PRIDED as an internationally acclaimed laboratory operating ultra modern medical pathological laboratories in Nigeria, offering a wide range of medical tests that guarantee accurate diagnosis and improved monitoring/treatment of medical conditions, PathCare Nigeria, has a vision to be theÂ benchmark for laboratory testing in the country.
In this interview with Sola Ogundipe, Prof. Ibironke Akinsete, Chairman Pathcare Nigeria, sheds light on the organisationâ€™s commitment to standards that earned it ISO certification. Further, she highlights the need to ensure adequate education and awareness about cancer while emphasising early screening as the best form of cancer prevention/treatment. Excerpts:
Concern over cancer burden
There is cause for concern over the rate of cancer cases in Nigeria because we do have quite a high cancer load in this environment. There is cause for concern because of the lack of awareness, lack of education and lack of facilities for diagnosis and management. Too many lives are being lost. Many people only come up when the cancer is very advanced and there is very little that can be done for them. And even then when they do come out, aciliies available for diagnosis and management are not very good.
Late presentation of patients
Factors responsible for late presentation include lack of awareness, lack of education and awareness to promote early diagnosis. Poor access to health facilities is also there. If you are aware, you are educated and have access to adequate healthcare, it makes it easier to seek help early. Government has its responsibility to provide this awareness, through the health sector, so do the people themselves owe it to one another to get appropriately educated onÂ issues concerned with cancer diagnosis and management. It is a collective responsibility and everyone must be involved.
Awareness and education
Access to the right information is limited only to a few people. There are 140 million Nigerians, but how many have access to health care services? Even among the so-called educated, how many are computer literate?Â How many can seek information from libraries or from the health care facilities. The point is that access to information and adequate healthcare is very limited. People should get the right information they deserve.
Assessment of cancer diagnosis and treatment in Nigeria
From the specifics and information available, the most common in women are cancers of the breast and of the cervix. In men are the cancers of the prostate and the liver. Colo-rectal cancer is also coming up in both male and female. But it is instructive to note that we still have huge problem of infectious disease and hign burden of non-infectious diseases such as cancer is coming up because of lifestyle, the environment and other factors.
It is difficult to cope if there is no adequate priority. Situation not made easier by fact that many medical care personnel are not aware of the number and sophistication ofÂ diagnostic tests required. They have been working in a very narrow range for many years. But PathcareÂ has brought to their knowledge that there are so many tests you can do on diagnosesÂ for many disease conditions. We regualrly give information to doctors, healthcare facilities on the rangfe of tests we offer on early diagnoisi and management of patients.
How PathCare is making a difference
What is really important to us at PathCare is early detection of cancer. We know that manyÂ people by the time we see them, it is too late and too difficult to manage the cancer. What we preach is prevention, early diagnosis and management because if cancer is detected early, it makes a lot of difference. To the various tiers of government, PathCare features essentially at the secondary and tertiary levels of healthcare. We offer pathological services including tests. But there is need to recognise the possible warning signs, know the symptoms and taking prompt action.
The idea is to promote early diagnosis. When you are able to recognise the probable warning signs of cancer, it is then you can take take prompt action that can lead to early diagnosis. Education is necessary. It is from increased awareness thatÂ warning signs such as abnormal bleeding, persistent indigestion, hoarseness of the voice and things like that would make you seek more information and then early diagnosis can come in.
Then we talk about screening. They are simple tests in a healthy person whichÂ can lead to early detection of cancer or pre-cancerous conditions before the person even has any symptoms. These are some of the things done in PathCare. For instance how do you detect cervical cancer early even when there are no symptoms?
This can be done through a simple early screening test called the pap smear. There are abnormal cells called pre-cancerous cells which give indication that cancer is on the way and pap smear enables these to be detected. Something can then be done about it to prevent it going on to being cancerous and spreading all over,
Stand on routine HPV vaccination
PathCare offers pap smear screening to whoever desires it. However, we do not offer the Human Papiloma Virus (HPV) vaccination. But we advice that every woman who is sexually active should have a pap smear done regularly. We are a diagnostic laboratory all right, offering pathology services, but we don’t offer vaccination. It is not up to us to make recommendation about the need for routine HPV vaccination.
This has to be a government policy.Â However, even if government is going to do something like that, it has to be properly planned and well worked out. It is not something that can be done adhoc. It must be sustainable andÂ adequate resources must be committed to it to ensure it can be done on such a large scale.
Cost of services
Good things do not come cheap. At PathCare, we are very quality-oriented. This is actually one of our driving factors. We do not offer anything substandard and if you are going to have quality, you have got to pay for it. In the facilties, everything is quality controlled right from when you step into the reception area. All the reagents, everyrthing is quality. Our results can be presented anywhere in the world. We do not use outdated reagents, and there are internal and external quality control.
The point now is that if even if these vaccines are going to be offered, they are pretty expensive right now. How many women can afford the cost? We knowÂ there are only two vaccines awaiting approval to be given by the FDA. It is an expensive venture and with Nigeria having so many other priorities related to health right now, it is unlikely government will take up. Let us even look at our success rate with polio immunisation for instance, it is going down. So will it be justifiable to ask the country to take on another burden?
For me I think it is important that we be aware that there are vaccines to prevent cervical cancer, but I really do not thinkÂ government can take up the responsibilityÂ of addingÂ HPV vaccination into routine immunisation.Â What I think can be done, at best, is for individuals toÂ decide to be vaccinated or not. Women can be screened, but whether or not to take the vaccine is still essentially a voluntary thing.
However, individuals can opt for the service or companies and other organisations can have it in their policies to offer the service to their employees, but there is no where such service is give free. Not even abroad. Nigeria cannot take on routineÂ HPV vaccination now.
Even abroad, screening is not offered free and where offerd, people do not go for screening. For us here in Nigeria, if we are going to do routine pap smear for everyone, it has to be very well worked out. We would have to inform and sensitise the people so that they would partake of the service. It is important, but is it sustainable?
We may need to do it in phases. It’s a good idea theoretically, but implementing the policies of the strategies would be the challenge. It it is not well done, it could lead to chaos and the whole thing would fall break down. Companies could start it off and then perhaps government can take it up afterwards.â€