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Thursday, March 4, 2010

Contending With Menace Of Cancer

-Kemi Yesufu

It is the trend the world over, that celebrities are recruited to champion causes. A famous name, several incidents have shown, is all that is needed to draw attention to a hitherto overlooked issue. By stroke of fate, some celebrities find themselves becoming the faces of causes they never thought they would willingly promote.

In the case of cancer, Nigeria has lost well-known and admirable personalities to this terminal disease. The most recent victims of the disease include former First Lady, Hajiya Mariam Babangida, wife of former Managing Director Niger Delta Development Commission (NDDC), Aliere Alaibe, and legal icon and human rights activist, Gani Fawehinmi (SAN). Mrs. Babangida died from ovarian cancer, Mrs. Alaibe from intestinal cancer, while Chief Fawehinmi lost the battle to cancer of the lungs. The death of these highly placed individuals have acted as some kinds of wake up call to Nigeria that indeed cancer is silently killing many of its citizens.

Cancer can be defined as the uncontrolled growth of abnormal cells that have mutated from normal tissues. This growth can kill when these cells prevent normal function of vital organs or spread throughout the body, damaging essential systems.

Cancer, known by its medical term, malignant neoplasm, has also been described as a class of diseases in which a group of cells display uncontrolled growth (division beyond the normal limits), invasion (intrusion on and destruction of adjacent tissues), and sometimes metastasis (spread to other locations in the body via lymph or blood). These three malignant properties of cancers differentiate them from benign tumours, which are self-limited, and do not invade or metastasise. Most cancers form a tumour, but some like leukaemia, do not. The branch of medicine concerned with the study, diagnosis, treatment, and prevention of cancer is oncology.

Cancer affects people at all ages with the risk for most types increasing with age. Cancer caused about 13 percent of all human deaths in 2007 (7.6million) people. Cancers are caused by abnormalities in the genetic material of the transformed cells. These abnormalities may be due to the effects of carcinogens, such as tobacco smoke, radiation, chemicals, or infectious agents. Other cancer-promoting genetic abnormalities may randomly occur through errors in DNA replication, or are inherited, and thus present in all cells from birth. The heritability of cancers is usually affected by complex interactions between carcinogens and the host’s genome.

Daily Independent met with Chidinma Uwajimogu someone who lived with the fear of inheriting cancerous genes, having lost her mum to the disease. Before Uwajimogu’s mum passed on in year 2006, she lost two close friends to the disease, so, it seemed that cancer was hell bent on making her life an unhappy one. This much she disclosed, “I lived with the fear of cancer. I lost two friends, both of them in their youth, to cancer. One of them, married with three children died of breast cancer. The second one died of cancer of the bladder. I lost these two women I was close to in 1997. Then, any little pimple on my body I self-diagnosed as cancer. Once I felt feverish I assumed it was cancer. I went for a mammogram test, blood tests. So you can imagine my state of mind when my mother was diagnosed with cancer at 59. This was a woman, after losing my father and had raised 10 children on her own who should now be enjoying the fruit of her labour, but rather than us spending money to buy her jewellery or other good things of life, we spent on hospitals and treatment for cancer. If one person in the family is stricken by cancer then every other member of the family is affected emotionally, financially and you wouldn’t smile until your sick relative smiles. I have seen the face of cancer not from strangers, but people close to me. I have personally suffered the devastation that cancer brings upon the sufferer, his/her friends and family.”

Nevertheless, the NGO facilitator, speaking in an optimistic tone advised that individuals with cancer patients in their families be emboldened by the simple fact that cancer like other ailments is kept at bay with a healthy diet, exercise and routine medical checks. “Yes, doctors do warn that if one of your family members has cancer, it increases the chances of you having the disease. But we also know that if you eat well, live a healthy life, exercise and do things in moderation, you will alter that genetic factor. Our health in God’s hands, but we can help ourselves by dropping the bad habits like smoking which increase the risk of having cancer.”

After years of fear characterised by countless tests to detect cancer, Uwajimogu, having proven by her doctors to be cancer free, took up the gauntlet to fight the disease by setting up the Ego Bekee cancer foundation. As someone greatly affected by cancer, the Ego Bekee Foundation founder had adopted a never-say-die approach in what can be termed a revenge mission on the disease. “It is one of the goals of the Ego Bekee Foundation to reach the grassroots with our message. Most of our advocacy works are carried out in the rural areas. If my siblings and I could feel the pressure financially by providing treatment for my mother, you can imagine how a rural dweller or less privileged person will fare. Most of our patients are rural women. They cannot afford to pay for treatment and most times they don’t even know what they are suffering from. You know there is so much stigmatisation of cancer in the rural areas. Some say it cannot be cured others. Others say cancer is caused by spiritual attack. Somebody even asked my siblings and I if we had checked to find out if my mother’s case was not caused by spiritual attack. It is true that the spiritual world exists, but we need to start from the things we see. So if there is a pimple on your body or a strange mark, check it out in the hospital, find out what it is all about.”

Speaking from her personal experience, Uwajimogu further said, “Through the years that I cared for my mum, I found out that cancer is curable, it is a condition that can be treated when detected early. This is why it is good to test for cancer if one has the suspicion or not that he/she may have cancer. Some people think there is no need of test for cancer, because it cannot be treated and it will amount to a waste of money treating the disease, but they are wrong. Rather cancer becomes incurable when people leave it till it advances to the late stages. The best thing is to see a doctor because you just might be at the stage where the disease can be treated.”

