Vehicles of death: growing links between lung cancer and smoke

Tobacco Smoking a sure way to contract lung cancer

Revolutionary case against tobacco use in Nigeria

-Alexander Chiejina

…Tobacco control bill yet to be passed by National Assembly

Without a doubt, the health, economic, social, and environmental consequences of tobacco use in Nigeria and the continent are enormous. Little wonder the World Health Organisation (WHO) recently revealed that African countries are experiencing a 4.3 percent annual increase in the rate of tobacco consumption.

This has resulted in an upsurge of lung cancer and related cases which are now prevalent in the society. It was against this background that experts, at a recent training for health reporters on cancer reporting organised by Journalists Advocacy on Tobacco and Health held recently at Ogba, Lagos urged that the trend should be checked. Speaking at the event, Akinbode Oluwafemi, programme manager, Environmental Rights Action/Friends of the Earth (FoEN), noted that tobacco smoking is responsible for more than 85 percent of lung cancers. This, he explained, is because smoking-related cancer accounts for 30 percent of cancer-related deaths, adding that renowned journalists in the country like Steve Kadiri, Yinka Craig, Momoh Kubanji, Tina Onwudinwe and Beko Ransome Kuti lost their lives due to the health hazards associated with the consumption of cigarettes. “Research findings have it that there are about 599 approved additives in a stick of cigarette. However, cigarette smoke has been proven to contain over 4000 toxic and cancer causing chemicals; carbon monoxide, nitrogen oxides, hydrogen cyanide, ammonia, to name but a few,” Oluwafemi disclosed. According to him, cigarette advertising, promotion and sponsorship such as ‘Welcome to London, cool feeling’ have made cigarette smoking appealing to a lot of youths, without some of these tobacco companies apprising the public of dangers associated with smoking.

Lending his view, Tosin Orogun, programme manager, Communications and IT, Africa Tobacco Control Regional Initiative (ATCRI), declared that the rise in cigarette smoking in the society is traceable to tobacco companies which increasingly target the developing world as barriers rise and smoking rates fall in more mature markets. “What we (ATCRI) have been trying to do is to facilitate the adoption, implementation and enforcement of effective in-country tobacco control policies, legislation and programs in Nigeria and across the continent,” Orogun revealed. Already, a 2009 report on the implementation of smoke-free environments aimed at combating Global Tobacco Epidemic shows that five more countries (Djibouti, Egypt, Islamic Republic of Iran, Malaysia and Mauritius) meet the best practices for health warnings on cigarette packages. Three other countries (Israel, Romania and the United Arab Emirates), meanwhile, offer comprehensive help in the drive to eradicate tobacco consumption. In the same vein, only Panama has joined the small group of countries that ban all forms of tobacco advertising, promotion and sponsorship, even as more than 90 percent of people lack protection from tobacco industry marketing. Six more countries (Czech Republic, Estonia, Fiji, Finland, the Netherlands and Seychelles) have levied tobacco taxes higher than 75 percent of retail price.

Lastly, of the world’s 100 most populous cities, 22 are smoke-free. Sadly, though, reports from the recently concluded media summit hosted by the American Cancer Society ahead of the AORTIC cancer in Africa, stated that 55 percent of school students are not aware that secondhand smoke is harmful to health, and only 1 percent of Nigeria’s population are protected by strong smoke-free laws. This lays bare the fact that if nothing is done to hastily check public smoking in the country, the rising figures of cancer and other non-communicable diseases may remain.

The bill to ban cigarette smoking in public places which had its public hearing before the National Assembly 19 July this year should quickly be passed into law. A part of the bill which seeks to protect people from secondhand smoke, raise taxes on tobacco, enforce a level of ban on tobacco advertising, promotion and sponsorship would in the long run, save Nigerians from self- inducing cancer types.

SOURCE

SMOKING CAUSES 85% CASES OF LUNG CANCERS - EXPERTS

'Loneliness worsens cancer'

LONELINESS makes cancer both more likely and deadly, according to scientists. The British Broadcasting Corporation (BBC) said yesterday that the proceedings of the National Academy of Science showed social isolation tips the odds in favour of aggressive cancer growth.
Rodents kept alone developed more tumours - and tumours of a more deadly type - than rats living as a group.

The researchers put it down to stress and say the same may well be true in humans.

Cancer experts say more work is needed to prove such a link in people.

Lead investigator, Gretchen Hermes, of Yale University, said: "There is growing interest in relationships between the environment, emotion and disease.

"This study offers insight into how the social world gets under the skin."

