Cancer…How to beat a killer disease

Cancer is a disease that knows no boundary when it assails; prevention, early detection and treatment are important in ending the disease.

Bisola Oliyide, a 23-year old undergraduate, was taught by her mother to do self-breast examination (SBE) after her monthly menstrual period. On an occasion of doing the routine, she detected a lump. She informed her mother, who took her to a teaching hospital. The lump was extracted. And further investigation revealed that it was benign.

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She could be said to be lucky because not many people end up that way. The disease does not know class. It affects everybody. The illiterate. The rich. The poor. The powerful. The not so powerful. The mighty. The influential. It attacks, maims and spares no one.

But there are survivors. Cancer can be treated. And not be allowed to kill. Prof Olukemi Odukoya, Pharmagonosy Department, College of Medicne, University of Lagos (CMUL), Idi Araba is a survivor.

The list of prominent Nigerians whose lives are being cut short by cancer is increasing by the day. Wife of former military Head of State, Gen. Ibrahim Babangida (retd), Mariam Babangida, died of ovarian cancer at the age of 61 In Los Angeles. Deputy Governor of Ekiti State, Mrs Funmilayo Olayinka also died of breast cancer.

Cassandra Gabriel, popularly known as Sisi Caro, died of breast cancer. Likewise 48-year old Roseline Ogbemudia, wife of the eldest son of Dr. Samuel Ogbemudia, the former governor of Edo State; popular socialite and sister of former Ekiti State Governor Ayo Fayose, Evangelist Bimpe Oluwayose-Sorinolu. Roseline and Bimpe both battled breast cancer till death. While the former died in a hospital in India, the latter, who had been treating the ailment since 2011, died in a London hospital.

Clara, wife of Governor Adams Oshiomhole of Edo State also died of cancer on 8 December, 2010, eleven days to her daughter’s wedding. Second Republic Senate Leader, Dr. Olusola Saraki, battled the ailment for five years; also 51-year old Remi Osholake, a fashion designer popularly known as Remi Lagos, and Sam Ojebode, an ex-Green Eagles star, died after battle with cancer.

Another Nollywood personality, who also succumbed to cancer last year, was Taiwo Bello, a movie producer and director who co-wrote the movie, Jenifa, with Funke Akindele and produced and directed the 2010 movie, Omije Mi.

In December, 2010, Yusuf Jibo, former Zonal Director of the Nigeria Television Authority (NTA), died of colon cancer. So also the ace journalist, Sele Eradiri and Dr Beko Ransome-Kuti.

In 2009, precisely on 5 September, Gani Fawehinmi, renowned lawyer and human rights activist lost the battle to cancer, after he was initially misdiagnosed; Remi Abiola, actress and wife of late business and politician, Chief M.K.O. Abiola, as well as Alaere Alaibe, wife of Bayelsa politician, Timi Alaibe, all died of cancer.

NTA ace broadcaster, Yinka Craig, 60, died on 23 September, 2008 as a result of cancer of the blood (leukemia), so also, Information Specialist, World Health Organisation, Oghide Austin, while musician-turned evangelist, Sonny Okosuns, lost the battle to cancer of the colon on 24 May, 2008 at the age of 61.

The list is inexhaustible. Mrs Comfort Ponnle, of MicCom cables and Alexander Ibru, Chairman and Publisher of The Guardian died of cancer. Chief sub-editor, Vanguard newspaper, Dayo Aminu died of cancer as well.

The former Chairman of the Advertising Practitioners of Nigeria (APCON), Dr May Nzeribe, died of Prostate Cancer.

Former president of Performing Musician Association of Nigeria, Mustapha Amego, fondly called Musky, died of colon cancer; Mrs Kofoworola Orija of the Bloom Cancer Foundation also dies of breast cancer.

In Nigeria, cancer incidences are common. No week passes without a Nigerian dying of cancer. Hundreds of thousands are dying silently. With a few survivors.

What causes cancer?

Cancer is a class of diseases characterized by out-of-control cell growth. There are over 100 different types of cancer, and each is classified by the type of cell that is initially affected.

Cancer is ultimately the result of cells that uncontrollably grow and do not die. Normal cells in the body follow an orderly path of growth, division, and death. Programmed cell death is called apoptosis, and when this process breaks down, cancer begins to form. Unlike regular cells, cancer cells do not experience programmatic death and instead continue to grow and divide. This leads to a mass of abnormal cells that grows out of control.

If the balance of cell division and death is disturbed, a tumor may form.