Explaining why more cancer cases are discovered among Nigerian women, Uwajimogu identified the female anatomy and lifestyle changes as the major cause. “Women are more at risk for cancer because of the way we are constituted. We have breasts and the men who have breast cancer are very few. Also a woman that has a cervix is more likely to go to the hospital to investigate what is going wrong with her body. Again, aside from the cancers that women develop owing to their anatomy, there are also cases of women suffering from other forms of cancer. Continuing she said, “Most people don’t eat healthy foods. They are more into fried, processed, and sugary food. Are we still eating the way we used to in the past? I don’t think so. Now we store food for weeks and use the microwave to warm the food when we bring it out. I believe that you are what you eat. I don’t think that it is advisable to smoke and drink for years and think that you feel very well. I have asked a smoker to give me reasons he smokes and he could not give me one. These are lifestyles we have imported and they definitely will come with consequences. But I don’t think that people weren’t dying of cancer before the fast food restaurants sprung up or we started consuming alcohol in large quantities or smoking became a common habit. The difference now is that more people are aware of the disease.”

Uwajimogu gave Nigerian doctors a pass mark on how her mum’s case was handled. She probably was lucky, as many have complained of wrong diagnosis leading to cancers reaching the advanced stage. Fawehinmi was reportedly treated for pneumonia for years locally before being diagnosed with lung cancer. To avoid misdiagnosis and its grave consequence Uwajimogu has some advice for doctors, government and individuals. “It is good for us to know that not all doctors can treat cancer. There are physicians, but there are specialists in some areas. It is important for a doctor if you cannot handle a case to refer it to a specialist who can. There are some cancer patients who would have survived if they had commenced treatment on time. So it is important that we have more doctors in oncology and nurses trained specially to care for cancer patients. It is very important that nurses caring for cancer patients are well trained, because some of the patients can be difficult because of the suffering they are going through. In fact I suggest that every medical facility in Nigeria be equipped for cancer screening so that people do not need to travel for miles for screening or to get any kind of help. This is not a tall order because every physician can conduct a breast examination and a gynaecologist can screen for cervical cancer. Women are also encouraged to examine their breasts, because most patients detect the lump before going to the hospital.”

An expert in the field of Oncology and President Elect of the Africa Organisation of Research and Training In Cancer (AORTIC), Professor Isaac Adewole, who spoke with our correspondent during the February 4 World Cancer Day, held in Abuja, called on Medical Doctors and Pharmacists in government hospitals to access drugs for the treatment of various forms of cancer. These drugs, he said, are stored at the National Medical Store, Oshodi, Lagos, noting however that the doctors and pharmacists have failed to avail victims of the drugs, some of which were said to have expired. Adewole decried the attitude of the professional health workers. He opined that they should be held liable for not doing enough towards arresting the situation.

According to him, “All that is needed is the Doctors and the Pharmacists to do their jobs by prescribing and dispensing the drugs. They are available at the National Store. Many of these drugs have expired and there is no way the stock can be replenished, because since they are still available and unused, there is no way they can make case for more.”

He however proffered that the concerned health authorities should prescribe and dispense the drugs for those in need. While noting that the number of cancer treating institution in the country are grossly inadequate, the University of Ibadan teacher, said “though we have just five radiotherapy machines in the country right now for a population of over 150 million, respite would soon come the way of cancer patients.

Though that is not the only equipment we find in a cancer treatment centre, we gathered that the Federal Ministry of Health is about to acquire and install 10 new such machines in our cancer treatment centres to boost other equipment we have on ground now.”

Adewole, who is coordinating the Bill and Melinda Gates Foundation sponsored American Cancer Society programme tagged the African Tobacco Control Consortium meant to reduce the use of tobacco, said the essence of his organisation was to provide a platform for government and the private sector to buy into the awareness campaign of the disease on the continent, adding, “Awareness is the key to this disease and that is one thing that is lacking, which the organisation is keen to bridge.”

Meanwhile Minister of Health, Professor Babatunde Osotimehin, promised that cancer patients in the country will soon heave a sigh of relief as the Federal Government in conjunction with MD Anderson Cancer Centre in the U.S.A. have concluded arrangement to train six specialists in palliative care and have also invested $2 billion in a partnership with the International Atomic Energy Agency(IAEA) to build capacity and upgrade cancer management facilities.

He said that the IAEA would train nuclear physicists, nurses, pharmacists, technologists and radiographers as well as ensuring the availability of nuclear medical and radiotherapy equipment for the diagnosis and treatment of cancer within eight years in 12 tertiary health institutions in Nigeria.

They include University College Hospital, Ibadan, National Hospital, Abuja, University of Nigeria Teaching Hospital, Enugu, Lagos University Teaching Hospital, University of Maiduguri Teaching Hospital, Maiduguri. Others are University of Benin Teaching Hospital, Federal Medical Centre, Gombe, Usman Dan Fodio University Teaching Hospital, Sokoto, University of Ilorin Teaching Hospital, University of Port Harcourt Teaching Hospital and University of Calabar Teaching Hospital.