Doctors already know that cancer patients who are depressed tend to fare worse in terms of survival.

It's possible that stressful situations could indirectly affect the risk of cancer by making people more likely to take up unhealthy behaviours that increase their risk

And previous research has suggested that social support can improve health outcomes for patients with breast cancer.

In the latest study, the researchers found that isolation and stress trebled the risk of breast cancer in the naturally sociable Norway rats.

Outcast rodents developed 84 times the amount of tumours as those living in tight-knit social groups, and the tumours also proved to be more aggressive.

The isolated mammals also had higher levels of the stress hormone, corticosterone, and took longer to recover from a stressful situation than fellow Norway rats.

The researchers ultimately hope their work will help cancer patients.

Co-researcher Martha McClintock, a psychologist at the University of Chicago, said: "We need to use these findings to identify potential targets for intervention to reduce cancer."

Ed Yong, of Cancer Research UK, said: "This study was done in rats. Overall, research in humans does not suggest there is a direct link between stress and breast cancer.

"But it's possible that stressful situations could indirectly affect the risk of cancer by making people more likely to take up unhealthy behaviours that increase their risk, such as overeating, heavy drinking or smoking."

SOURCE

Waging war against cancer

At the recently concluded conference of the African Organisation for Research and Training in Cancer, held in the coastal city of Dar es Salaam, Tanzania, President Jakaya Kikwete called for urgent action to combat. He promised to use his position as the chairman of the African Union to call on the leaders of the continent to take the high incidence of cancer more seriously. We cannot agree more with him.

We are concerned that cancer has become such a common disease in Nigeria that more attention needs to be paid to adequate education and a campaign to open the eyes of the populace to the need to be more proactive in combating it.

In Nigeria, according to statistics, breast and cervical cancers are the most common among women while prostate cancer is more common among men. It is disheartening that except for a rash of nongovernmental organizations that have taken it upon themselves to mount awareness campaigns, not much is being done by government agencies and the ministries of health to complement these moves.

This is not to say that no measures have been embarked on by these agencies, but we must go beyond the rhetoric that seems to dominate some of these attempts. The time toact is now because many of our citizens are still ignorant about this disease and in many cases of cancer, early detection is the key to any hope of successful treatment. The various causes of the disease are also due to lifestyle factors and poor health habits.

Without knowledge and information on a wide scale to assist in early detection, there is almost no chance of fighting cancer. In fact, the level of ignorance at times is so abysmal that it beggars belief.

Some people today still think cancer is caused by ‘‘the devil'' and would therefore prefer to go to so called spiritual homes or traditional healers to seek a cure. There is an urgent need to have a coordinated approach against all forms of cancer in the country. In August,Turai Yar'Adua, the president's wife launched an appeal fund for the building of what was called an International Cancer Centre in Abuja with much fanfare. At the launch, millions were raised. Now, several months down the road the parcel of land where the centre is to be sighted is still fallow, as no sign of development has taken place.

Mr. Kikwete could have been talking about Nigeria when he told delegates, "Cancer services in Africa are grossly inadequate while statistics are really frightening in relation to the frequency, late stage of presentation and the number of deaths attributed to cancer. Cancer is more than an ordinary disease. Indeed it is many diseases. It is one of the maincauses of death worldwide.

I am told that globally cancer causes more deaths than HIV, TB and Malaria combined." For Nigerians who have been diagnosed with cancer the challenge of finding care is a daunting one characterised by a lack of equipment, drugs and trained personnel. Patients have to travel from one end of the country to the other for chemotherapy and other forms of treatment, which in most cases are expensive and out of their reach.

We are calling on government agencies, c o r p o r a t i o n s a n d n o n -governmental organisationsto see this not as a lone fight to be fought individually.

The best way to begin to tackle the problem of treatment is to make the basic instruments for early detection available in our hospitals nationwide to provide an alternative for those who truly feel they have no other option but to appeal to traditional healers and spiritual deities.

SOURCE

Myths and facts of a disease

• By Olukorede Yishau

Rahama Sani is a social worker. In her career, she has seen many women with cancer. But that never prepared her for the fate that befell her in August 2005. As a habit, Sani, every month, carries out breast self-examination or BSE immediately after her monthly menstrual period. Unlike her previous experience, she discovered there was a lump. Is it invasive or benign? She wondered. Fear enveloped her. Yet, she decided she would go for proper examination.

