February 4, every year, the entire world unites in marking the World Cancer Day, aimed at intensifying the fight against cancer through awareness creation. On this year’s occasion, which has “I am and I Will” as the campaign theme, a professor of Radiation Medicine, College of Medicine, University of Nigeria, Nsukka, Prof. Ifeoma Okoye, who is also the President, Breast Without Spot, tells ANGELA ONWUZOO, that for Nigeria to defeat cancer, the fight must be everybody’s business. Okoye, who is also the Director of the UNN Centre for Clinical Trials, also calls for increased participation in research activities to tackle the burden of cancer in the country. Excerpts:
Why do we have an increase in cancer cases globally?
In the case of Nigeria, the point is that we have the least ability to cope with it, due to the lack of proper infrastructure. We have poor infrastructure; projects in the National Cancer Control Programme are not implemented as a result of lack of budgetary allocation. Now, worldwide, the cancer issue has not been made a global priority. We need to make the cancer issue a global priority, especially in the context that the International Agency for Research on Cancer, has said that without any equivocation, cancer has become the biggest killer.
Reasons for the increases – First is environmental factors like smoke. Smoke of any form, fume of any form and tobacco smoke contribute to increase in cancer cases. Others are putrefaction from environmental waste, the way we dispose our environmental waste is barely acceptable. If you go to a complex flat in Nigeria, for instance, each one of them has a generator and because they are not all on ground, some are kept on the corridor and the fume that is being generated is being inhaled by everybody around the flat. So, environmental pollution is contributing a lot to cancer burden.
Then you have animal husbandry and our food processing practices, the pre-production practices, the fertilizer used, the insecticides and chemicals that are being used in our foods and those given to our poultry. All these are contributors to the global cancer burden.
Also, inactivity-obesity and stress are factors – so much stress in the society, such as emotional stress. They are all contributory factors.
We also have the issue of western lifestyle. Eating of junk foods. There are a lot of foods that are laden with preservatives and addictive, as well as over processed foods that we consume.
In fact, the World Health Organisation has called on developing nations to go back to their local foods.
Lentils-legumes are very good to the body, but we don’t eat them. We used to eat a lot of lentils in the past and Nigeria has a lot of lentils.
We should go back to lentils and stop this intake of highly processed foods.
We think that by talking about cancer in Nigeria, we are inviting it. We think that even sitting to listen to a talk on cancer, we are inviting it. We think that even by coming for screening, we are inviting it also. In fact, people will start blaming you for going for screening if anything was found
Do we have the right facilities and manpower in Nigeria to tackle the emerging epidemic?
Of course, we don’t have the right facilities in place. We do not have facilities for diagnosis, both for radiological and pathological diagnosis. We need a lot of training for our manpower. Even the training that we have is barely harnessed because of the poor facilities that are available. We don’t even have the facilities to do what we know how to do; they are not even there. So, the issue of facilities must be adequately addressed if Nigeria must defeat the cancer scourge. We have limited radiation oncologists. And if we get the right facilities in place, we would be attracting patients from other countries, instead of the other way round.
You called for the establishment of a National Cancer Registry. What impact would it have in the fight against cancer in the country when established?
When we have a National Cancer Registry, it will enable us to know what is going on with the level of confidence as far as cancer is concerned.
And it would enable the country have accurate statistics on cancer and the type of cancers recorded each year. So, the benefit is profound because it can assist to fine-tune areas that need to be paid more attention in terms of research and funding.
Then, we need to embark on population screening that will enable us know the number of Nigerians suffering from the disease. We need to increase awareness so that people will come to the hospital facilities where the record can be put on the registry. A lot of people die at home from what they don’t know. Some of them could be from cancer. Therefore, we need to have increased participation in research activities to tackle the burden of cancer in Nigeria.
What are these myths about cancer in Nigeria, and is cancer really a death sentence as being portrayed in some quarters?
Cancer is not a death sentence if detected early. And I really would like to dwell on the myths that we have in Nigeria. Our myth is that we don’t like talking about cancer.
We think that by talking about cancer in Nigeria, we are inviting it. We think that even sitting to listen to a talk on cancer, we are inviting it. We think that even by coming for screening, we are inviting it also. In fact, people will start blaming you for going for screening if anything was found.
Procrastination, denial, stigma, fear, “is not my portion” syndrome, “I bind and cast it,” “it cannot happen to me even if it happens to other people,” are the problems we have in Nigeria. All these form part of the syndrome, attitude and practices of our people.
Some people even think that when somebody examines your breast, the breast might disappear. Even concerning this vaccination with HPV vaccine, some have begun to spread rumours that it causes infertility. They had even started spreading the rumour before we even started the campaign. The vaccine does not cause infertility. It is absolutely safe. After listening to a lot of talks on it last year, I became more convinced that, as a country, we need to start doing more. We shouldn’t just stay there and leave our people to die when there is something that can be done to help them actually prevent cancer.
What exactly is your NGO, Breast Without Spot, doing to reduce the burden of cancer in Nigeria?
First of all, we have always believed that the major problem of Nigeria, concerning cancer, is late presentation. Late detection is the bane of cancer in this country. It is the reason people think that cancer diagnosis is a death sentence because most of our patients present
late.
So, because of that knowledge gap, when Breast Without Spot started, we focused on raising an army of advocates that can reach the populace with the right information and properly educate them on cancer. I found out that a one-to-one advocacy worked better. I had this vision that the way to multiply myself was to use an existing infrastructure. So, we thought about the National Youth Service Corps members. We went to the NYSC to partner with them and they gave us access to come to their camps and talk to the entire camp and ask for volunteers. Among those volunteers, sometimes 20 to 100 of them, we now train them after which they take it up as their Community Development Programme. So, in many states, we have CDS Breast Without Spot. We have gotten a good yield by using the youth corps members. They have gone to schools, churches, and markets, among others, to educate people about cancer. The dream is to access all the 36 states of the federation and FCT, when the funds are available. Hence, the overriding goal of Breast Without Spot is to reduce late presentation, to create awareness on prevention and early detection and reduce late detection so that we can drive down morbidity and mortality.
