•As LUTH, NSIA discuss breast cancer challenges, advancements

By Chioma Obinna

A panel of leading medical experts at the Lagos University Teaching Hospital, and the NSIA LUTH Cancer Centre have expressed fears that with N70,000 minimum wage, many Nigerians may not afford treatment for breast cancer, calling for early detection and personalised treatment for patients.

The experts also warned against alternative treatments for breast cancer, saying, it only fast-track death sentences for patients. Addressing pressing issues around breast cancer in Nigeria, they harped on raising awareness about cancer prevention strategies, and the latest advancements in treatment.

Speaking, the Chief Medical Director of LUTH, Prof Wasiu Adeyemo who was represented by the Chairman of the Medical Advisory Committee, CMAC, Dr Ayodeji Oluwole stressed the need to enlighten women about breast cancer.
“The more you create awareness, people can be better informed. And what else can be better than seeing two survivors, one of 17 years and the other one of five years, which shows that this is a disease that should not necessarily kill women? If they all know how to go about seeking treatment.”

He said breast cancer is preventable and curable if discovered early. Noting that there was no programme yet to absorb indigent patients, he said the government has already established a programme called CAP, that is, a chemotherapy access programme in most of the teaching hospitals for people who have cancer.

“But the most important thing is the National Health Insurance Act. There is a portion of it that talks about cancer treatment and it is better to employ women that everybody should register for the National Health Insurance Act. Once you register, the cost of treatment will come down. The ideal thing is to make it free. Any woman who is with N70,000, obviously cannot afford cancer treatment. But I’m sure the government is looking into that and that’s why this advocacy is very important. When women begin to talk about, how this disease is ravaging them, the government should listen. We have a listening government.“

In his submission, Dr Lawal Abdulrazzaq emphasised the importance of early detection and personalised treatment plans for breast cancer patients.

“The high cost of treatment, coupled with limited access to specialized facilities, can be a significant barrier for many patients. Because the minimum wage at 70,000, no patient with breast cancer can afford NSIA/LUTH Cancer Centre. The consultation fee at NLCC is going to make a mess of somebody’s monthly salary if you are a minimum wage earner.”

He traced another challenge to ignorance “most of the time on the part of the patients, or sometimes on the part of the doctors. There is also a need to do public enlightenment. Then there is a need for support. Support is not only funds.

“There are about three main challenges. One is ignorance. People are not aware. The second is funds. The third is coordination of stakeholders and support for these patients. In a country where the minimum wage is N70,000, how can a patient afford radiotherapy that is N1.7 million? What it then means is that if there is no body pain, then the patient is being left to die. The government has set up the Cancer Health Fund, but it is just a drop in the ocean. There is need to expand access to that fund, and there is also a need to expand the coverage.”

On stigma, he urged for support from spouses. “The spouses are particularly culprits in this instance. Once the woman has one breast, they will have side mamas or baby mamas. Breast cancer can be cured. Early detection is the key. Public enlightenment is the foundation. Patients must have self-care, but we must strive to give patients affordable care.”

He said breast cancer can sometimes be reduced to a death sentence that has been passed since birth but the overwhelming evidence suggests that breast cancer requires the active collaboration of the patients, the society, and the medical community to be able to successfully execute the death sentence on any patient.

Noting that the most effective treatment is one the patient accepts and can access, he listed the various risk factors for breast cancer, including family history, lifestyle factors, and hormonal influences. While some factors, such as genetics, are beyond a person’s control, others, like diet, exercise, and smoking habits, can be modified to reduce risk.

On prevention, Lawal said prevention of breast cancer is a difficult thing because no one knows the exact causes of breast cancer but certain risk factors increase a person’s risk of developing breast cancer. He said women have nine times the risk of breast cancer than men.

“Another thing that reduces a woman’s risk of developing breast cancer is if she carries a pregnancy to term at a younger age. Some have said 20 years, and some have said 25 years. But whatever it is, a woman who carries pregnancy to term at a younger age has a reduced risk of developing breast cancer. Also, women who have multiple children have a reduced risk of developing breast cancer.

Also, breastfeeding has been known to protect a woman from breast cancer. So you must breastfeed and breastfeed for at least two years. So that has also been shown to be protective against breast cancer. We are not too sure about hormones. That’s the contraceptive pills. The jury is still out. They are still being studied.

“However, smoking has been associated with so many cancers that it has been said that smoking is a cancer-generating habit. So do not smoke. Smoking is found to be associated with a worse outcome in women who develop breast cancer.”

On alternative therapy, he warned against such treatments, that alternative therapy alone has never been shown to cure breast cancer. Speaking, the Chief Clinical Coordinator of NSIA/ LUTH Cancer Centre and Clinical and Radiation Oncologist, Dr HABEEB Mohammed who noted that cancer treatment and management was getting better at a slow rate listed social factors that influence the risk of cancer including excess alcohol intake, cigarette intake, sedentary lifestyle, previous exposure to ionizing radiation, myths about breast cancer, and hydrocarbon exposure.

He said screening is basically to improve outcomes and prognosis if the patient has it. Screening reduces the risk of mortality and fatality from breast cancer.

Rating that the government is trying to improve access to care for cancer care, he said the six geopolitical zones are going to be equipped with better equipment, with better funding and LUTH is one of the centres that will benefit from it. Very soon, we are going to have a PET scan.

That is, we are going to have a place where you can do a radiation scan, which is one of the highest scans you can do for monitoring cancer.”

He disclosed that the cancer Centre in the last five years has seen close to 11, 000 patients.

He disclosed that Breast cancer is the single most common cancer in Nigeria and the incidence of breast cancer in 2020 was over 2 million cases worldwide and over 5 million people are living with the disease.
Breast cancer mortality and fatality have reduced in the developed world by almost 60 percent and this is because they have introduced screening programs and an awareness programme