In her words: "I wanted a female doctor to examine me. So, I waited till September when the female doctor arrived. She confirmed there was a lump and ordered some investigations. All investigations confirmed it was just a benign lump. So, there was no problem. Then I was planning to go for umrah. I planned that if I travelled to Saudi, I will have it removed and looked at properly. Unfortunately, I could not make it because I could not get the visa."

She was thus left with the Hobson’s choice of doing the pathological examination of the lump in Nigeria. That was in October 2005. The result came in November 5, 2005. Since the past results had shown that the lump was not invasive, she was not prepared for what she got. The result said the lump was invasive, which means it was capable of developing into other areas. She was shocked, confused and almost fainting.

The truth was too much for her to believe. She said: "When I got the result, I was like, this was not my own because there was a typographical error in my name. But when I went to see the pathologist, he confirmed it was mine. I said we should have a second opinion. This was done by this renowned pathologist in ABU Teaching Hospital, Dr. Rafindadi. I went to see him in Zaria and they did the test again and he confirmed the same result. I was so confused. But he counselled me."

Before then, the only sign she could remember having in 2004 was shoulder pain radiating to the breast. After the discovery, she confided in her family. "But I took the decision to have mastectomy alone because no one would support to have one of your breasts removed, especially when it happened when you were thinking of having a child.

"I did not have a child in my first marriage and was just planning to remarry and have a child when this happened. They just thought have you ever seen somebody who is living with one breast, or have you ever seen somebody who has a baby with one breast. I took the decision alone because I am well-informed that if I don’t take a decision early, it may be more traumatising. The person I wanted to marry was in the UK and he was very supportive all through," she recalled.

Like Sani, Gladys Boateng, a Ghanaian also participated in the 7th conference of the Africa Organisation for Research and Training in Cancer (AORTIC), in Dar es Salaam, Tanzania, which was attended by over 700 people from different parts of African and the Diaspora. Both of them are cancer survivors. But unlike Sani, Boateng knew next to nothing about cancer when she was diagnosed in 1999. The mother of three had to contend with all kinds of myths.

According to her, "in October 1999, I had gone to the hospital for something else and the doctor conducted some tests and after thorough examination of my breast he found something hard. I didn’t notice it until the doctor told me. It was like mosquitoe’s bite and they discovered the place was a bit hard. He asked me to see a surgeon and after seeing the surgeon, he confirmed that it was cancer."

Boateng said: "I have heard about people who had cancer but I know that they don’t normally go to the hospital. They only stay at home. They don’t even like to talk about it and later on, you hear that they are dead. I thought the same thing was going to happen to me. So, I was scared because I felt it was a death sentence that has been passed on me. "

After the test, she chose to consult a priest who advised her not to go to the clinic. Boateng told Newsextra that if she went to the clinic she would emaciate, lose her hair and later die. She was made to believe that all she needed were prayers.

"He prayed for me and told me about so many people that had died. He also told me that his wife had a worse case than mine and he was able to pray for her and she became healed. He said mine too cannot be a difficult one that if I go to the hospital, I will lose all my hairs, grow lean and die at the end.

But it took a vist to a relation in South Africa for her to realise that the priest had fed her with myths. She also met other survivors and gave her hope to fight and defeat cancer.

Boateng: "Later on, I went to the hospital and also went to South Africa to live with a relation because at that time my family was not around. So, I had a surgery done in South Africa and after the surgery, the doctor told me that the cancer had gone to one. I thought it was a good news. But a patient close to me in the same hospital told me that it means it had gone into my system to appear anywhere in my body. So, I became scared at that point. But another survivor from South Africa came to visit me and I attended their meeting. At the meeting, I met other survivors who encouraged me.

"In Ghana, there was no survivor because people were afraid to come out and talk about it. At the meeting, I saw about 300 people who had cancer and I was encouraged. After the meeting, they broke into smaller groups and were sharing their experiences. After hearing their stories, my eyes became open to the real fact about cancer that it does not kill, that if you go for early treatment, you can still live. After the meeting, I had a change of heart and I became encouraged and felt I could do the same in Ghana."

That was how she started Reach for Recovery Ghana, which gives support to breast cancer survivors, especially the young ones who have refused to talk.

But is cancer as dangerous as many like Boateng were made to believe? As far as Dr. Sani Malami, cancer specialist and publicity secretary of the Nigerian Cancer Society (NCS) is concerned, it is dangerous when it is not discovered early and treated appropriately. "Most cancers lead to death. We know for a fact that globally cancer was responsible for more deaths than malaria and HIV/AIDS and tuberculosis combined and you know these are the major public health problem that we face at the moment, but because of modalities that have been put in place in our country and other countries, they do not constitute much fatal consequences as cancer does," he said.

