Towards making cancer care and management services more available and accessible in Nigeria, a medical expert, Prof Wasiu Adeyemo, has called for the training and engagement of more oncologists and other sub-specialties of cancer in the country.
Adeyemo, who is the Chairman Medical Advisory Council, CMAC, Lagos University Teaching Hospital, LUTH, decried the shortage of cancer specialists even as he tasked the State and Local Governments to augment the efforts of the Federal government in the area of cancer treatment and prevention by replicating the Nigeria Sovereign Investment Authority/ Lagos University Teaching Hospital (NSIA-LUTH) Cancer Centre, NLCC.
In a chat, he told Good Health Weekly that the NLCC, which is reputed to be the most comprehensive cancer centre in Nigeria with an unlimited pool of specialists in all fields, is a Public Private Partnership and brainchild of the Federal government with equipment, personnel, and experts across 15 sub-specialties .
“Even though the LUTH trains oncologists and other medical personnel, the shortage of healthcare personnel remains a perennial challenge.
“Five years ago when LUTH advertised for Residency training for doctors, about 1,560 doctors applied. Two years ago, 430 applied, and just two months ago, only 143 applied. The issue of shortage of personnel is a big one and needs to be addressed,” Adeyemo remarked.
Calling on all stakeholders in the health sector to be involved in easing the problem of personnel shortage, he said, “We centre too much on the Federal government, but if the state governments and the local governments do just 10 percent of what the Federal government does, we will be better off. Personnel shortage in cancer treatment and management is serious.
“Yes, we train these doctors, but when they graduate, where do they go? There are so many of them that do not want to go abroad but if there are no opportunities for them in LUTH, LASUTH, OAUTH, UNIPORT and others, then where do they go. How do we help the system?
“The states and LGAs really need to open up because they are closest to the people. They need to replicate what the Federal government is doing. Who says that two or three states in the South South, South West, South East and others cannot establish cancer centres?
“Let us even ask, for instance, how many radiotherapy machines do we have in Nigeria for a population of over 220 million? I think that we all need to get our heads together to ensure that we do the needful. We need to replicate this Centre.”
The Centre Director NSIA-LUTH Cancer Centre, NLCC, Dr Lilian Ekpo, explained that 40-50 percent of the patients seen at the Centre are breast cancer patients.
Lamenting that breast cancer is almost like an epidemic in Nigeria, she said there are 10-12 new cancer patients daily, with a total clinic attendance about 60-75 patients daily as first timers and follow up.
“The NLCC boasts some of the most advanced equipment used in providing advanced treatment of various types of cancer. It is the only centre in Nigeria and West Africa with a fully kitted Brachytherapy suite with a 3-Dimensional HDR Gamma med brachytherapy machine.
“There are two radiotherapy wings containing sophisticated equipment such as two Varian vital beam linear accelerators and one Varian Halcyon linear accelerator, two chemotherapy suites, a General Electric CT Simulator, one C-Arm Machine and ultrasound machines.”
Further, Ekpo stated: “We work extensively with our professional partners to deliver exceptional care to patients once they walk into our doors with the utmost care, as we understand the burden diagnosis of cancer has on the patient, their friends and family.
“To ensure we stay ahead of the knowledge curve in the cancer care space, we have developed meaningful partnerships with leading cancer research institutes that give us access to the latest advancements and training in cancer care.”
Ekpo who urged Nigerians to go for regular screening with a view to detecting early if it occurs and finally, getting treatment, lamented the inequity in cancer care, late presentation for treatment, discrimination based on ethnicity, gender, sexual orientation
The Head of Clinical and Radiation Oncology, NLCC, Dr. Muhammad Habeebu, explained that the outcome of cancer treatment depends on the state of presentation and also on the facilities and quality of manpower.
“For stage 1 disease, that is, cancer that is confined to the primary organ, the 5-year survival rate is over 95 percent. For stage 4, that is disease that has spread, the 5-year survival is less than 5 percent.
“However, in NLCC where we have the standard quality of care and the personnel, our outcome s almost as good as what is available in the best centres anywhere. So we are having our patients coming a little earlier than before.
“We have a number of stage 2 and stage 3 patients and they are doing quite well even though we have only been functional for about three years. There are a good number of patients in these three years that are doing well with good follow up and this is an improvement on what used to be.”
According to Habeebu, cancer tumours can be classified into three groups – benign tumours, malignant tumours, and pre-cancerous (or premalignant) tumours.
He said that cancer can also be classified according to the types of cells they start from, explaining that there are five main types – carcinoma, sarcoma, lymphoma and myeloma Leukemia, brain and spinal cord cancer.
“Some of the modifiable risk factors include – alcohol consumption , overweight or obesity, diet and nutrition , physical inactivity, tobacco smoking, ionising radiation, workplace hazards , and infection/ infectious agents.
“The non-modifiable risk factors include – age, cancer causing substances (carcinogens), genetics and the immune system.”
In the view of the Head of Department of Medical Radiation Physics, NLCC, Dr Samuel Adeneye, the centre has medical physicists that employ the knowledge of physics to treat different cancers,
He said some of the latest cancer therapy technologies such as Radiation Therapy and IMRT, are utilised.
“These technologies are used to protect the patient. What we do is to use the technologies to spare the organs at risk. Cancers are in different areas of the body, and the job of the medical physicist is to protect the organs that surround the area of the cancer. “We do the quality assurance.
There are big machines in the NLCC, and we ensure ensure they work optimally. with machines, involved in training, training resident doctors, interns, and others.”
Credit: Sola Ogundipe (Vanguardngr.com)