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Cancer is fast becoming a major killer in Nigeria. Hardly any day passes without either the diagnosis of new cases of cancer, its complication or its related deaths in Nigeria. Today, a number of high class Nigerians are either dying or suffering severely from cancer in Nigeria and around the world. In the past, I lost loved ones to this monster – when people hardly ever spoke about it. First was my elder sister.
Then, my younger brother. Both died from primary liver cell carcinoma (PLCC). And this occurred just a few years apart. When the scan revealed the diagnosis in Port Harcourt, I was a medical student. I completely understood the prognosis. I also knew that, with our level of poverty, we could not prolong their lives. We did all we could to make their last days on earth peaceful – but it was still very painful.
Just last year, I lost a very close colleague from the same cancer. For him, he had resources that allowed him to travel to the United States for liver resections a number of times. But despite the surgeries in world renowned centers, chemotherapy (and I think radiotherapy), he still succumbed to the disease leaving behind a young wife and two wonderful sons. I am not sure there is any family in Nigeria where someone has not suffered from this monster. The bad news is that, despite this large unrecognized epidemic, the world is not doing enough about discovering the cause and treatment of the disease.
Like most health issues in Nigeria, the true burden of cancer in Nigeria is not known because of poor statistics and under reporting of cases. However, the World Health Organization (WHO) estimates that over 100,000 Nigerians are diagnosed with cancer annually (that is about 300 cases per day! Or 12 cases every hour!!). Out of this number, 4 out of 5 (or approximately 80,000 people) die from the disease. Despite this level of morbidity and mortality, cancer has not been given its rightful place in health politics in Nigeria, and thus has practically remained an unrecognized issue (URI). Breast, cervix and prostate gland cancers are said to be the most common forms of cancer in Nigeria. But with the rising prevalence of PLCC, one is unsure if this will not with time take over from the rest of the cancers as the commonest form in Nigeria.
However, although most cancers cannot be cured, majority can be prevented. This is why Nigeria must join the rest of the world to fight this epidemic. February 4th every year is World Cancer Day (WCD). It’s a day the world set aside to create awareness on cancer. It serves as a platform for stakeholders and the general public to awaken to ways of preventing, early detecting, treating and managing cancer.
This year, the theme is “We can. I can”, and seeks to explore avenues through which everyone collaboratively and individually can work towards a sustainable reduction of the burden of cancer. Everyone must own the fight against cancer, if we are to succeed against it.
The alarming indices are particularly disturbing as preventive measures and early detection and treatment can go a long way to prevent untimely death. According to the WHO, one- third of all cancers can be prevented; another one- third can be successfully cured with timely diagnosis; whilst palliative care can improve the quality of life of the last third. There is therefore the need to strengthen infrastructure, improve public awareness about preventive measures and early diagnosis as well as increase availability and accessibility of treatment through establishment of more treatment centers.
In order to achieve this, there is the need for increased government expenditure and commitment in this area. The current allocation to health amounts to only 3.65 % of the 2016 budget. This falls short of the 5.78 % allocated in 2015 and a clear departure from the agreed 15 % of national budget to be allocated for health made in 2001 in the meeting of African head of states and government which Nigeria hosted in Abuja. With the aforementioned shortfalls, universal health coverage cannot be achieved, which would improve availability of affordable and efficient health services, including cancer care. At present the Nigerian Health care system is not ready for the rising cancer cases and also ill equipped to handle the complexities in managing cancer.
Therefore, there is certainly a need for a paradigm shift towards pragmatic approaches to averting the impending catastrophe. This gives more credence to the theme of this year’s World cancer day “We can. I can”.
It’s time we unite, using our circle of influence to inspire government to make policies that will ensure the availability of adequate recourses and infrastructure that will help reduce premature deaths from cancer. The needed policy changes can be achieved through effective advocacy at all levels of government. These policy changes will engender greater commitment from government and the private sector. In addition to waiting for needed policy changes, the slogan “We can. I can” brings home the point that we as individuals and communities can also play a role in fighting cancer.
We all can reduce individual risk of developing cancer by adopting strategic lifestyle changes. Smoking, alcohol consumption, poor diet, abuse of drugs, and sedentary lifestyle are risk factors for cancers which can be avoided. Arming individuals and communities with apt knowledge of the links between lifestyle and cancer can help people make healthy choices and understand that the premature deaths from cancer can be averted by making right choices.
In addition, we can avail ourselves of available screening tests to facilitate early detection, as cancer is more amenable to treatment if diagnosed in the early stages. Many of the common cancers like cancer of the breast, cervix and prostrate have screening tests which aid their early detection. Employers in the formal sector, educational institutions and NGOs working in this space can encourage increased uptake of cancer screening by individuals and communities by advancing knowledge and awareness in those under their sphere of influence, as well as paying for these screening processes.
We can all help to defuse myths and stigma surrounding some cancer cases by arming ourselves and those in our sphere of influence with the right information. This in turn will create acceptance, adequate recovery path and the love required in recuperating and surviving cancer. The wide gap in awareness of cancer in rural communities due to paucity of information and high illiteracy level also needs to be addressed. Until cancer awareness is stepped down to the grassroots and actions are taken to prevent and treat the disease, millions of people in developing countries like Nigeria will continue to die unnecessarily over the coming years. We must act now because the threat posed by cancer epidemic is massive and set to destabilize the socio- economic development of unprepared Nations.
Finally, achieving the required objectives begins with our personal resolve and together we shall rise above the challenges by making healthy life choices. Understanding that early detection save lives is key to this campaign but we must first challenge perception and dispel myth. Efforts should be made to improve asses to affordable orthodox care for the public. It is vital at this time to improve asses to care by making the case for investing in cancer control and building quality cancer workforce. Together we can work to increase impact and create a healthy environment if individually we say “I can and collectively agree we can”.
By
Dr. Obinna Oleribe, Grace Iyalla, Muna Ekweghariri and Dr. Oluwakemi Akagwu
Excellence and Friends Management Care Centre (EFMC)
Dutse Abuja
www.expertmanagers.org
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