INTERVIEW: How Nigeria can reduce cancer-related deaths

As the world celebrates World Cancer Day, health experts are calling for increased awareness of the disease and adequate funding to improve healthcare services in Nigeria.

The World Cancer Day, celebrated on February 4 yearly, is an initiative of the Union for International Cancer Control (UICC) and is marked by countries all around the world.

The day aims to save millions of preventable deaths each year by raising awareness and education about cancer and putting pressure on governments and individuals across the world to take action against the disease.

The President of the Nigeria Cancer Society (NCS), Adamu Alhassan, in this interview to commemorate the Day, explains the importance of early diagnosis in reducing deaths from cancer-related illnesses in Nigeria.

He also spoke on the implication of late case presentation, collaborations between concerned parties and strategic ways to defeat cancer in the country.

Mr Alhassan is a public health expert working with the Department of Family Medicine at the Federal Medical Centre Nguru, Yobe State.

PT: How will you rate the level of cancer awareness in the country?

Alhassan: This is the major reason why all stakeholders in the Nigerian Cancer Society (NCS) are bringing in new energy and vigour to be able to reawaken the consciousness of Nigerians because, sincerely speaking, the level of awareness is low and we really need to up the ante in order to ensure that we get out there, we get across to the general populace particularly those in the rural areas.

Because, you discover that the radio, TV jingles, newspaper publications end up in the hands of the few who are literally in the capital cities, but we in the Nigerian Cancer Society, are advocating for more inclusiveness whenever it comes to advocacy and awareness creation.

Cancer is a preventable disease and It is a disease that is actually preventable. You know, there is the saying that preventive medicine is better than curative medicine and this is the major reason why awareness should be the key priority of every individual, and it is actually our priority in the Nigerian Cancer society to raise the awareness and that is what we are doing.

We are not going to relent on that as we continue to push until we ensure that we have significantly reached across to those who really matter.

PT: Late diagnosis has been identified as a major reason for deaths in cancer. Some cancer patients are already above stage one before doctors confirm the presence of cancer. How can you rate cancer diagnosis in Nigeria?

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Alhassan: This also boils down to the fact that the awareness level on cancer is quite low in the country.

Because when you say late diagnosis, it is usually not late diagnosis on the part of those diagnosing cancer but rather in terms of presentation by patients.

You know, there are these general myths, especially in the rural areas that cancer is like a taboo. They will tell you that if you go to the hospital and get diagnosed of cancer, you will be given an injection, which will lead to death. And that is a very serious myth and misconception by the public and that is what usually attributes to late presentation at the hospital.

If you don’t come early, you know how cancer cells behave and how easily they spread to other organs. That is usually the major reason. In terms of the diagnostic tools, you may be right if you say we are still not where we are supposed to be as a country and that is the reason why there is a serious need for government involvement in ensuring that the diagnostic tools are in place.

Accessibility is also very important because it’s not just for you to come and keep them at the hospitals in the state capitals or Abuja. And then those in the rural areas cannot access where to have the basic diagnosis that can detect cancer early.

You see, a typical example is the Pap smear that is used for cervical cancer screening in women. Pap smear should be easily accessible anywhere anytime and, in fact, it should be free in all our hospitals, so that any willing woman can walk into any facility and have the test done. Of course, if there is any suspicion, they will take it up from there and build further on making more accurate and specific diagnosis. Early diagnosis in cancer care is very important because it is in stages. So the earlier you catch it the better and better prognosis for the patient.

PT: How can Nigeria manage more patients if cancer is detected early?

Alhassan: Improvement in the number of cancer patients being managed or cured depends largely on the commitment of the government.

If the government is committed and serious in ensuring that there is availability and accessibility of cancer diagnostic tools and management, it will go a long way.

I am just coming from the National Assembly now where a public hearing is still in progress on certain bills and some of them have some direct correlation with cancer. Some of these bills are aimed at promoting the improvement in healthcare delivery services in Nigeria. If there is additional funding to health care, additional funding for cancer treatment and advocacy and control, of course that will determine how any cancer can be cured.

