TODAY, February 4, the entire world will once again shift attention to cancer, which is the leading cause of death globally and Nigeria is not left out.
Since the death of former First Lady, Mrs Maryam Babangida, from ovarian cancer on December 27, 2009, many Nigerians have been puzzled about cancer, which has no respect for individuals. Even the high and mighty have succumbed to cancer.
For instance, in the aftermath of Mrs Babangida's death, the Surulere Lagos office of the National Cervical Cancer Prevention Programme (NCCPP), a Non-Government Organisation (NGO) and an initiative of the Mass Medical Mission, which works on cancer, witnessed a massive turnout of Nigerians who went there to screen for both cervical and breast cancer.
The National Coordinator of NCCPP, Dr Kim J-Egwuonwu, who confirmed the development, said the people did not only screen, they sought information on things to do to prevent different types of cancers.
Cancer is a class of diseases in which a group of cells display uncontrolled growth and sometimes spread to other locations in the body via lymph or blood.
Unfortunately, before now, many Nigerians were not taking cancer as seriously as they should. With literacy that is below world average, Nigerians rank lowest on global cancer awareness.
Some simply lack the knowledge of the existence of the disease and for those who are literate, cancer hardly lies within the spectrum of their consciousness.
Another factor contributing to low cancer awareness in the country is poverty. With 71 per cent of Nigerians living on less than $1 per day, many are preoccupied with the hustle and bustle of daily living.
Similarly, the fear of finding out is another factor. Some ask, “What will I do if I know?” Hence, the general attitude is that most people will not go for screening different types of cancers including lung cancer, colon cancer, prostate cancer, etc and they run the risk of going down with these diseases.
Furthermore, experts say poor medical access also account for why Nigerians are not taking cancer seriously. Consequently, a lot of people are dying from the disease.
Every year, 12 million people are diagnosed with cancer and 7.6 million people die of cancer worldwide.
According to the World Health Organisation (WHO), if no action is taken, the global impact of cancer is projected to reach 26 million new diagnosis by 2030 and the disease will cause about 17 million deaths.
In the last five years, there has been increased prevalence in all forms of cancer, especially with the pandemic of HIV infection in Nigeria.
“This has resulted in increased incidence of cancers generally and Kaposi Sarcoma particularly,” said Dr Patience Osinubi, the coordinator, Cancer Control Programme, Federal Ministry of Health (FMOH).
Explaining the dramatic rise in the number of new cancers developing throughout the world, the Chairperson, World Cancer Day Planning Committee, Institute of Human Virology in Nigeria (IHVN), Dr Elima Jedy-Agba, disclosed that although a few type of cancer occur among the young, it is a disease of old people.
People are adopting lifestyle changes that are increasing their risk of cancer. These include the amount of physical activity they do, putting on weight, smoking tobacco and drinking alcohol.
According to Dr Jedy-Agba, in the past few decades, a new threat has emerged in the form of HIV/AIDS as a risk factor for cancers. She noted that HIV/AIDS is very common in Nigeria and the rest of Africa and because the infection weakens the immune system, it increases cancer risk.
This association between HIV and cancer was recognised very early leading the United States Center of Disease Control and Prevention (CDC) to classify some cancers as AIDS Defining Malignancies (ADM). That is, these cancers are so commonly associated with HIV/AIDS that anybody who has them should be suspected of having AIDS and should be tested. Dr Jedy-Agba listed these cancers as those of the uterine cervix, lymph nodes – Non-Hodgkin’s Lymphoma – and Kaposi Sarcoma.
The key message for today's World Cancer Day is, ‘HIV/AIDS increases Cancer Risk…stay safe, stay healthy”.
“We encourage individuals who are HIV negative to stay safe by avoiding infection and we encourage individuals who are HIV positive to stay healthy by being compliant with their medications and seeing their doctor if they have any suspicious symptoms and insist that they are examined thoroughly,” Dr Jedy-Agba added.
Furthermore, she said recently, particularly in countries where HIV treatment had been available for a long time, “We are now seeing People Living with HIV/AIDS (PLWA) developing other types of cancers more commonly than is expected. These are called Non-AIDS Defining Malignancies (NADM) and together, these two conditions are increasing the cancer burden among PLWA.”
