Early diagnosis, routine based population-level screening can significantly improve cancer outcomes and patients survival in Nigeria.
This was the submission of the wife of Ondo state governor, Mrs. Betty Anyanwu-Akeredolu at the Multidisciplinary Cancer Management Course, organized by Society of Oncology and Cancer Research of Nigeria ,SOCRON, and American Society of Clinical Oncology, ASCO, in Lagos at the weekend.
According to Mrs. Akeredolu who is the founder of Breast Cancer Association of Nigeria, BRECAN, promoting early diagnosis of cervical and breast cancer among women will go a long way to achieving remarkable success in cancer care and control.
Highlighting the context-appropriate approaches to improving cancer care and control in Nigeria, Mrs. Akeredolu emphasised the need for routine based population-level screening, noting that screening of breast cancer must take place at the primary health care facilities.
She said: ” Using Ondo state as an example, there is at least one primary health care facility in each ward.
“With our current plans to ensure clinical breast examination services are offered at all the primary health centers, we can be sure we will be covering up to 80% of our target population since 85% of pregnant women in the state receive Ante-Natal Care at health facilities and up to 74% have institutional delivery, indicating high patronage of the health facilities by women of reproductive age.
” The primary health facilities are then required to refer patients with symptoms to the general hospital at the local government for what I will call “first-level diagnosis.
“patients with positive diagnosis are then referred to a well-equipped cancer diagnostic center in the senatorial district to complete diagnosis within a specified time frame.
“We believe this strategy will significantly increase early detection and presentation of breast cancer in Ondo state”.
She also stressed the need to improve patient navigation at the health systems level, while lamenting that a sizable proportion of patients are lost to follow-up in the cancer care continuum as a result of the complexity and poor functioning of health system especially as it relates to cancer care.
Mrs. Akeredolu disclosed that every single day in Nigeria, 39 women are diagnosed of cervical cancer, while 22 die on that same day, with breast cancer killing 36 women daily.
The BRECAN founder therefore called for critical evaluation of Nigerian health system and re-model it to ensure accessibility, affordability and quality in order to curb loss to follow-up.
According to her, there is also a need to actively engage religious leaders who in most cases are either the first point of call or the only point of call for women noticing breast cancer symptoms.
“This we’ve started doing in Ondo state as we have just commenced a study to understand the knowledge, perception and pastoral practices relating to breast cancer among Christian religious leaders in Akure, Ondo state.
” We are also set to conduct a similar study among Muslim clerics and traditional healers “babalawo” in collaboration with some researchers from University of Washington by August this year.
“Aside from understanding the problems associated with delay in presentation from this angle, these studies are also setting the stage for an effective collaboration with these religious leaders to ensure they provide only psychosocial support and referral services rather than make attempts to treat”.
Mrs. Akeredolu affirmed that, her NGO, BRECAN, has a team of survivors called “Team Survivor” in many parts of the country and they have been providing psychosocial support to breast cancer patient, calling on the government to invest in this area as well.
To achieve cancer care and control, both health providers and civil societies must consciously and conscientiously engage the governments to act more responsibly in ensuring the formulation and implementation of cancer care and control at their respective levels.
Given the low position breast and cervical cancer occupy on the ladder of health priorities in Nigeria, Mrs. Akeredolu called for relentless effort in advocating for government to make both forms of cancer a priority and create a budget with adequate funding for its control.
Her words: “Having survived breast cancer for twenty two years and still counting, there is no better poster child to show that breast cancer can be beaten if you take the right steps at the right time. One of such steps is being breast aware, which I strongly believe is the entry point to surviving breast cancer.
“Yes, we have a lot to do to tame these diseases but we will not quit until breast and cervical cancer case fatalities drop to zero. Given my experience, I can confidently say breast cancer is not a death sentence and it should kill no woman”.
She therefore stressed the need for all hands to be on desk in ensuring that breast and cervical cancer fatalities are reduced to almost zero in Nigeria.