By: Blessing OPEYEMI
Cancer, according to the National Cancer Institute, is a disease in which some of the body cells grow uncontrollably and spread to other parts of the body.
On how it comes to be, the NCI expatiate that it “can start almost anywhere in the human body, which is made up of trillions of cells” and that when these cells (which grow and multiply through a process called cell division) grow old and become damaged, they die, and new cells take their place but this orderly process sometimes break down and abnormal or damaged cells begin to grow and multiply, forming tumours (lumps of tissue) which can be cancerous or non-cancerous (benign).
Also, according to the NCI, there are more than 100 types of cancer and they are usually named after the organs or tissues affected.
In Nigeria, cancer is one of the poorly addressed causes of morbidity and mortality which affect both sexes irrespective of age. The country has one of the highest cancer mortality rates in the world, with approximately four out of five cases resulting in death, according to the Global Cancer Observatory (GLOBOCAN).
GLOBOCAN, in a study published in 2021, also reports that in Nigeria, as of 2020, there were 233,911 cancer cases in total with 124, 815 new cases and 78,899 deaths which are about 34% mortality rate of the known and registered cases. The issue of late diagnosis and inadequate access to good treatment leads to a higher mortality rate in developing countries like Nigeria.
Also, in Sub-Saharan African countries, especially Nigeria, where religious and traditional beliefs and superstitions are prevalent, cancer patients who have not been diagnosed often believe they are under spiritual attacks and therefore visit traditional healers or religious centres in search of solutions and only resort to medical treatment when their cases have advanced; with no access to adequate and/or advanced and affordable treatment, death becomes inevitable.
According to the International Agency for Research on Cancer (IARC) and World Health Organisation (WHO) data in 2020, there are five most common cancers in Nigeria and they are breast, prostate, cervix, colorectal, and non-Hodgkin lymphoma cancers respectively.
Breast cancer is the commonest cancer in Nigeria (and the world) and it mostly affects women. It is the leading cause of cancer deaths currently, representing about 23% of all cancer cases and approximately, 18% of deaths are attributed to it in the country (IARC/WHO 2020). Major modifiable risk factors linked to breast cancer are alcohol consumption, smoking, lack of physical activities, being overweight, and obesity. Other contributing factors beyond the patient’s control are genetic factors, family history of breast cancer, age (older women have been recorded to have more cases of breast cancer than younger women), and gender (more women are affected than men).
Prostate cancer is the leading cancer case in men. It reportedly accounts for 12% of all cancer cases with 11% of death in registered cases in Nigeria. The American Cancer Society defined the prostate as a gland found only in males that makes some of the fluid that is part of semen. The prostate, which is found below the bladder and in front of the rectum, is about the size of a walnut and can be much larger in older men. Prostate cancer begins when cells in the prostate gland start to grow out of control. The early prostate cancer stage is usually asymptomatic. Symptoms of advanced prostate cancer stages include difficulty in urination, urine or semen containing blood, erection difficulties, hips, back(spine), and or chest(ribs) pain, weakness or numbness in the legs or feet or even a loss of bladder or bowel control from cancer pressing on the spinal cord.
Cervix cancer is the second commonest cancer among women in Nigeria aged 15 to 44 years in Nigeria but it is also one of the most preventable.
According to the HPV Centre, about 70% of all known cases of cervical cancer are caused by the human papillomavirus (HPV) serotypes 16 and 18, which are most commonly transmitted through sex. HPV can also be transmitted through the use of contaminated hospital equipment and from mother to child during pregnancy. A 2021 report from the HPV Centre estimates that every year more than 12,000 Nigerian women are diagnosed with cervical cancer and almost 8,000 of them die from the disease.
The main cause of cervical cancer, according to the World Health Organisation’s (WHO) Africa office, is “persistent or chronic infection with one or more of the ‘high-risk’ types of human papillomavirus.”
The WHO also says HPV is the most common sexually acquired infection and often affects young adults who become sexually active early in their lives.
Colorectal cancer is cancer of the colon, bowel and rectum. These are parts of the digestive system that begin at the mouth and end at the anus. Colorectal cancer is the third commonest cancer type globally with around 1.80 million cases and causing 862,000 deaths–the second-highest of all cancer deaths–at the end of 2018. Previously thought to be uncommon in Africa and Nigeria, colorectal cancer cases have been steadily rising in the past few years.
The risk factors that can increase the odds of developing colorectal cancer include age, alcohol consumption, smoking, and race (black and African Americans have been reported to be at high risk of developing cancer). It can be prevented by eating a balanced diet with less meat and more fibre, quitting smoking, exercising often, maintaining a healthy weight, and getting screened for colorectal cancer as adults.
The non-Hodgkin lymphoma is the third commonest cancer type among Nigerian women. Non-Hodgkin’s lymphoma begins in the lymphatic system, which is part of the body’s germ-fighting immune system. Here, white blood cells called lymphocytes grow abnormally and can form growths (tumours) throughout the body. In most instances, doctors don’t know what causes non-Hodgkin’s lymphoma. It begins when the body produces too many abnormal lymphocytes.
Normally, lymphocytes go through a predictable life cycle–old lymphocytes die, and the body creates new ones to replace them. In non-Hodgkin’s lymphoma, however, the lymphocytes do not die, yet the body keeps creating new ones. This oversupply of lymphocytes crowds into the lymph nodes, causing them to swell.
While there is a prevalent rise in cancer cases in the country, the disease itself is only one part of the story. Health care in Nigeria has become one of the most underfunded and least robust systems in the world.
On one hand, there is a shortage of personnel with an ongoing brain drain in the health sector. Nigeria averaged fewer than 1 doctor per 1,000 people and had fewer than 90 oncologists (doctors trained specifically in cancer treatment) as of 2021.
On the other hand, there is also the issue of underfunding. Since 2001, successive Nigerian governments have consistently allocated less than 10% of the national budget to health care, despite a 2001 declaration by African heads of state — known as the Abuja Declaration — to allocate at least 15% of their national budgets to health care.
All of this means that millions of Nigerians do not have access to quality healthcare and are at greater risk of death if they develop any of these common cancers and adequate care is not quickly taken.
