011), lost his live to colon cancer on the 2nd of December 2nd 2010.

Today, one could count prominent Nigerians who have been cut short by this hydra-headed monster. They include wife of former military president, Maryam Babangida, renowned activist and social crusader, Gani Fawehinmi, wife of Edo State Governor, Adams Oshiomole including indigent Nigerians to name but a few.

Presently, cancer has become one of the leading causes of death in the world,
especially in the developing countries. What is worrisome in a country like Nigeria with over 140 million people is that the detection of the killer disease is usually very late.

However, as the nation joins the rest of the world to mark World cancer day (every February 4th), calls have been made for a coordinated approach towards preparing a working document for national cancer research, and collaboration with stakeholders in cancer care and research, to facilitate national policy on cancer management in Nigeria.

Explaining the aetiology of the disease, Remi Ajekigbe, consultant radiotherapist and oncologist, Lagos University Teaching Hospital, Idi-araba, disclosed that cancer is an abnormal uncontrolled growth in the body that refuses to stop even when the initial trigger has been removed. The oncologist revealed that cancer can occur in any part of the body and spread to other areas as it is the only disease that spreads from the primary side of the body to the other part of the vital organs like the lungs, liver, kidney, heart and brain.

According to him “The spread of the disease to the adjacent and distant structures of the body is as a result of the excessive and progressive multiplication of cells. Don’t forget that the interaction between a person's genetic factors and three categories of external agents, including physical carcinogens, such as ultraviolet and ionizing radiation; chemical carcinogens, such as asbestos, components of tobacco smoke; and biological carcinogens, such as infections from certain viruses, bacteria or parasites can give rise to the growth of cancer cells.”

For his part, Innocent Ujah, Director General of Nigerian Institute for Medical Research (NIMR), Yaba Lagos stated that the current estimated 350,000 new cases of cancer diagnosed annually in Nigeria is far from the true cancer crisis in Nigeria.
Speaking at an inaugural meeting of the national Cancer Research Network (CRN) in Lagos last week, the DG stated that a large number of cancers are not detected as majority of Nigerians are poor and live in rural areas far removed from health facilities.

Ujah also noted that the attitude of Nigerians who deny the possibility of them having cancer because of faith and believe system also leaves large cases undetected until it becomes full blown adding that with inadequate research, the problem is even more complicated.

In his words, "Nigeria contributes almost negligible portion to the global body of literature on cancers and most of these are hospital based, perhaps representing the tip of the iceberg as we know that majority of Nigerians live in rural areas, largely poor, far from health facilities and unable to access the facilities. Cancer awareness efforts and screening methods to enhance early detection do not seem to have had much impact on the nation.”

Ujah explained that of the two cancers devastating women in Nigeria (cancers of the breast and the cervix), one has good prognosis if detected early while the other can be prevented but they continue to cost untold hardships and deaths" because of dearth of facilities and other constraints.

Taking a look at the cancer management in Nigeria, the problems of impeded access to health care, ignorance, poverty and a general lack of coordination of issues of health education complicate matters. Worse still, imaging facilities for staging patients with cancer, such as computerized tomography (CT) and Magnetic Resonance Imaging (MRI) are difficult to come by, and when available the cost of such studies put them out of reach of the average citizen.

Even of more concern is fact that clinical services for cancer are grossly inadequate and poorly distributed. Only a few centers have functioning radiotherapy equipment. Radiologic services are generally available, but access is seriously limited by high cost. The same argument of high cost applies to chemotherapy. While pathology services are generally available, the scope of services is limited.

Giving the obvious reality, it is obvious that health authorities in the country need to seek ways to facilitate training and re-training of all cadres of health care workers in cancer care and management he said.

For Ujah “there is the need to coordinate cancer research in the country, collaborate with all stakeholders in cancer care and research, facilitate national policy on cancer management based on research findings and conduct trainings and capacity development in cancer care and research. This is because research findings will in the long run influence national policy, processes and procedures on prevention, treatment and control of common cancers in Nigeria."

For Akin Osibogun, Chief Medical Director, LUTH, “education to help people recognize early signs of cancer and seek prompt medical attention for symptoms, which might include: lumps, sores, persistent indigestion, persistent coughing, and bleeding from the body's orifices is essential. Also, screening programmes to identify early cancer or pre-cancer before signs are recognizable, including mammography for breast cancer, and cytology (a "pap smear") for cervical cancer will further reduce the incidence of cancer related deaths in the country.”

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