Another World Cancer Day: Nigeria's Prognosis

Even as a student of medical laboratory science, i never for once gave it a thought that cancer could be far-reaching and deleterious until an encounter that I had in 2007 at the Pathology department of Nigeria’s premier teaching hospital, University College Hospital, Ibadan. While on clinical posting to the department, I met a woman who just had her worst fear confirmed, she was diagnosed to have a metastasizing (madly spreading) cancer in her left breast.

Breast cancer is not just a disease, but a constellation of medical aberrations that is triggered off by the presence of an abnormal cell (cancer cell) which spreads and infects local and distant cells, causing problems as it comes in contact with previously normal cells. It is characterized by extensive destruction and interference with normal homeostatic and hemostatic functions of the body, making it a dreaded nightmare for any lady (and men) who greatly adore the female mammary glands.

Like most cancers, breast cancer has been associated with genetic predisposition and individuals with one or more family members with the condition are more at risk of suffering from breast cancer, in addition to other malignant conditions, compared to those without relatives who suffered from the condition.
Globally, medical scientists and geneticists have been able to identify the genes, chromosomal loci, chemotactic factors and cytogenetic markers that directly induce cancer, and those with indirect attribution to the abnormal condition. BCR-2 gene, TNF- a factor, and several cytokines, necrotic and apoptotic gene actions, wrong actions, and inertness have been found to be compromised during breast cancer.

Enough of scientific jargons!

On the international scene, the hope of individuals living with various forms of cancer- prostate, skin, cervical, skin, liver etc has been greatly raised owing to the advancements in the field of cancer studies. There are now better treatments, earlier diagnosis, and better prognostication of the apoplectic medical and social menace. Application of radiotherapy in killing cancer- infected cells is gradually thinning out, as focus is now on cancer cell- specific treatments that protect cancer patients from the harzadous, excrutiatingly painful and unimaginably expensive treatments which usually leave the patient bedridden for the best part of the years left for such an individual to spend on planet earth.

It is therefore not out-of-place for the western world to celebrate today, the success and new rays of hope being seen at the long end of cancer tunnel. Patients in these countries are also joining the celebration, so also are the governments of these nations who evidently set their priorities right- the wellbeing of the citizens is greater than any other agenda. However, in most African countries, the story is the same, but none is as pathetic as Nigeria’s cancer story.

In Nigeria, the predicament of patients with cancer is complexed by the paucity of facilities, treatment options, expensive chemotherapeutic and radiologic regimens, coupled with an unfriendly atmosphere created by grave negligence by government at all levels on the travails associated with terminal conditions like cancer.

One of the manifestations of administrative complacencies is the non existence of cancer centers to cater for the needs of cancer patients, especially in areas like south eastern Nigeria where the incidence is higher.

While on training at the UCH Ibadan, I also met family members of a cancer patient who had to bath, sleep, cook, eat and perform daily chores under an Iroko tree in the hospital environment. The dissappointment they have in the Nigerian government is boldly written on their faces as they were compelled to bath in the open space, pay the high costs of radiotherapy, and pray that their loved one recover, in whatever shape, from the cancer assault; much to the chagrin of the insensitive government that prefers to spend money on anything bu the good health of Nigerians. Pathetic!

These incidences are usual in medical facilities that are overstressed and they go a long way in showing how backward the Nigerian government is in ensuring the health status of Nigerians, and ensuring that the sick are better catered for.

There is therefore the need for the government to redefine its focus and visions for the health of the nation, and take steps to ensure that as much as possible, Nigerians, both male and female, young and old, have access to the best treatment medical science can provide.

Millions of Naira are spent daily by Nigerian governments on frivolities like seating (coughing, speaking and standing) allowances, furniture allowances, (in)security votes, constituency allocations, wardrobe allowances, travelling allowances and several others, which makes the nation spend millions daily that could be utilized for the betterment of the nation. It is not unexpected of a nation like Nigeria where natural resources like crude oil flows like the ocean; eyebrows are however raised when primary issues like good health are sacrificed to satisfy a few selfish, recalcitrant, pot- bellied rich men and women at the detriment of the larger poorer population.

Today’s World Cancer Day is not just about cancer and cancer patients, it’s about making individuals, authorities and governments at all levels aware of the plights of patients who are lying around in different hospitals under the influence of diseases like cancer. It is therefore not a time for jamboree, empty rallies and useless promises; it’s a time for all eyes to be opened.

The citizens should be aware of how to protect themselves, as much as possible, from getting in contact with substances that predispose them to cancer (e.g. the Ajinomoto seasoning), ladies (and husbands) should get more enlightened on the best way to check breasts for unusual lumps, young and old ladies need to be aware of why, when and how to get Pap smear screening which has reduced incidence of cervical cancer by 70 per cent in some western countries, and men should be aware of early signs of prostatis which indicates an ensuing prostate cancer. This is more important in individuals with a family history of any form of cancer.

Federal, state and local governments should also be aware of their duties. They should know that cancer lacks respect and can anyone, no matter the state or status, could be affected hence access to qualitative healthcare should be part of their realistic point agenda. There is also the need for the health care system to be revamped and patients should be empowered to make choices, especially where the opinions of the physician opposes that of the patient, as synonymous with several cancer- related complications. Ethical codes should be empowered to clearly stipulate the right course of action.

Nigeria is without doubt way behind other countries of the world in qualitative cancer therapy. While the reason for this might be complex to decipher, the way forward is not. All hands must be on deck. We must reprioritize. We must restrategize. And above all, we must be ready to make the right call, even when pressures against such abound. Cancer management is a clinical picture of the Nigerian nation, the longer we wait in taking decisions, the worse the prognosis. Hence, a stitch in time…

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