Even as Nigeria joined the rest of the world to commemorate the 2011 World Cancer Day on February 4, the focal person for cancer control in Nigeria, Dr Patience Osinubi, National Coordinator, National Cancer Control Programme, Federal Ministry of Health, pointedly attributed the increasing incidence of cancer in Nigeria to general lack of awareness and apathy to go for screening.

Dr Patience Osinubi

But she believes the battle against the disorder can be won if only Nigerians would heed the clarion call to go for screening early. In this chat with Sola Ogundipe, she speaks on the current profile of cancer control and management from perspective of the Federal Ministry of Health.

Excerpts.

Cancer is a cause for global concern. In Nigeria, cancer has contributed to mortality because many of the patients present in the advanced stages of the disease when only radiotherapy and palliative care can be administered. They often have poor prognosis. There are designated hospitals in the six geopolitical zones as cancer treating centers. They are Lagos University Teaching Hospital, Lagos; National Hospital, Abuja; University of Nigeria Teaching Hospital, Enugu; University of Maiduguri Teaching Hospital, Maiduguri; University College Hospital, Ibadan; Federal Medical Centre Gombe; University of Port Harcourt Teaching Hospital, Port Harcourt; Ahmadu Bello University Teaching Hospital, Zaria: Uthman Danfodio University Teaching Hospital, Sokoto and University of Benin Teaching Hospital, Benin City.These hospitals have had cancer diagnosis and treatment equipment procured through the VAMED project and are to receive new equipment very shortly.

Challenges of cancer diagnosis, treatment and control in Nigeria

In recognition of the inadequacy cancer treatment and diagnostic equipment, Federal Ministry of Health signed a technical agreement with the International Atomic Energy Agency, IAEA, to procure 10 new radiotherapy and 10 new nuclear medicine equipment at a cost of $37.5million for the six designated hospitals. An initial $2m has been paid to initiate the training of relevant health personnel. Part of this partnership involves fellowship training abroad for relevant health specialists.

Most prevalent types of cancer in Nigeria

The most prevalent cancers amongst females are breast and cervical cancers and amongst males are prostate and liver cancers. The national cancer burden can be effectively managed if only Nigerians would take their health seriously and go for regular cancer screening. It is not more difficult than that.

National Consultative Committee on Cancer

The NCCC was put together by the Federal Ministry of Health. It is composed of renowned health professionals of all disciplines in the area of oncology and relevant stakeholders including NGOs. It is chaired by Prof. F.A. Durosinmi–Etti and serves as an advisory committee to the ministry in its policy formulations on matters concerning cancer prevention and control. This committee has guided the Ministry to develop the 5 year Nigeria Cancer Control Plan, 2008-2013, which is currently being implemented.

Limited access to treatments that offer prospect of prolonged survival

Most cancer patients present in advanced stages but I do not believe that any physician will limit access to treatment for any cancer patient. The truth is that at that stage there is very poor prognosis and the main goal will be to improve the patient’s quality of life through pain control and palliative care. To overcome this, the patient must present in hospital early.

Connection between rising profile of environmental pollution and cancer

Environmental pollution has been documented to be a risk factor for cancer. All over the world,. Governments, including in Nigeria, are making efforts to reduce environmental pollution and reduce climate change. Skin cancer is the commonest environmental related cancer. The harsh exposure to ultraviolet rays of the sun increases the risk of skin cancer among albinos. The Health Minister has hosted several skin cancer awareness and screening campaigns and was personally responsible for the treatment of a very bad case of skin cancer. Fortunately Nigeria has been spared from nuclear accidents. We advise people not to build homes next to factories where there is a lot of smoke emitted from their chimneys.

Government policy on cancer screening

Regular cancer screening is Goal 2 on the 5-year Nigeria Cancer Control Plan. FMOH strongly advocates for regular cancer screening especially for breast, cervical and prostate cancers. We have gone into the urban and local communities to screen for cancers and have treated so many who were lucky to be detected early. FMOH has carried out FREE public cancer screening campaigns in the six geopolitical zones. The Government Policy is Ssceen! Screen!! Screen!!!

National cancer registry

Cancer data is pertinent for cancer prevention and control planning. There is a National Cancer Registry, located in University College Hospital, Ibadan. The FMOH has up-scaled the cancer data management system in Nigeria. Zonal cancer registries have been designated in one hospital per geopolitical zone. In addition, in collaboration with the Institute of Human Virology of Nigeria, we have successfully organised three cancer registration courses where over 150 cancer registry staff have been trained in the latest CAN Reg. 4 software for collecting data. Computers and the CAN Reg. software were also given to the participating hospitals. The plan is that Institutional cancer data is forwarded to the zonal headquarters in that Zone who in turn forward all the data sent to them to the National Cancer Registry ion Ibadan. Many of these registries are currently being refurbished for efficiency.

Cancer screening services

All the 55 teaching hospitals nationwide, to date, can offer limited cancer screening services. Increase of the existing capacity for better cancer screening services is desirable. Eleven mammography machines and other cancer screening equipment procured for the hospitals have arrived and will be distributed accordingly.

Pilot scheme of free cervical cancer vaccination of young Nigerian girls with Gardasil and Cervarix vaccines

Giant strides have been made in the vaccination of young girls against cervical cancer. As part of the commemoration of the 2011 World Cancer day Prof Onyebuchi Chukwu launched the HPV vaccines bought by the FMOH. This first batch will be given to young girls from indigent homes. The vaccines will be available in designated hospitals in every state.

Research on local herbs to investigate anti-cancer properties

On the 20th of January, 2011, the Nigerian Cancer Research Network was inaugurated at the National Institute for Medical Research. The goal is to encourage scientists to look inwards and investigate locally available vegetables and fruits for research into cure for Cancer. Some scientists like Prof. Atawodi of ABUTH has documented that okra, tomatoes and some other local vegetable have anti cancer properties. Research finding by our scientists will be published in due course for public information.

Nigeria and International Atomic Energy Agency in an eight-year partnership: This Technical Partnership as well as the Programme of Action on Cancer Therapy,(PACT) involves the procurement of up to date Cancer treating equipment and Nuclear Medicine equipment to improve cancer diagnosis and treatment. To show that Nigeria is very serious, the FGN paid an initial $2m to activate the partnership. This fund has enabled six doctors to go abroad for Fellowship programmes in oncology alongside this, radio nurses, radio laboratory scientists and radio pharmacist and technologists. In addition IAEA is sending an expert team to Nigeria to assess the next necessary level of collaboration in cancer management.