It has been estimated that 10 per cent of all HIV/AIDS patients will go on to develop cancer.
In Nigeria with over three million people affected by HIV/AIDS, this means that HIV/AIDS is responsible for an additional 300,000 cases of cancers that would not be there if there was no HIV.
In a statement to mark the World Cancer Day 2010, the chairperson of the World Cancer Day Planning Committee at the Institute of Human Virology in Nigeria, pointed out that as a result of the looming threat that cancer poses, particularly to HIV/AIDS patients, the institute has begun to carry out cancer prevention, treatment and research activities in Nigeria in collaboration with the Federal Ministry of Health.
These include resuscitation of a national system of cancer registration through training, infrastructural support, and mentoring of cancer registrars in Nigeria.
The IHVN is also developing a network of cancer clinical trials centres in collaboration with Society of Oncology and Cancer Research of Nigeria (SOCRON) and 13 teaching hospitals and research institutes.
IHVN, which was established in 2004 to address the HIV/AIDS crises in Nigeria, has also been designated an international site for clinical trials with the United States’ National Institutes of Health funded AIDS Malignancy Consortium, an international cancer research group that is focused on developing new treatment for cancers occurring among PLWA.
Similarly, experts are advocating increased awareness among Nigerians as a strategy to reduce cancer deaths.
Accordng to Dr Osinubi, if cancer awareness messages go out from NGOs, electronic and print media, religious leaders, professional bodies and associations, school principals, among others, the populace will be well enlightened.
On his part, Dr J-Egwuonwu said massive awareness of cancer among Nigerians could be converted into testing and screening.
More than 30 per cent of cancer could be prevented by modifying or avoiding key risk factors, according to a 2005 study by international cancer collaborators.
Risk factors include: tobacco use, being overweight or obese, low fruit and vegetable intake, physical inactivity, alcohol use, sexually transmitted HPV-infection, urban air pollution and indoor smoke from household use of solid fuels.
Prevention strategies increase avoidance of the risk factors listed above including vaccination against human papilloma virus (HPV) and hepatitis B virus (HBV), the control of occupational hazards, reduction in the exposure to sunlight and early detection. About 30 per cent of cancer is treatable if discovered early.
Recognising early signs of cancer and seeking prompt medical attention will similarly help. Symptoms to look out for include: lumps, sores, persistent indigestion, persistent coughing, and bleeding from the body's orifices, among others.
Screening programmes to identify early cancer or pre-cancer before signs are recognisable include mammography for breast cancer, and cytology (a “pap smear”) for cervical cancer.
Highlighting the efforts of the Cancer Control Programme of the FMOH to combat the disease, Dr Osinubi said the primary focus was cancer prevention because it was far more economical to prevent the disease.
“A major effort of the Federal Government of Nigeria is the signing of the Framework Convention on Tobacco,” she said, adding that the FMOH advocated tobacco control and effective policies at federal, state and local government levels. The convention, will however, be domesticated to have the desired significant impact.
Another area being aggressively pursued is cervical cancer prevention, Dr Osinubi said.
It is documented that Human Papilloma Virus (HPV) infection, particularly high risk types 16 and types 18, is likely to lead to cervical cancer.
It is preventable by the administration of HPV vaccine to young girls' pre-sexual exposure. The National Cervical Cancer Control Policy states that girls from ages nine years should be eligible for the vaccine.
Also, the FMOH advocates breast cancer prevention by encouraging self and clinical breast examinations and mammography.
Dr Osinubi said, “This should be done at least every two years from age 35 years for early detection of breast cancer.”
She added that abnormal breast lumps could be evaluated this way for very early treatment intervention. A mammogramme goes for N3,000 to N5,000 in public hospitals.
On skin cancer, the FMOH advocates the use of sunscreens and protective covering like hats, long sleeve clothing to reduce excessive exposure to sunlight.
Men are also advised to check the serum level of Prostate Specific Antigens to detect any unusual rise in the levels as high levels may indicate early onset of prostate cancer. The FMOH said in the future, vaccines would be available to treat this cancer.
Undoubtedly, it is laudable that some Nigerians want to know about cancer. But do they have to wait for personalities to die from cancer before individuals take measures to check cancer?
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