How cancer spreads

Scientists reported in Nature Communications (October 2012 issue) that they have discovered an important clue as to why cancer cells spread. It has something to do with their adhesion (stickiness) properties. Certain molecular interactions between cells and the scaffolding that holds them in place (extracellular matrix) cause them to become unstuck at the original tumor site; they become dislodged, move on and then reattach themselves at a new site.

The researchers say this discovery is important because cancer mortality is mainly due to metastatic tumors, those that grow from cells that have traveled from their original site to another part of the body. Only 10 per cent of cancer deaths are caused by the primary tumors.

Signs or symptoms of cancer

Signs and symptoms are both signals of injury, illness, disease, or that something is not right in the body. A sign is a signal that can be seen by someone else-maybe a loved one, or a doctor, nurse, or other health care professional. For example, fever, fast breathing, and abnormal lung sounds heard through a stethoscope may be signs of pneumonia. A symptom is a signal that is felt or noticed by the person who has it, but may not be easily seen by anyone else. For example, weakness, aching, and feeling short of breath may be symptoms of pneumonia.

Symptoms depend on the type and location of the tumor. For example, lung tumors may cause coughing, shortness of breath, or chest pain. Tumors of the colon can cause weight loss, diarrhea, constipation, iron deficiency anemia, and blood in the stool.

Some tumors may not cause any symptoms. In certain tumors, such as pancreatic cancer, symptoms often do not start until the disease has reached an advanced stage.

A few patients show no signs or symptoms until the cancer is far advanced. However, there are some signs and symptoms, although not specific, which usually occur in most cancer patients that are fairly easy for the person to detect.

There are over 200 types of cancer. Anything that may cause a normal body cell to develop abnormally potentially can cause cancer.

Why Nigerians are dying of cancer?

Many Nigerians are dying of cancer with only few surviving. According to a Public Health Physician, Community Health Department, Lagos University Teaching Hospital (LUTH), Idi Araba, Ariyibi Nasir, a lot of people present late to the hospital despite improvement in diagnosis.

He said cancer is an abnormal increase in the number of cells in the body. “It could affect a particular organ of the body, where the organ begins to increase in size, due to unregulated cell division. Normally, every cell undergoes growth. For example the skin sheds off old cells as news ones grows. This mechanism is being regulated. But when it becomes uncontrollable, that means the regulatory mechanism is off.

“There are two types of abnormal growth, benign and malignant. Either can exert pressure on immediate or extended organs. But the most dangerous is malignant growth. That is cancer. It disrupts the organs around that area and grows inhibited. It can leave where it started off, attack other organs of the body and causes further damages. It is the organ it affects that is named after it. The commonest among women in Nigeria is breast cancer and cervical cancer; leukemia in children while prostate is common in men.”

Experts are of the view that cancer is on the increase in Nigeria because, “there is improvement in diagnosis. The statistics we are working by now, from the World Health Organisation (WHO) says 250, 000 new cases are seen annually, with 10, 000 deaths per year. Unlike other non communicable diseases (NCDs) that you can say these are the causes, you cannot say that about cancer. We only have predisposing factors.

“In some types of cancer, way of life is a predisposing factor like cancer of the lung resulting from smoking unlike breast cancer that you cannot put your hands on, except perhaps the genes resulting from hereditary; or women who have not sucked in their life or women do not sulk adequately.

“When you look at some of these factors, we say they are non modifiable. Non modifiable are factors that cannot be influenced. Like breast cancer in women and prostate cancer in men. Not that men don’t have breast cancer but the female gender due to presence of hormones such as Estrogens are at higher risk. Age is also a non modifiable factor. Genetics/hereditary, i.e. a person’s make up; race like being a Caucasian for instance are non modifiable factors.

“The modifiable risk factors are the ones we can change or influence or play a role in. Lifestyle is a major risk factor. Smoking, drinking alcohols or abusing drugs; do you eat junk, i.e. empty calorie food; do you over eat or eat less. Are you predisposed to germs, for instance Hepatitis B that can be contracted from sexual partners, and which manipulate lung cancer growth? Exposed to multiple sexual partners or engaging in early sexual activities that can aid contracting papilloma virus which causes cervical cancer. Every two minutes, a woman develops cervical cancer.