Malami said: "The truth is that there are as many myths as the number of communities we have. But that is because of the fear of the unknown. It has been known in our communities that we have all kinds of cancer. Unfortunately because this has not been addressed appropriately and because there are no facilities to debunk some of these myths, it has been especially difficult to get people to understand. This is also because many of these cancers are detected late and they lead to death and especially death among people in their productive age. So, there is no relationship between cancer and evil spirit, casting of spell or as some people suggest that it is adulterous women who contract cancer. There is no truth in it. Cancer is caused by a single cell, which has undergone a change in its biological composition, and it multiplies very rapidly and invades other areas and inevitably consumes the individual."

It is the need to deal with all types of cancer that Sani told Newsextra that government needed to put in place facilities that could aid early detection. She said a situation whereby many patients are assigned to one doctor and they have to queue at major hospitals such as the University Teaching Hospital, Ibadan would not do the nation any good.

Sani: "I hope our government will put in place proper diagnostic facilities so that people won’t be wrongly diagnosed and they can take informed action. We need to improve the diagnostic system. I am sure a lot of people have been wrongly diagnosed."

However, for Dr. Paul Jubrin, consultant pathologist and Head, Department of Histopathology, National Hospital, Abuja, it is not much the problem of facilities. He told Newsextra in Dar es Salaam that "the facilities for the treatment of cancer in Nigeria are actually up-to-date."

So, what is the problem? Jubrin answers: "The problem is that it is not well-distributed. Cancer radiotherapy, one of the latest treatments of cancer, is only in Lagos, Abuja, Ibadan and Zaria. At least, you expect up to two of them in each geo-political zones of the country. If you come to the National Hospital, Abuja, we have state-of-the-art equipment. We recently introduced nuclear medicine, which you can use to detect cancer in your body and apart from that we have oncology unit. It is just distribution that is the problem. National Hospital has started training for oncologists. The screening method for cervical cancer called pap smear is between N2,000 and N3,000. It is not available everywhere. Now, we have what we call vispal inspection with iodine. You don’t even need a specialist for this."

Another important angle comes from Olufunmilayo Olopade, a professor of medicine at the University of Chicago. Olopade said at a session of this year’s AORTIC conference in Dar es Salaam that cancer researchers still have a lot of work to do. "I hope that this work will be done by members of AORTIC in partnership with all of us who are working in the Diaspora because until we get to the point where we can say we have eradicated cancer from the planet, our job is not done," she said.

This was also why the African Union chairman and Tanzanian president Jakaya Kikwete challenged African leaders to look for ways to battle cancer to a standstill. He said the continent lacked the wherewithal to do it alone. So, he called on international donors to assist. Kikwete, in response to a request from AORTIC founding father, Jim Holland, promised to get leaders on the continent to take the fight against cancer serious.

Along this line, the Chief Medical Officer of the American Cancer Society (ACS), Otis Brawley, urged those involved in the battle against cancer to use a report released at the AORTIC conference on winning smoke-free air as a tool. Brawley said with this report entitled Global Voices: Rebutting the Tobacco Industry, Winning Smokefree Air, smoke-free public places are examples of low cost and effective intervention against cancer.

Until that is achieved, people living with cancer can hang on to the words of Boateng that having cancer is not a death sentence. The secret, she said, is detecting and treating it early, without being bogged down by the many myths woven around it. "Having cancer is not the end of the world. There is life after cancer. You can still live," she counselled.

SOURCE

Africa and the fight against cancer

ABOUT 20 million new cases of cancer will be discovered in the next 10 tears in Africa, if urgent steps are not taken the check its spread.

During the last edition of the African Organisation for Research and Training in Cancer (AORTIC) conference in Dar Es Salaam, Tanzania, participants agreed after thorough deliberation that women from developing countries will be mostly affected by 2020.

According to the World Health Organisation (WHO), cancer now kills more than HIV/AIDS, Malaria and Tuberculosis globally. In fact, it is said that cancer is more than an ordinary disease.

To combat the scourge of cancer in Africa, the continent should view the disease from a broader development perspective rather than a narrow health perspective. Cancer services in Africa are grossly inadequate while statistics are real frightening in relation to the frequency, late stage of presentation and the number of death attributed to cancer. Global incidence of cancer is increasing due to dramatic changes in life expectancy, combined with profound charges in lifestyle. The number of death attributed worldwide to cancer, is approximately at 12 per cent of the total number of death in the world.

African Union (AU) Chairman and Tanzanian President Jakaya Kikwete, who spoke at the conference, advised African leaders to find a lasting solution to the cancer scourge on the continent.

