Health

Cancer Diagnosis: Death sentence or new perspective to life?

Cancer Diagnosis: Death sentence or new perspective to life? Folashade AkpanBy Folashade Akpan

At 25 years and newly married, Mrs Elizabeth Awo-Ejeh was full of life and had her dreams of building a family while pursuing the career ahead of her.

However, in 2021, she discovered a lump in one of her breasts. To her, it was not anything to bother about since it did not hurt her, neither was there any discharge from it.

During a visit to the hospital, the doctor even reassured her that the lump was nothing to worry about.

“However, deep down, I felt something was not right. Thankfully, my husband encouraged me to seek a second opinion.

 

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“At the next hospital, the doctor recommended a breast ultrasound because I was only 24 years at the time. The results showed that the lump was a Fibro Adenoma, a non-cancerous tumour.

“The doctor advised me to either remove it or wait for six months to see if it would go away on its own. I chose to wait, but after six months I began to feel a sharp pain and noticed some discharge.

“I immediately knew that something was wrong and went back to the hospital for another ultrasound. This time, the results showed the lump could be cancer,’’ she said.

According to her, after a biopsy, she was diagnosed with invasive ductal carcinoma, Estrogen Receptors and Progesterone Receptors-positive.

“At just 25, newly married and with dreams of starting a family and building my career, I felt my world fall apart,” she narrated.

Like many, Awo-Ejeh believed cancer diagnosis to be a death sentence. But her perception has changed since medical experts convinced her that it can be treated.

According to her, she was referred to a hospital where she underwent eight sessions of chemotherapy and a mastectomy to remove the affected breast and 25 sessions of radiation.

“With God’s help, I am now in remission. Since the cancer is hormone receptor-positive, I have been on hormone therapy for five years, taking medication daily to prevent a recurrence.

“Cancer is highly treatable, especially when detected early, which is why I am sharing my story,” she said.

For Mrs Mariam Salami, before her diagnosis, she lived an unhealthy lifestyle, often prioritising convenience and comfort over well-being.

She said her diet was filled with processed foods, high in sugar and unhealthy fats, with minimal intake of healthy diet.

However, getting diagnosed with cancer was something she was completely unprepared for.

“The news hit me like a wave, leaving me feeling heartbroken, shocked and overwhelmed. I was consumed by sadness and a deep sense of fear.

“Questions flooded my mind as I tried to make sense of it all, wondering how this could have happened and what I could have done differently.

“It felt like my world had been turned upside down in an instant, and I was left grappling with uncertainty, struggling to find the strength to face what lay ahead,” she said.

Salami said that her experience during treatment was filled with immense pain and anguish, with every step testing her strength in ways she never imagined, leaving her physically and emotionally drained.

However, through it all, the support she received from her spouse, family, friends and colleagues strengthened her throughout.

The World Health Organisation (WHO) describes cancer as a large group of diseases that can start in almost any organ or tissue of the body.

It happens when abnormal cells grow uncontrollably beyond their usual boundaries to invade adjoining parts of the body and/or spread to other organs.

WHO also says cancer is the second leading cause of death globally, accounting for an estimated 9.6 million deaths, or one in six deaths, as of 2018.

According to data from the Global Cancer Observatory (GLOBOCAN), Nigeria recorded 127,763 new cancer cases in 2022.

The consequence is 79,542 deaths from breast cancer, prostate and cervix uterias the top cancer species in the country.

The Federal Ministry of Health and Social Welfare says there was no actual data on the number of cancer survivors in the country as the nation recently began to collect data on cancer survivors.

According to Dr Uchechukwu Nwokwu, the National Coordinator, National Cancer Control Programme, the ministry before now, only collected data on survivors from hospitals, adding that such data were not stored in Cancer Registry (CANREG) software.

He said what was available in the software were diagnosis, age and the type of cancer, adding that under the new strategic plan, survivorship now stands as an area of interest in the database.

However, based on the programmes implemented by the Federal Government through the ministry, such as the Cancer Access Partnership Programme (CAPP) and the Cancer Health Fund (CHF), data on those who have accessed the programme exists.

“Those we refer to as “survivors” in cancer management are those who have lived with the disease or have managed it and survived for five years. We consider them as having survived the disease.

“This is because most cancers are not curable. About 40 per cent are actually curable, but majority, about 46 per cent are not curable.”

According to Nwokwu, about 6,000 cancer patients have accessed CAPP.

“For those who have commenced therapy after diagnosis, we can confidently say based on our experience that 50 per cent of them survive the disease.”

He, however, said that the major challenge that has affected survivorship of the disease was late diagnosis and commencement of treatment.

Speaking on why the disease does not pose a death threat as it did before, Dr Hannatu Ayuba, said this was because there were now advancements in the management of cancer in all the different modalities of treatment.

Ayuba is a Radiation and Clinical Oncologist at the National Hospital, Abuja.

She cited early detection as one of the factors, adding that there were also improved screening methods and more sensitive biomarkers that make it easy to detect the disease before it manifests.

She also said there are more improved surgical techniques such as minimally invasive surgeries and robotic surgeries which are highly precise.

“There have also been advancements in radiation therapy by the use of highly targeted treatments, intensely modulated radiation treatment, stereotactic body radiation and stereotactic radio surgery.

“All these have benefits just like surgery when it’s done in very sensitive areas, protecting nearby critical structures.

“Also, there are more sensitive, more advanced therapies in radiation treatment like the proton therapy, and intensity modulated proton therapy and in the chemotherapy modality, there are more tailored regimens from clinical trials,” she said.

These, according to her, have brought out different and more effective patterns of targeted treatments that improve efficacy with reduced toxicity profiles.

Ayuba said in immunotherapy, there were special medications used to help improve the immune system to fight cancer cells.

She said in precision medicine, there was genetic profiling, molecular diagnostics, which guide and personalise treatment decisions for different diseases, giving some form of customised treatment for patients.

“There are more advanced, more effective medications for hormone therapy for certain tumors that are hormone sensitive like breast and prostate.

“We also have stem cell transplants. These are procedures that help to rebuild the immune system after high dose chemotherapy has been given for certain cancers that need such treatments” she said.

The oncologist said that all these have improved patient outcomes.

She said that presently, the practice in most of the nation’s tertiary hospitals where cancer is managed is the employment of more improved procedures in supportive care.

She said it also included the management of the side effects that patients go through, pain management and mental health in cancer survivors.

Prof. Muhammad Pate, Coordinating Minister of Health and Social Welfare, urged Nigerians to not be afraid about cancer as it was no longer an invitation to death.

This, he said, was because due to genomics, advances in the technology and precision medicine, there was the possibility that an increasing number of cancers will be curable.

He, however, said that it was not over yet, adding that even with technological advancements, cancer now stands as the fastest growing Non-Communicable Disease (NCD) in Nigeria.

Ms Gloria Orji-Nwajiogu, a two-time survivor of breast cancer and an advocate, cancer survivors need a lot of intervention to continue with their lives.

Orji-Nwajiogu, President of the Network of People Impacted by Cancer in Nigeria, said that the issue of stigma that accompanies the disease was worrisome.

“It’s not just about the treatment; we should think about the survivorship.

“Unfortunately, that is one area that we have been lacking in Nigeria and that is because even some of the doctors do not believe that there can be cancer survivors in Nigeria so why do you need to make plans for them.

“I would want legislation so that a cancer patient, even after diagnosis, will not be laid off work. Many private-sector employers sack them, though hose in government employment are not usually affected,” she said.

 

News Agency of Nigeria (NAN)

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