Primary prevention can help avert the risk of developing cancer in Nigeria, as the World Health Organisation (WHO), says an estimated 116,000 new cases of cancer and 41,000 cancer-related deaths were recorded in 2018.
More than half of cancer occurring today is preventable by applying knowledge that we already have in terms of lifestyle changes, scaling up treatment options and preventive services.
The leading causes of cancer depend on where you are in the world. “In Nigeria, the five most common cancers are breast, cervical, prostate, colon and lymphomas,” says AliyuUsman Malami, of the Department of Radiotherapy and Oncology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.
Cancers arise from almost any part of the body, so a lot of these cancers arise from no known cause.
Cancer is the uncontrolled growth and spread of cells. It can affect almost any part of the body. The growths often invade surrounding tissue and can metastasize to distant sites. Cancer causes about 1 in every 6 deaths worldwide, more than AIDS, tuberculosis. Although Cancer can be prevented and treated if properly diagnosed and presented early.
Early diagnosis of cancer generally increases the chances for successful treatment, it can reduce your risk of getting cancer in the first place? It sounds too good to be true, but it’s not.
“We are identifying the majority of patients with cancer at stages 3 and 4, drastically reducing successful treatment outcomes” says Zainab Bagudu, managing director and chief executive officer Medicaid Cancer Foundation.
According to Bagudu, Access to screening and diagnostic services is the most critical aspect of cancer care and the lack of equitable access to these services remain the reason why mortality rates for cancer in Nigeria and Sub Saharan Africa is alarmingly high when compared to other countries.
Based on reality, cancer care is not where it should be in Nigeria and too many people are dying of the disease. To avert this growing trend of the prevalence of cancer, Nigeria can do take these four steps.
Lifestyle modification
Evidence shows that lifestyle modification in terms of maintaining a healthy weight, eating healthy diet, exercising regularly, drinking alcohol in moderation if at all and protecting yourself from infections can lead to lowering the risk of developing cancer.
Overall, cancers are linked to lifestyle, which is largely accounted for common cancers. Malami said that getting at least 30 minutes of physical activity each day can make a big difference in your general health and well-being.
“Exercise to your routine to reduce stress, increase energy, boost your immune system, control your weight and reduce your risk for cancer,” he said.
The most important aspect of diet for cancer prevention is overnutrition, overconsumption of calories and weight gain contribute greatly to the cancer burden.
Oge Ilegbune a general practitioner, head of strategy, development and outreach at Lakeshore Cancer Centre says most of the risk factors cut cross across still boils down to a healthy lifestyle as they are directly or indirectly linked to cancer.
“What I always tell people is that the lifestyle modification for cancer prevention is not different from lifestyle modifications that should be adopted for hypertension or diabetes mellitus.”
Cancers include breast cancer, colon cancer, esophageal cancer, lung cancer, oral cancer, pancreatic cancer, prostate cancer, pharyngeal cancer, laryngeal cancer, and stomach cancer, as well as kidney and uterine cancer, are linked through lifestyle.
“Cancer is real; it is not caused by witchcraft or spiritual attack. It’s actually lifestyles and activities that predispose us to cancers,” said Malami.
“I am calling on all Nigerians to change from a sedentary lifestyle,” he said, and further called for changes in dietary habits, including switching to foods low in fats and calories, and increasing the levels of vegetable consumption.
Increase screenings, vaccinations, and awareness
Cancer screening at regular intervals with effective tests are established to protect against some specific cancers. Vaccinations have been shown in a large randomized controlled trial to cut the risk of cervical cancer and awareness educating against ignorance and misconceptions will reduce the risk of dying of the disease.
Pap tests, along with the addition of the newer human papillomavirus (HPV) test, help reduce the future cancer risk of cervical in both women and girls.
“Cervical cancer is a unique cancer in the sense that a proper vaccination with the right vaccines against the virus will prevent the girls from having cancer in their lifetime, unlike other cancers that do not have vaccines,” said Jide Akeredolu, a medical practitioner and district governor, Rotary International District of 9110.
Clinical breast exam and mammography are not preventive; they are key to early detection and successful, less aggressive treatment, conferring significant survival benefit.
“On average, an individual woman has the absolute risk of developing breast cancer during a particular decade of life is lower than 1 in 8 over an 80-year lifespan. The younger you are, the lower the risk. Being a woman and getting older are the main risk factors for breast cancer,” says Olayinka Odumosu, founder and a Patient Navigator, Pink & MetaPink Star.
For men, prostate-specific antigen (PSA) screening for prostate cancer will clear discussion of its limitations and potential risks
“A diagnosis of prostate cancer could cost N147, 000 to N152, 000, surgery could cost N350, 000 to N950, 000, and twenty-five to thirty sessions of chemotherapy could cost N150, 000 to N360, 000. In total, a patient needs about N1.3million to N3.3million to treat prostate cancer in Nigeria,” Runcie Chidebe, the researcher and executive director, Project PINK BLUE.
However, a clear need for improvement in rates and implementation of cancer screening, education, awareness, and vaccination to still much more needs to be done at both the local, state and federal levels to help the individual make healthier choices that will realize the huge potential of cancer prevention.
Integrated healthcare, collaboration can improve cancer care
There are so many factors that go into cancer care, these experts say that working with the Federal Government of Nigeria, and some private entities and international agencies can improve treatment service and care.
Annual reports on progress and benchmarks must be submitted to Congress. Funding would be dependent on the scope and quality of the plan and the achievements of the benchmarks.
“It is estimated that every country or low middle-income country like Nigeria should have one radiotherapy machine for 100 people. So there should be close to two million machines, since the country’s population, is approaching 200 million people,” says Chukwumere Nwogu, a cancer epidemiologist; thoracic surgical oncologist and chief executive officer, Lakeshore Cancer Centre.
Nwogu said Nigeria need to have special buildings or vaults for the machines, which is also expensive.
“There is a compelling opportunity to engage collaboratively with the public and private healthcare institutions. Physicians, nurses, pharmacist, allied healthcare workers, researchers, non-governmental organisations and the citizenry can work to stop the cancer challenge,” he said.
A big challenge is that the drugs (currently available) are quite expensive and there is a need for action to reduce the cost of the drugs.
Runcie Chidebe, the executive director of Project PINK BLUE, we want to urge the Nigerian government to invest in cancer care and make cancer a health priority. ‘I am appealing to all Nigerians to please go for screenings regularly and make it a routine.”
Malami further said that while cancer has been on a continuous rise in Nigeria, the reality is that the management of the disease is not improving “because we are serious”.
“We are not yet there. The government is not doing enough,” he said. He noted that Nigeria with a population of 200 million population has only seven radiotherapy machines, and added that there is hardly any time that three or four are working concurrently.
“One machine is supposed to serve 250 people in the population. Even if cancer treatment has been added to NHIS, the scheme has just covered less than five percent,” he noted.