He described cancer as “more than an ordinary disease. It is one of the main causes of death worldwide. I am told that globally cancer causes more death than HIV, TB and Malaria combined.”

More than 70 per cent of cancer patients will live in developing countries which have only 5 per cent of the resources set aside for cancer control. Over the past 30 years, there have been steady gains overall in the quality of care available to those with cancer in developed countries but Africa has witnessed very little gain. At the moment, the cost of cancer care as practised in the established market economies far outstrips the resources of many African countries. The continent therefore has to look at ways to keep cost down and yet provide the best possible care.

Talking about cancer in Africa will not be complete without touching on its implication for development. It is now well known that health of population is linked closely to the socio-economic status of individuals.

No discussion on strategies to fight cancer in Africa would be complete without addressing two important issues - the health infrastructure which is very inadequate and the lack of human resources as a result of inadequate training and brain-drain.

Mrs Rahama Sani, a Nigerian-based in Kano and Mrs Gladys Boateng from Ghana who now runs a Non-Governmental Organisation (NGO), Reach for Recovery Ghana, to create awareness on the disease, told our correspondent at the conference that they were shocked when doctors told them that they had cancer.

Mrs Boateng, mother of three, said she was diagnosed with breast cancer in October 1999. She said she had gone to the hospital for something else when the doctor examined her and found out that she had breast cancer. She said she didn’t notice it until the doctor gave her the information.

“I had gone to the hospital for something else and the doctor conducted some tests and after thorough examination of my breast he found something hard. I didn’t notice it until the doctor told me. It was like a mosquito bite and they discovered the place was a bit hard. The doctor asked me to see a surgeon and after seeing the surgeon, he confirmed that it was cancer,” Mrs Boateng said.

Asked how she felt when she was told that it was cancer, Mrs Boateng said, “I have heard about people who had cancer but I know that they don’t normally go to the hospital. They only stay at home. They don’t even like to talk about it and later on, you hear that they are dead. I thought the same thing was going to happen to me. So, I was scared because I felt it was a death sentence that has been passed on me. But after the test, I consulted a priest who told me and advised me not to go to the hospital that I will emaciate and I will die.

“Later on, I went to the hospital and also went to South Africa to live with a relation because at that time my family was not around. I had a surgery done in South Africa and after the surgery the doctor told me that after taking a nine-limp note, the cancer had gone to one. So, I thought it was good news that whatever it is, the cancer had been taking care of. But a patient close to me in the same hospital told me that it means it had gone into my system to appear anywhere in my body. So, I became scared at that point. But another survivor from South Africa came to visit me and I attended their meeting. At the meeting, I met other survivor who encouraged me. In Ghana, there was no survivor because people were afraid to come out and talk about it. At the meeting, I saw about 300 people who had cancer and I was encouraged.

“After the meeting, when they broke into smaller groups and others were sharing their experiences that after they have taken nine-limp note it has come to five and I began to ask them how many years they’ve been diagnosed with cancer and they began to tell me the number of years. Some will tell me seven years, some six, five, eight etc.

“After hearing their stories my eyes became open to the real fact about cancer that it does not kill and that if you go for early treatment you can still live. After the meeting, I had a change of heart and I became encouraged and I felt I could do the same in Ghana.

“Before I was diagnosed with cancer, I did not notice any symptom but I could remember I noticed a sharp pain in my breast but I didn’t take it seriously.”

She said the doctor told her that what she thought was a mosquito bite was a lump.

“When I broke the news to my family, they were all calm but they were scared. At a point they supported me to some extent. My husband and I were married for 33 years but at the moment we are separated,” she added.

Mrs Boateng told women who may be in a similar situation that “breast cancer is not a death sentence and certainly not the end of the world if you go early for treatment after it is detected. Some people get scared and worried after being diagnosed with cancer. Every woman likes the breast but they should not be worried because of the loss of their breast. There is a disease in it but if you don’t allow them to take it off, the cancer will travel to other parts of the body and that is what kills people. Having cancer is not the end of the world. There is life after breast cancer. You can still live”.

Rahama, who is also a cancer survivor, said she discovered she had cancer in August 2005.

She went to hospital and the doctor conducted a test and found out that she had breast cancer. She said she used to go for breast self-examination every month. She said when she went for the examination in August 2005 she discovered that there was a lump in her breast. After the examination, the doctor confirmed there was a lump and ordered some investigations.

