Dr. Ifeoma Okoye is a Professor of Radiology at the University of Nigeria Nsukka (UNN), and the University’s current Director of Centre For Clinical Trials (UNNCECT), with main interest in Non-Communicable Diseases (NCD) Research has explained that four out of every five cancer patients in Nigeria die even when the deaths are practically avoidable, in an interview with Tai Anyanwu of New Telegraph.

How much threat do breast cancer and other malignant tumors pose to Nigerians?

Cancer is a very deadly disease though preventable, if proper information about the causes of the disease, management relevance of early detection is communicated to the people.

According to the World Health Organisation (WHO’s) findings, Nigeria has the highest mortality rate in Africa. Four out of five cases of cancer in Nigeria result to death. In fact, some authorities say that the mortality in Nigeria is highest in the world.

What factors drive the scourge of breast cancer (cancers) in our environment?

Ignorance is number one. People don’t go for screening, for early detection. Of course where there is a history of cancer in one’s linage, there is little or nothing such people can do about it.

However, life style has a lot to do to keep one away from cancer affliction. Unfortunately, Nigerians have imbibed what one can described as westernization of diet, which makes our people load themselves with sugar, alcohol and smoking which creates fertile ground for cancer. Many just sit down without carving out time to exercise themselves enough. Of course, very important contributor to the risk factor is environment. There is little or nothing individuals can do about environmental factor, but government can be held accountable. Some of the factors contributing to cancer risk are vehicle fume, air conditioner, generator fume, indiscriminate habit of refuse disposal and the putrefied fumes they exude.

Do the risk factors have other unique consequences on human health other than causing cancer?

Most unique thing about the risk factors is that they are also the one that drive none communicable diseases such as stroke, heart attack, premature aging, diabetes, dementia and other chronic diseases. The risk factors actually contribute 60% more deaths than Hiv/Aids, malaria, tuberculosis and other communicable disease where focus are on.

If we just get the education aspect of Cancer to the people make them understand it, it will be a win-win situation.

There is need to eradicate the low level of ignorance among our people; demystify the fear and denial that this mysterious disease is due to some diabolical reasons, witchcraft, family enemy, poison and the “it is not my portion syndrome or accepting on clinical symptoms and signs from unqualified persons. All these are underscoring late presentation of cancer.

How true is the general belief that once one comes down with cancer there is no remedy?

In the medical circle, we say that cancer whether breast cancer, cervical cancer or other cancers, is not a death sentence. Most of the cancer related deaths are preventable; and by preventing the incidence of cancer-causing HPV infection, incidence of cervical cancer can be significantly reduced. Two companies have also produced Vaccines against HPV (Cervarix and Gardasil and a Quadrivalent Vaccine). For optimal prevention HPV infection, any of these three Vaccines should be given prior to sexual debut. Women are at risk throughout their lives and infection can occur at any age, vaccines will also be beneficial for young girls and women.

Pre-cancerous lesions, which are not cancer, but have the potential to progress to cervical cancer, can be detected through different types of screening, conducted early from age 20. Available screening methods are pap smear test or visual inspection with Acetic Acid or Lugols Iodine (VIA or VILI). These can find changes in the cervix that can be treated before they become cancer. VIA or VILI are currently recommended for use in developing nations, because the woman can have cervix looked at, painted, an abnormality found and treated at the same time.

In the case of breast cancer, what is the hope for survival?

The key is to detect changes in the breast such as lump, scaling breast, dimpling, nipple that is pulling in, redness of the nipple and other abnormal changes in the breast early enough. Then commence early treatment or management. Let me make it clear that men also not exempted from breast cancer and this is not noticed because men have small breast size. In fact, 7% of Nigerian men have breast cancer, especially in Northern Nigeria.

It is important to detect breast cancer through a combination of self-examination, by health care provider examination and by mammography.

Monthly self-breast examination is recommended from age 20 and as soon as breast buds appear in a girl child. Clinic breast examination by health care providers should be conducted for people between ages 20-23, every three years. For those above 40 years of age, it should be done annually; mammography for 20-23 years old, yearly test is recommended, one to two years for ages 40-49 while for people 0f 50-65 yearly test is recommended. In summary, the key to survival is early detection and management. For effective management of cancer cases, tertiary health institutions like teaching hospitals are the best place to seek help.

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