OLAYINKA ODUMOSU is the founder and a patient navigator of Pink & MetaPink Star. In this interview with ANTHONIA OBOKOH, she spoke on the rising cases of breast cancer in Nigeria and the need for government to create more awareness to tackle the issue.
What is the lifetime risk of developing breast cancer?
Breast cancer is a disease in which cells in the breast grow out of control and there are different kinds. The kind of breast cancer depends on which cells in the breast turn into cancer. No breast is typical. What is normal for you may not be normal for another woman. Most women say their breasts feel lumpy or uneven. Breast cancer can begin in different parts of the breast with most starts from the ducts or lobules and it can spread outside the breast through blood and lymph vessels. When breast cancer spreads to other parts of the body, it is said to have metastasized.
On average, a woman absolute risk of developing breast cancer during a particular decade of her life is lower than 1 in 8 over an 80-years lifespan. The younger you are, the lower the risk. Being a woman and getting older are the main risk factors for breast cancer. However, studies have shown that your risk for breast cancer is due to a combination of factors. The main factors that influence your risk include being a woman and getting older. Most breast cancers are found in women who are 50 years old or older.
Some women will get breast cancer even without any other risk factors that they know of; I have seen this in my practice as a patient navigator. Having a risk factor does not mean you will get the disease, and not all risk factors have the same effect. Most women have some risk factors, but most women do not get breast cancer.
What are the risk factors you cannot change in developing cancer?
Inherited changes (mutations) to certain genes, such as BRCA1 and BRCA2. Women who have inherited these genetic changes are at higher risk of breast and ovarian cancer.
Also, reproductive history, early menstrual periods before age 12 and starting menopause after age 55 raises the risk of getting breast cancer. Besides, women having dense breasts that have more connective tissue than fatty tissue, which can sometimes make it hard to see tumours on a mammogram, are at higher risks of breast cancer. More so, women who have had breast cancer are more likely to get breast cancer a second time. Some non-cancerous breast diseases such as atypical hyperplasia or lobular carcinoma in situ are associated with a higher risk of getting breast cancer.
Family history of breast cancer, a woman’s risk for breast cancer is higher if she has a mother, sister, or daughter (first-degree relative) or multiple family members on either her mother’s or father’s side of the family who have had breast cancer. Having a first-degree male relative with breast cancer also raises a woman’s risk. Research suggests that other factors such as smoking, being exposed to chemicals that can cause cancer and changes in other hormones due to night shift working also may increase breast cancer risk.
Breast cancer is now an epidemic in Nigeria, how is Pink & MetaPink Stars creating awareness?
Pink & MetaPink Stars is a Support Group for Early Stage and Metastatic Breast Cancer Patients which was born out of our Patient Navigation Program, an Amorvard Trademark. Patient navigation is simply about breaking barriers to treatment for a cancer patient by walking through the treatment continuum with each patient right from the point of community outreach and screening programs through the point of diagnosis through to survivorship. According to data to the PN data spreadsheet, between 2016 – 2019, over 90 percent of patients diagnosed with breast cancer cannot afford the treatment. More than 98 percent fall into depression and confusion navigating their way through their treatment continuum. Hence, there is a need for psychosocial support, counselling, financial counselling, dietary counselling, and aerobic sessions.
We aim to teach the patient how to live their best life despite a diagnosis of breast cancer. Pink & MetaPink Stars is an initiative of Amorvard open to corporate sponsors and partnerships and support. Pink & MetaPink Stars is the number one patient choice for Psychosocial Care/Support in cancer care. We offer free Psychosocial Support to breast cancer patients in Nigeria.
How can breast cancer prevalence be controlled in Nigeria?
Awareness and education is very important. People need to be aware that this is real. Most patients still hide and live in denial. Some people discover an abnormality in the shape and outlook of their breast but because they are not aware or knowledgeable about what is happening, they stay back at home and do not visit any nearby primary health centers or hospitals but instead they opt for herbal product which is not scientific. Education is a continuous thing which is one of the key areas amongst many others our patient navigation program focuses on.
Treatment support is a very vital aspect of a breast cancer patient that the Nigerian government needs to look into. The government needs to find a way to support patients’ treatment. According to data and from our evidence-based patient navigation data program, over 90 percent of patient diagnosed with breast cancer in Nigeria cannot afford the treatment and over 85 percent of patient who report early eventually move to metastasis because of the delay in treatment due to financial setbacks and inability to afford the treatment. Several and most of my patients fall in this category and it saddens my heart. I plead with the government to please come to the aid of these women by coming up with programs that support their treatment. According to recent study/data, patient navigator services has greatly helped in the psychosocial care of breast cancer patient in Lagos state and Nigeria at large. Continuous improvement in the delivery of psychosocial care is Paramount to further support and help breast cancer patients in Nigeria and West Africa at large. This is why I said earlier, that our patient navigator program which is a trademark of Amorvard Service is open to partnership with all stakeholders to deliver best and evidence-based psychosocial care to cancer patients. Psychosocial care, linking patients to the right care, counselling, financial counselling, guidance through the treatment journeys are all essential elements of our patient navigator services.
Health Insurance in Nigeria needs to be improved greatly. In Nigeria, over 87 percent of the cancer patient’s expense is not covered by insurance. Over 65 percent of the patient are not even under any insurance cover! The remaining 35 percent who have insurance do not have robust cover that takes care of a considerable portion of their treatment, so what is the point? The government should please look into insurance coverage for breast cancer patients and all other types of cancer as well.
Lastly, the healthcare professionals need to be well trained /exposed and properly cared for so they are better able to deliver and give the best of care to their patients.
For many decades, breast cancer has been in existence. Can you tell us by what percentage has the country increase awareness?
I will say 50 percent, but we need to create more awareness; hence the strong need for our patient navigator services /program. Most remote areas in Lagos and other parts of Nigeria do not have access to free screening let alone education/ educational materials on breast cancer. We need more awareness and this should go in line with treatment support because of what use is awareness if you are aware, you cannot afford the treatment?
How can breast cancer awareness be deepening in the country, relations to the awareness knowledge?
Healthcare facilities need to engage the Patient Navigator Services. Patient Navigators play an important role in the healthcare team. We link patients to primary care providers, health information, health screening, financial assistance or transportation. At Amorvard, our community navigators assist patients and their families throughout the entire cancer care continuum, from screening and diagnosis through treatment and survivorship, all the way to palliative care and the end of life. We need to embrace patient navigation in Nigeria and seek to increase awareness of this disease through patient navigation / patient navigator services.
How can the government help so that breast cancer surgeries can be subsided and accessible in different healthcare facilities in Nigeria?
The health insurance needs to be accessible by all. For a start, the government can come in by doing 90 percent expense of the cost of breast surgeries while the patient and their family takes care of the remaining expense and other unforeseen additional treatment expense. I strongly think this will go a long way for a start.