Her words: “All investigations confirmed it was just a benign lump. So, there was no problem. Then I was planning to go for Umrah (the lesser hajj). I planned that if I travel to Saudi, I will have it removed and looked at it properly. Unfortunately, I could not make it because I could not get the visa. Later in October we decided to remove the lump and have it examined in Nigeria in October 2005. I got the result precisely on November 5, 2005, which confirmed there was invasive cancer. I was shocked. I was confused. I was almost fainting. I decided to call the surgeon. I said there was a mix up in my name. So, I said it could not be me.

“In 2004, I had shoulder pain radiating to the breast. I saw a doctor who thought it was arthritis and prescribed a drug for me and I got over it.

“I had to confide in my family, but I took the decision to have mastectomy alone because no one would support you to have one of your breasts removed, especially when it happened when you were thinking of having a child. I did not have a child in my first marriage and was just planning to remarry and have a child when this happened.

“They just said have you ever seen somebody who is living with one breast, or have you ever seen somebody who has a baby with one breast? I took the decision alone because I am well-informed that if I don’t take a decision early, it may be more traumatising. The person I wanted to marry was in the United Kingdom and he was very supportive all through.

“I did three investigations. I did mammogram, there was nothing, until the pathologist said they should remove it and examined it and he confirmed there was cancer. When I got the result, I was like this was not my own because there was a typographical error in my name.

“But when I went to see the pathologist, he confirmed it was mine. I said we should have a second opinion. This was done by this renowned pathologist in Ahmadu Bello University Teaching Hospital, Dr Rafindadi. I went to see him in Zaria and they did the test again and he confirmed the same result. I was so confused. But he counselled me,” she said.

Dr Sani Malami, cancer specialist and publicity secretary, Nigerian Cancer Society, described cancer as dangerous when it is not discovered early and treated appropriately. He disclosed that most cancers lead to death.

According to him, it is a fact that globally cancer is responsible for more death than malaria and HIV/AIDS and tuberculosis combined.

When asked about the myth associated with cancer, Malami said, “it has been known in our communities that we have all kinds of cancer. Unfortunately because this has not been addressed appropriately and because there are no facilities to debunk some of these myths, it has been especially difficult to get people to understand. This is also because many of these cancers are detected late and they lead to death and especially death among people in their productive age.

“So, there is no relationship between cancer and evil spirit, casting of spell or as some people suggest that it is adulterous women who contract cancer. There is no truth in it. Cancer is caused by a single cell, which has undergone a change in its biological composition, and it multiplies very rapidly and invades other areas and inevitably consumes the individual.”

According to consultant pathologist, Head, Department of Histopathology, National Hospital, Abuja, Dr Paul Jubrin, the facilities for the treatment of cancer in Nigeria are actually up-to-date, but the problem is that it is not well-distributed. Cancer radiotherapy, one of the latest treatments of cancer, is only in Lagos, Abuja, Ibadan and Zaria.

“At least, you expect up to two of them in each geo-political zones of the country. If you come to the National Hospital, Abuja, the state-of-the-art equipment are there. We recently introduced nuclear medicine, which you can use to detect cancer in your body and apart from that we have oncology unit. It is just distribution. National Hospital has started training oncologists. The screening method for cervical cancer called pap smear is between N2,000 and N3,000. It is not available everywhere. Now, we have what we call vispal inspection with iodine. You don’t even need a specialist for this,” he said.

 

SOURCE

Cancer: Africa’s contention with a population threatening disease

Two cancer survivors who attended the African Organisation for Research and Training in Cancer (AORTIC) Conference in Dar Es Salaam, capital of the United Republic of Tanzania, told KUNLE

OLASANMI, who also attended the conference, about their experiences and how they survived it

If something urgent is not done about the spread of cancer in Africa, about 20 million new cases will be discovered in the next 10 years. During the last edition of the African Organisation for Research and Training in Cancer (AORTIC) conference in Dar Es Salam, Tanzania, participants agreed, after thorough deliberation, that women from developing countries will be the most affected by the disease by 2020. According to the World Health Organisation (WHO), cancer now kills more than HIV/AIDS, malaria and tuberculosis globally. In fact, it is said that cancer is more than an ordinary disease.

To combat the scourge of cancer in Africa, those at the conference reasoned, the continent should view the disease from a broader development perspective rather than a narrow health perspective. Cancer services in Africa are grossly inadequate, according to them, while statistics are frightening in relation to the frequency, late stage of presentation and the number of deaths attributed to cancer. Global incidence of cancer is increasing due to dramatic increases in life expectancy, combined with profound changes in lifestyle. The number of deaths attributed worldwide to cancer is approximately at 12 per cent of the total number of deaths in the world.

