World Cancer Day: Patients lament treatment gaps in Nigeria

Only one radiotherapy machine functional in North – Expert  ‘Nigeria has only 90 cancer specialists’    By Ojoma Akor (Abuja) Zahraddeen Yakubu Shuaibu (Kano)  Ado Abubakar Musa (Jos) Mohammed Ibrahim Yaba (Kaduna) Risikat Ramoni (Lagos)    As Nigeria joins the rest of the world to mark World Cancer Day, citizens  suffering from cancer are lamaenting […]

• Only one radiotherapy machine functional in North – Expert 

• ‘Nigeria has only 90 cancer specialists’ 

 

By Ojoma Akor (Abuja) Zahraddeen Yakubu Shuaibu (Kano)  Ado Abubakar Musa (Jos) Mohammed Ibrahim Yaba (Kaduna) Risikat Ramoni (Lagos) 

 

As Nigeria joins the rest of the world to mark World Cancer Day, citizens  suffering from cancer are lamaenting the poor access to care because of the inadequate number of treatment centres, cancer specialists and high costs of treatment in the country. 

The patients and medical experts said there is need to address these challenges in order to close the gaps in cancer care in the country. They called on government at all levels, philantropists and other stakeholders to subsidise treatment for cancer to alleviate the hardships they face. 

 According to the President of the Nigeria Cancer Society, Dr Adamu Alhassan Umar, the commonest cancers are breast, prostrate and cervical cancers. 

 While lamenting the dearth of cancer data in the country, he said Globacan estimates that Nigeria recorded 124, 000 new cases of cancer in 2020, out of which 78, 000 people died. 

‘Only three radiotherapy machines functional in Nigeria’ 

Dr Umar said as at December last year, only three out of the seven cancer treatment centres in the country  had functional radiotherapy machines. Radiotherapy machines use radiation in treating cancer patients. 

The seven tertiary hospitals in Nigeria that have radiotherapy machines are: National Hospital Abuja, Usmanu Danfodiyo Teaching Hospital, Sokoto; Ahmadu Bello University Teaching Hospital, Zaria; University of Nigeria Teaching Hospital, Enugu, University College Hospital, Ibadan, University of Benin Teaching Hospital, Benin and the Lagos University Teaching Hospital, Idi-Araba. 

He said the functional radiotherapy machines are at the National Hospital Abuja, the Lagos University Teaching Hospital and the one at the University of Nigeria Teaching Hospital, Enugu. 

 He added that the National Hospital Abuja and University of Nigeria Teaching Hospital, Enugu have a private public partnership agreement that enables the inputs of private stakeholders in the maintenance and operation of the radiotherapy machines. 

He said, “For example in the North, only one is currently functional. That is the one at the National Hospital, Abuja. I learnt they are replacing the old machine in Sokoto with a new one which is actually good but the problem is that the time in changing and maintaining the equipment costs the patients dearly. 

“Imagine a patient travelling all the way from Borno State or Yobe State for radiotherapy treatment at the National Hospital, Abuja, or in Lagos and then travelling back to continue other forms of treatment. So it is actually telling on patients and this is the problem that we have in Nigeria. 

“The lack of maintenance culture, and the lack of qualified personnel to handle these machines  also count. We are supposed to have these machines in basically every hospital that is managing cancer patients but unfortunately it is not so.” 

He called on government, policymakers to create appropriate policies to bridge the gaps and ensure availability of cancer centres for screening treatment and palliative care. 

Why governors should have state cancer control plan – Expert 

Runcie Chidebe, a cancer control advocate, said cancer care in Nigeria requires more government attention as less than 90 cancer specialists otherwise known as clinical oncologists are treating over 100,000 patients. 

He explained that the huge gap between the number of patients and doctors has led to an increase in the number of hours, days and weeks spent at the hospital before seeing a doctor. 

Runcie who is also the Executive Director Project Pink Blue said: “The cancer treatment centres are not sufficiently equipped. A facility like University of Port Harcourt Teaching Hospital does not have any functional radiotherapy machine. 

“There is no government-owned facility that has a radiotherapy (machine) centre in the whole of South-South. It is also the same story in the North East zone.” 

Runcie said cancer treatment centres are so far away that only 60 per cent of Nigerians are closer to comprehensive cancer treatment centres in Nigeria. 

He recommended that each state governor should take cancer care seriously, adding that, “If we continue to leave it with the federal government alone, it is not going to really work.” 

‘No PET scan machine in Nigeria’ 

Runcie lamented that the unavailability of a single Positron Emission Tomography (PET)scan in the whole country calls for concern. The scan is important in cancer treatment and management. 

