• 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.
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Osotimehin also said that the government had gone into a partnership with the Anderson Cancer Centre in the United States with an agreement to train six specialists in palliative care.