And don’t forget if it is detected early in some stages, it’s not even cancerous and it can be cured completely. At that very early stage, one has not even been certified to have cancer and that will be a good thing and it will definitely go a long way in improving our statistics.

PT: Do you think the Nigerian government is doing enough in cancer control and health care?

Alhassan: What I can categorically say here is that on the part of the legislature, there is a serious zeal and commitment in making sure that proper attention is given to cancer but on the part of government again, they are also trying but I think there is still a need for them to do more. We need to improve on provisions for cancer in the health budget.

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We need to improve on channelling these resources to appropriate quarters where they can be utilised to improve the welfare of patients suffering from cancer, to prevent those that don’t have cancer, to increase the general awareness because there is so much more you can do with advocacy and awareness creation not only in treatment.

PT: Can you highlight major challenges encountered by some members of the Nigeria Cancer Society which also includes people living with cancer?

Alhassan: The challenges are multifactorial, starting from the immediate locality and the society in general. You know cancer is also one disease that people attach a lot of stigma to, just like HIV.

People think you can easily touch somebody and contract cancer which is not actually the case. These are the things associated with the myths and misconceptions by the public and these are the things that are affecting even presentation by patients that are suffering from cancer.

You know, they call it ‘Jeji’ in hausa so people say if you have ‘Jeji’ and go to the hospital, they will give you injection and you will die. Surprisingly most of the ailments that the local populace refers to as ‘Jeji’ are not actually cancerous conditions.

Generally speaking, we have to lot of cancer Non-Governmental Organisations (NGO) in Nigeria but poor funding is the bedrock of non-performance of most of these organisations.

There are so many of them that are very good, that have a very clearly marked out agenda to improve and contribute towards cancer prevention to improve the well-being of cancer patients, but the funding is not forthcoming.

So you see, without funding, there is basically very little or nothing that you can do and that is the reason why we will continue to advocate for better funding for cancers and health care in Nigeria.

We at the NCS are like policy advisers. We advise government, individuals and organizations on how best to improve on funding mechanisms. So as to directly contribute towards the development and improvement in cancer treatment and control services in the country.

The NCS collaborates effectively with organisations like the Africa Health Budget Network (AHBN) on better funding mechanisms for health care in Nigeria and the collaboration is yielding positive results. We remain very optimistic.

PT: During a National health dialogue organised by PREMIUM TIMES in 2019, the Minister of Health, Osagie Ehanire, said there are plans to roll out a cancer trust fund. Are you aware of this or any fund to reduce the burden of cancer treatment in Nigeria?

Alhassan: You see the problem with us as a country is the fact that we say a lot of things and we don’t follow up.

Sometimes, these statements are made without a very concrete plan of action already in place. Look at the construction of the International Cancer Centre, you don’t hear much about it.

So what we are saying to the government is that whenever they want to make a statement they should ensure that they have a clear road- map and clearly stated timelines.

They should also ensure they have a period of execution they have deliverables that can ensure proper scrutiny, monitoring and follow up. This is what we are doing now at the level of the NCS. We have started very well and we are not going to relent on our efforts in voicing our concerns. we are going to keep making our voices heard, we are going to keep reaching out. It is a clarion call by all and sundry. The slogan of the World Cancer Day for the past three years has been “I am and I will” hence our resolve to ensure that we keep pushing the agenda for better health care in general.

We want people to believe that the opportunity and the capacity to make the noise is in them that is why everybody is a stakeholder.

We should all come together and continue to talk to the government, the legislature and other non-state actors so that we can improve and better the services available for cancer patients and educate and awaken the consciousness of those that are not affected by cancer so that they can have a clear indication of how to prevent cancer.

It is important to note that if detected early, cancer is 100 per cent curable and that is the reason why all hands must be on deck.

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