Chairman of the African Union (AU) and the President of Tanzanian, Jakaya Kikwete, who spoke during the conference, advised African leaders to find a lasting solution to the cancer scourge in the continent. He described cancer as “more than an ordinary disease. It is one of the main causes of death worldwide. I am told that globally, cancer causes more death than HIV, tuberculosis and malaria combined.”

More than 70 per cent of cancer patients will live in developing countries, which have only five per cent of the resources set aside for cancer control. Over the past 30 years, there have been steady gains overall in the quality of care available to those with cancer in developed countries. But Africa has witnessed very little gain. At the moment, the cost of cancer care as practiced in the established market economies far outstrips the resources of many African countries. Participants at the conference therefore wants the continent to find ways to keep the cost down and yet provide the best possible care.

It would not be complete to talk about cancer in Africa without touching on its implication for development. And that the participants did. It is now a well established fact that the health of the population of a country or continent is linked closely to the socio-economic status of the individuals. Therefore, it was agreed that no discussion on strategies to fight cancer in Africa would be complete without addressing two important issues: these are the health infrastructure, which it was agreed at the conference is very inadequate and the lack of human resources as a result of inadequate training and brain-drain e to the search for greener pastures.

Rahama Sani, a Nigerian based in Kano, and Gladys Boateng from Ghana, who runs a Non-Governmental Organisation to create awareness about the disease, said they were shocked when doctors told them that they had cancer. Boateng, a mother of three, who runs Reach for Recovery Ghana, said she was diagnosed of breast cancer in October 1999. She said she had gone to the hospital for something else when the doctor examined her and found out that she had breast cancer. She said she didn’t notice it until the doctor gave her the information. Boateng said, “I had gone to the hospital for something else and the doctor conducted some tests and after thorough examination of my breasts he found something hard. I didn’t notice it until the doctor told me. It was like a mosquito bite and they discovered the place was a bit hard. The doctor asked me to see a surgeon and after seeing the surgeon, he confirmed that it was cancer.”

Asked how she felt when he was told that it was cancer, Boateng said, “I have heard about people who had cancer but I know that they don’t normally go to the hospital. They only stay at home. They don’t even like to talk about it and later on, you hear that they are dead. I thought the same thing was going to happen to me. So, I was scared because I felt it was a death sentence that has been passed on me. But after the test, I consulted a priest who told me and advised me not to go to the hospital that I will emaciate and I will die. But later on, I went to the hospital and also went to South Africa to live with a relation because at that time my family was not around. I had a surgery done in South Africa and after the surgery the doctor told me that after taking a nine-limp note, the cancer had gone to one. So, I thought it was good news that whatever it is, the cancer had been taken care of. But a patient close to me in the same hospital told me that it means it had gone into my system to appear anywhere in my body. So, I became scared at that point. But another survivor from South Africa came to visit me and I attended their meeting. At the meeting, I met other survivors who encouraged me. In Ghana, there was no survivor because people were afraid to come out and talk about it. At the meeting, I saw about 300 people who had cancer and I was encouraged. After the meeting when they broke into smaller groups and others were sharing their experiences that after they had taken nine-limp note it has come to five and I began to ask them how many years they’ve been diagnosed of cancer and they began to tell me the number of years. Some will tell me seven years, some six, five, eight, etc. After hearing their stories, my eyes became open to the real fact about cancer that it does not kill. That if you go for early treatment you can still live. After the meeting, I had a change of heart and I became encouraged and I felt I could do the same in Ghana.”

She continued her story, “Before I was diagnosed of cancer, I did not notice any symptom. But I could remember I noticed a sharp pain in my breast but I didn’t take it seriously. The doctor told me that what I thought was a mosquito bite was a lump. When I broke the news to my family, they were all calm but they were scared. At a point, they supported me to some extent. At the moment we are separated, but they supported me. We were married for 33 years but at the moment we are separated.”

Boateng was quick to advice women who are in a similar situation, “Breast cancer is not a death sentence and certainly not the end of the world if you go early for treatment after it is detected. Some people get scared and worried after being diagnosed of cancer. Every woman likes the breast but they should not be worried because of the loss of their breast. There is a disease in it but if you don’t allow them to take it off, the cancer will travel to other parts of the body and that is what kills people. Having cancer is not the end of the world. There is life after breast cancer. You can still live.”