“Diet is a huge predisposing factor. How healthy are we eating today? Noodles and pasta, fizzy drinks Do we take fruits that contain anti oxidants that mop up free radicals? Free radicals, also known simply as radicals, are organic molecules responsible for aging, tissue damage, and possibly some diseases. These molecules are very unstable, therefore they look to bond with other molecules, destroying their health and further continuing the damaging process. Antioxidants present in many foods, are molecules that prevent free radicals from harming healthy tissue. Exercise is also good for the body. But how many do that these days.

“Prevention through the modifiable factors is important in developing cancer. As physicians, we do now create awareness on best way out. We now educate on lifestyle changes. Making the right life choices in diet, living, and existence. In short, healthy lifestyle. We want to get to the level where people will be empowered with the right information. And also be involved in their health management. Avoiding injurious substances like Energy drinks. The basic ingredients are sugar and caffeine. Sugar can trigger diabetes while caffeine triggers the body to work excessively.

“It is good and in order to ensure good policies are put in place by the government. Nothing stops the government having a policy on all local government areas to have cervical cancer screening and treatment centres. You see, most non communicable diseases do not give signs. They are just there developing. Because they are asymptomatic, screening and testing for them are the best way to pick them up easily.

“For instance, breast cancer can be detected through mammogram, cervical cancer through pap smear. For changes would have been taken place at a cellular level. And if detected at that level, can be treated. At self, one can do Self Breast Examination (SBE) in picking up breast cancer. Any lump that is detected can be further examined.

“We need to educate people on advantages of going to the hospital early when they feel illness or abnormality in their body. They should not be going to spiritual homes or traditional healers. First come to the hospital, get the condition diagnosed and treated. People need to know that it is not arrow from the enemy.

“We have the facility and expertise to detect, treat, manage and rehabilitate cancer cases in Nigeria. There is no need to travel overseas to treat cancer. We have measures like mammogram for breast cancer; papsmear at our Community Out clinic at LUTH. Assuming a cervical cancer is detected, we have Obys and Gyn department. Radiotherapy at its advanced stage is available in the hospital. Do not put a cost to your health. Just have an aim- to get well. People may want to stay away because they consider some of these treatments expensive, but no money can replace a lost live. With a N3, 500, papsmear can be done. But people spend more on Aso ebi and drinks at bear parlous and other frivolities. Mammography is below N50, 000. People should know that the treatments are available and are so cheap. They should not wait till things have snowballed. Because even at the best of centres, advanced cancer is not treatable.

“For those who have non modifiable factors, constant screening is essential. People who are passive smokers should avoid cigarette smoke. Both active and passive smokers are liable to developing cancer; even passive smokers are at greater risk. Government policy of not smoking in public places is commendable, but implementation is important. People should adhere to the law.”

Agreeing with Dr Ariyibi is the Chief Executive Officer (CEO), Care. Organisation. Public Enlightenment. (C.O.P.E.), Mrs Ebunola Anozie, who said lifestyle, environmental and biological factors have been identified as the major reasons cancer cases are increasing in Nigeria.

“Cancer was no longer the disease of old people, young girls and boys who are below 16 years are also suffering from it. Out of 10 cancer cases, five are cancer of the breast, two are cancer of the prostate, another two for cervical while the other cancers are in the one per cent. Breast cancer in women is the most prevalent cancer, only one per cent of men suffer from it.”

Recommendations

She said: “Awareness is key to reducing the disease because most women who present do it very late when the cancerous growth would have advanced to Stage 3 or 4. Prevention and early detection can save a person’s life. A lot survivors are living because they presented early. Though there are challenges at hospitals because, when some present early but because the theatre is full to capacity, the waiting period would have worsened the case. Living in Nigeria is stressful and the health system is not helping matters.

“ Parents should ensure their children, once they reached puberty, go for regular screening. I enjoin the Federal Government to provide affordable and accessible health. It should ensure that the National Health Insurance Scheme (NHIS) is available to people in time of adversity. I will also call for the establishment of a comprehensive national cancer centre. It would improve treatment of the disease. I also urged total overhaul of the health sector. In Israel, there is cancer centre. Our national cancer registry is not effective because of the way it is being run,” she said.

Anozie said there have been cases of misdiagnosis.

She said: “The former Deputy Governor of Ekiti State, Mrs Funmilayo Olayinka, was misdiagnosed when she came down with cancer. Cases of misdiagnosis are high. The way out is for the government to invest more in infrastructure.”

She decried the problem of epileptic power supply, saying equipment, such as linear accelerator, was sensitive to power surge.

“Most equipment are damaged by power outage. I condemn hospitals that acquire obsolete equipment for patient management and treatment,” she said.

-TheNation

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