The Ravaging Cancer Scourge

It is still not the best of times for Nigerian women, as over 40 of them die from breast cancer in the country daily. Martins Ifijeh writes on the anguish of breast cancer patients and what the government, stakeholders and citizens must do to stem the ravaging scourge

Adeolu squeezed herself into the long chair where her husband sat, with her head resting on his laps as she gazed into the emptiness of the expanded room. Her mien depicts so much hollowness like someone hoping the rain falls soon. Truly, she hasn’t experienced much rain and sunshine in recent times. The happiness of the entire family has lost steam. All they think of now is extinguishing her dark cloud and bring back the watercolor sky.

“She first noticed a lump on her left breast two year after we got married, “ her husband muttered, “then she started experiencing pain, then the breast began to swell, and then …here we are; she is no longer able to do anything because cancer has taken over the entire breast and related parts of her body. All we do now is hope her medications improve her health, while God restores her body back.

As though eager to tell her sorry tales herself, Adeolu, who could barely speak aloud, garnered strength and sat up and relayed her story amid pain which were coming in trickles, mostly at the left side of her body.

“In 2013, when I noticed a small dot on my breast, it didn’t occur to me it was going to snowball into something of this nature. At that point, I didn’t give it much thought, until it began to increase in size, say like the size of a bean seed, then it started to give me cause for worry.”

Unknown to her, the inability to decisively tackle the small dot on her breast was her biggest undoing. The mad cells didn’t wait for her to keep observing how it would disappear on its own. Rather, it replicated, spread and had its footings strongly embedded in the tissues of her breast.

In no time, the breast’s skin began to take the look of an orange, with little fine dimples scattered around it, the left breast became heavier and unusually bigger. Unfortunately, this was when she and her husband decided to visit the hospital for checkup. But it was too late to destroy the cancer cells. She was told what she had, was now beyond lumpectomy; the lump couldn’t be removed anymore. Radical mastectomy had to be done on her.

Adeolu and her husband were shocked. They thought cancer was an illness they only read about on paper or hear people talk about. They thought it was a far away disease that has its particular target population, a population very distant from their own. But they were wrong, cancer was already within their midst. It knows no tribe, religion, financial, academic and spiritual status. It’s a roaring lion seeking only one thing – to destroy. But experts have said prevention and early detection were, key to overpowering the big monster.

But Like many Nigerians who would rather show how much religious they are by first spending lots of time seeking miracles against their ill health, which ordinarily should be tackled promptly, (in addition to the prayers), Adeolu and her husband didn’t betray that ‘Nigerianness’ at all. They spent months praying and hoping it would disappear and never come back. But the mad cells continued to grow. They were deaf to reasoning, a characteristic doctors and researchers have continuously sort to conquer.

And then the verdict came from the doctor, “he told me we would have to perform the radical mastectomy now or that might be the least of my problem in the coming months,” explained Adeolu. Eventually, around June 2014, the breast was cut off, but not before she and her husband spent so much on various awkward treatments, as well as spiritual helps.

“And then I started sessions of chemotherapy which gulped everything we had. I couldn’t continue because everyone around us had given their quota to my recovery. There was no where I could run to for help. And then I decided to stop the remaining sessions pending when I would be able to get the fund for it,” she noted.

She explained that by the time she was able to raise some money, the cancer cells, like a plague of locust, had spread to her internal organs. “I was told by my doctor that the cancer was currently on stage four. He said what I really need now is radiotherapy to slow down the cells, as surgery will be impossible at this point, even though I have fully resumed my chemotherapy session,” she explained.

But in a country where only one radiotherapy machine works and there are over two million cancer patients, with most of them clamouring to use the machine, there may only be a glimmer of hope for the several people on the long queue waiting to access radiotherapy treatment in the country with a major chunk of them even unable to afford the financial implication of radiotherapy treatment.

Adeolu, is one among several Nigerians going through the pain of breast cancer with treatments hampered by late presentation of cases, high cost of treatment and lack of treatment facilities, including radiotherapy machines, as well as oncology personnel.

However, several thousands of Nigerians are dying from the scourge yearly with experts suggesting that over 40 Nigerian women die from breast cancer scourge every day in a country that prides itself as the giant of Africa.

In an interview with THISDAY, a medical expert, Dr. Rufus Arebamen, said it was unfortunate that most people do not present their cases on time to the hospital, as it was easier to treat cancer cases when at their early stage, adding that the high number of deaths occasioned by the scourge in the country was chiefly due to late presentation.

“It is easier to treat cancer at the very early stage than when it has spread within the body. Most times when presentation is done late, there is really little or nothing a doctor can do. At the moment there is no cure for it, so the best that can happen is for people to cautiously prevent it, and in cases where they are noticed, diagnosis and treatment should be done on time. “This is why we are still having most breast cancer patients dying because by the time they come to the hospital, the lump, which ordinarily would have been removed and the patient will be fine, would then not be able to be removed because the cancer cells have spread to the mass of the affected breast or even neighboring tissue,” he said.

He advised that there should be more awareness on the disease, especially on breast, cervical and prostate cancer, which have killed more Nigerians than other types of cancer.

In the same vein, a Consultant, Clinical and Radiation Oncologist, Dr. Omolola Salako, vented her frustration recently while chatting with students of the Health Journalist Academy at the Pan Atlantic University, Lagos. She said as an oncologist, she was no longer enjoying her job because of the high number of deaths of her cancer patients due to their late presentation of cases, adding that cancer is treatable if presentations were made on time, but that rather, the late presentation was making the work uninteresting.

“By the time people present cases to the hospital, you will discover their cancer has reached stage 3 or stage 4. And at these stages, treatment is difficult, even though some percentage of persons still come out alive from it, but the guarantee is higher when people present cases either at the pre cancerous stage, stage 1 or stage 2,” she noted.

She said breast cancer, which has become the number one killer of women in the country was preventable if every Nigerian adhere to self-examination practice and present changes in their breast to the doctor for onward diagnosis and advise.

According to her, Nigerians should stop living in denials that cancer was far from them. “We must recognise that it is not far from us, only that we have to make conscious efforts to protect ourselves against the scourge,”she added.

On government and stakeholder’s response to tackling the scourge, a Professor of Clinical and Radiation Oncologist, Professor Sunday Adeyemi Adewuyi, in a recent cancer summit in Abuja, explained that there were not enough cancer machines in the country, adding that this has in no small measure led to the death of several cancer patients in the country.

He said the recommended number of cancer machines, according to the International Atomic Energy Agency (IAEA) is one machine to 250,000 population, or one machine to 350 to 450 cancer patients, but that Nigeria currently has seven radiotherapy machines which means there is one cancer machine to over 30 million people.

However, among the seven cancer machines in the country, only the one at the Usman Danfodio Teaching Hospital (UDTH), Sokoto is currently working, which means 180 million Nigerians are currently matched to only one machine in an otherwise rich country, that boasts of years of robust oil revenue, wealthy national and international corporate organisations, as well as several wealthy Nigerians with some of them owning oil wells in the country.

According to Adewusi, Nigeria is expected to have 840 cancer machines to match the recommended numbers per the population. South Africa, has 18 radiotherapy machines, which means one machine to 1.3 million citizens, while another fellow African country, Egypt,
has 35 cancer machines, that is one machine to 1.2 million citizens. Japan has 611 cancer machines, with one machine to 150,000 citizens, while China has 453 machines, with one machine to 1.8 million people.

The statistics and comparison, therefore showed that Nigeria was responding to cancer in an abysmally poor and pathetic way.