He also lamented the absence of reagents for tumor marking. Tumor marking is a diagnostic done for people battling with cancer already to know if there is any malignancy (cancer spread) left in their body or not. 

 He said, “The reagents (ingredients) used for tumor marker are not available in Nigeria, rather, they are ordered from South Africa and it has a timeline.” 

Patients’ experiences 

In 2012, a cyst appeared on Bashir Sulaiman’s cheek which was then suspected to be cancerous. From Nakowa Hospital in Kalun community of Shendam Local Government Area of Plateau State where he under-went a minor surgery, to Murtala Hospital in Kano, and eventually Aminu Kano University Teaching Hospital in Kano, Suleiman said the cyst which has grown to envelop one side of his face has been properly diagnosed as cancer at the Aminu Kano University Teaching Hospital. 

He said almost 10 years since the cyst appeared, he continues to live with excruciating pain and is now financially exhausted from treatment. Bashir added that before he was referred to Kano for treatment, he had depended on traditional medicine for almost seven years which turned out unfruitful. 

He told Daily Trust that the major challenge for cancer patients is that access to specialists and treatment is not instant. “If you come today for an appointment with a doctor, if you are not lucky to see the doctor, you will be asked to come back another day. So, it has not been easy,” he said. 

Nineteen-year-old Mohammed Farhan Musa who is resident in Unguwar Shanu of Kaduna State has been battling stomach cancer over six months. Having undergone surgery at the Barau Dikko Teaching Hospital in Kaduna, he was referred to the Ahmadu Bello University (ABU) Teaching Hospital, Shika in Zaria for another surgery. 

The teenager’s father, Malam Musa Abubakar, told Daily Trust that doctors at Barau Dikko Hospital and Shika had donated for his son’s treatments because he could not raise the money but said that has not solved their problem. 

“The cost of each chemotherapy is N60,000 and the cost of tests is N11,500. We are now at home because we can’t afford to continue with treatment but the hospital asked us to return in February. As we speak, he is in pain but we cannot return to the hospital due to financial problem,” he said. 

Malam Abubakar explained that his son’s doctors have resolved that he needs chemotherapy every three weeks but said the injections and drugs are very expensive. “We were initially advised to take him to Abuja for the chemotherapy but the family cannot afford it,” he said. 

A cancer survivor, Martina Chia, who just recovered in 2020, said it was not easy for her surviving cancer breast which she spent seven years battling with coupled with stigma from people. 

“To cut the story short, I had to undergo radiotherapy in the Abuja National Hospital which took me over three months. Also during the treatment, I  almost lost my brain when I took drugs, so it wasn’t easy at all. I spent between five to six million naira during that time,” she said. 

Situation in states 

In Plateau State, experts say there are rising cases of cancer diseases based on the cases received by oncologists across hospitals. Dr Mercy Isichei, an oncologist at the Jos University Teaching Hospital (JUTH), said majority of cancer patients are younger with prostate cancer being the most common among men while breast cancer is most common among women. 

The State Commissioner for Health, Dr Nimkong Larndam told Daily Trust that though cancer cases are being handled in JUTH and Bingham University Teaching Hospital, Jos, the federal government has made plans to upgrade the treatment cancer centre at JUTH, and is expected to be completed by the end of 2022. 

Speaking on the prevalence of cancer in Kaduna State, an Oncologist with ABU Teaching Hospital, Dr Aisha Mustapha, said specialists are available but there is need to improve sub-specialisation and training on cancer care. 

Dr Mustapha said treatment centres are available but “there is no single functional external beam radiotherapy machine in the whole of northern Nigeria except the National Hospital Abuja. Imagine the burden on the machine,” she said. 

Dr Mustapha who is also the Kaduna State Secretary of Nigerian Medical Association said there is still no formal sub-specialty training in oncologic surgery in Nigeria, and few opportunities for training abroad. 

A source at the Aminu Kano Teaching Hospital (AKTH) told our reporter that the common cancer case in the state is breast cancer and that he the hospital attends to between 50 and 100 patients every week.  

Kano does not have any radiotherapy machine and patients have to be referred to the National Hospital Abuja or Lagos. 

A consultant radiotherapist and clinical oncologist, Dr Muhammad Inuwa Mustapha, said 70 per cent of the cancer patients in the state require radiotherapy but find it difficult to do so, as there is no single radiotherapy machine in Kano. 

He added that it has been stressful sending his patients to Abuja for radiotherapy which costs N600,000 per patient. 

He lamented that people don’t come for cancer treatment until it reaches advanced stage, saying there are higher chances of survival when diagnosed early. 

The Director of Hospital Servicies at the Federal Ministry of Health, Dr Adebimpe Adebiyi did not respond to messages about what the ministry was doing to address the gaps at press time.