Sani, who is also a cancer survivor, said she discovered she had cancer in August 2005. Like Boateng, she went to the hospital for some other issue and the doctor conducted a test and found out that she had breast cancer. She said she usually carries out self-examination on her breasts every month. She said when she went for the examination in August 2005, she discovered that there was a lump in her breast. After the examination, the doctor confirmed there was a lump and ordered some investigations.

She added, “All investigations confirmed it was just a benign lump. So, there was no problem. Then I was planning to go for Umrah. I planned that if I travelled to Saudi, I will have it removed and looked at properly. Unfortunately, I could not make it because I could not get the visa. Later, in October, we decided to remove the lump and have it examined here in Nigeria. I got the result precisely November 5, 2005, which confirmed there was invasive cancer. I was shocked. I was confused. I was almost fainting. I decided to call the surgeon. I was confused. There was a mix up in my name. So, I said it could not be me. In 2004, I was having shoulder pain radiating to the breast. I saw a doctor who thought it was arthritis and prescribed a drug for me and I got over it. I had to confide in my family. But I took the decision to have mastectomy alone because no one would support you to have one of your breasts removed, especially when it happened when you were thinking of having a child. I did not have a child in my first marriage and was just planning to remarry and have a child when this happened. They just thought: have you ever seen somebody who is living with one breast or have you ever seen somebody who has a baby with one breast? I took the decision alone because I am well-informed that if I don’t take a decision early, it may be more traumatising. The person I wanted to marry was in the United Kingdom and he was very supportive all through. I did three investigations. I did mammogram, there was nothing, until the pathologist said they should remove it and examined it and he confirmed there was cancer. When I got the result, I was like this was not my own because there was a typographical error in my name. But when I went to see the pathologist, he confirmed it was mine. I said we should have a second opinion. This was done by this renown pathologist in Ahmadu Bello University Teaching Hospital, Dr. Rafindadi. I went to see him in Zaria and they did the test again and he confirmed the same result. I was so confused. But he counselled me.”

Cancer specialist and Publicity Secretary, Nigerian Cancer Society, Dr. Sani Malami, described cancer as dangerous when not discovered early and treated appropriately. Malami said most cancers lead to death. According to him, it is a fact that globally cancer was responsible for more death than malaria and HIV/AIDS and tuberculosis combined.

When asked about the myth associated with cancer, Malami said, “It has been known in our communities that we have all kinds of cancer. Unfortunately, because this has not been addressed appropriately and because there are no facilities to debunk some of these myths, it has been especially difficult to get people to understand. This is also because many of these cancers are detected late and they lead to death and especially death among people in their productive age. So, there is no relationship between cancer and evil spirit, casting of spell or as some people suggest that it is adulterous women who contract cancer. There is no truth in it. Cancer is caused by a single cell, which has undergone a change in its biological composition and it multiplies very rapidly and invades other areas and inevitably consumes the individual.”

Consultant Pathologist, Head, Department of Histopathology, National Hospital, Abuja, Dr. Paul Jubrin, said the facilities for the treatment of cancer in Nigeria are actually up-to-date, but the problem is that it is not well-distributed. Cancer radiotherapy, one of the latest treatments of cancer, is only available in Lagos, Abuja, Ibadan and Zaria. The pathologist said, “At least, you expect up to two of them in each geopolitical zone of the country. If you come to the National Hospital, Abuja, the state-of-the-art equipment are there. We recently introduced nuclear medicine, which you can use to detect cancer in your body and apart from that we have oncology unit. It is just distribution. National Hospital has started training for oncologists. The screening method for cervical cancer called pap smear is between N2,000 and N3,000. It is not available everywhere. Now, we have what we call vispal inspection with iodine. You don’t even need a specialist for this.”

SOURCE

Introduction - The JATH Initiative

JOURNALIST ADVOCACY ON TOBACCO & HEALTH INITIATIVE OF NIGERIA (JATH)  is a media-based health communication, not for profit, non-governmental organization dedicated to the understanding of public health issues and movement for change in public health awareness in Nigeria. It is a network of journalists and Academics drawn from various media organization in Nigeria who work to secure a safe, clean environment and healthy living by preventing tobacco use and advocating changes in public health and environmental policy.

AIMS AND OBJECTIVES:
To facilitate health communication and civic education.
To advocate policy change in public health.
To build strong media partnership for tobacco control and build capacity of Nigeria youths to respond to myriad problems of tobacco use.
To sponsor and/or support programs and/or activities aimed at promoting and propagating humanities ad human discourse in Nigeria.
To help people defend and protect their rights to clean air, for seeking legal redress on abuse of the environment.
To conduct research on public health advocacy.