Cancer is no respecter of persons. It attacks the priviledged and the less priviledged. On saturday, former Information and Communications Minister Dr Dora Akunyili succumbed to cancer after a two-year battle. She became the latest among people of status to fall victim of the ailment. How can this disease be tackled? OYEYEMI GBENGA-MUSTAPHA reports that its prevention, early detection and treatment are important to check the disease.
Prof. (Mrs.) Dora Nkem Akunyili, a former Director General of the National Agency for Food and Drug Administration and Control (NAFDAC) and former Minister of Information, has joined the list of Nigerians who died of cancer. She was aged 59. She died in a Specialist Cancer Hospital in Indian on Saturday, June 7, at 10 am, Nigerian time, after a two-year battle with cancer.
Her death last Saturday underscored one fact:, the disease knows nobody or class. It can kill the high, the mighty, the rich and the poor. The type of cancer she died of is yet to be disclosed.
The list of prominent Nigerians whose lives have been cut short by this dreaded disease is increasing by the day. Wife of former military Head of State, Gen. Ibrahim Babangida (retd), Maryam Babangida, died of ovarian cancer at the age of 61 In Los Angeles. The late Funmilayo Olayinka, former Deputy Governor of Ekiti State, also died of breast cancer just as the late Cassandra Gabriel, popularly known as Sisi Caro in the rested Nigerian Television Authoritry (NTA) soap, the Village Headmaster, died of breast cancer.
Likewise, the 48-year-old wife of the eldest son of former governor of Edo State; Dr. Samuel Ogbemudia, Roseline , died of cancer. The same fate befell the philantropist and sister of former Ekiti State governor Ayodele Fayose, Evangelist Bimpe Oluwayose-Sorinolu.
The duo of Roseline and Bimpe just like Akunyili, battled breast cancer till death. While the former died in a hospital in India, the latter, who had been treating the ailment since 2011, died in a London hospital.
Another victim, the late Mrs Elizabeth Kafaru, a frontliner herbal medicine practitioner died of cancer just as Clara, wife of Edo State governor, Adams Oshiomhole died of cancer on December 8, 2010, eleven days to her daughter’s wedding.
Second Republic Senate Leader, the late Dr. Olusola Saraki, battled the ailment for five years. Also, the late 51-year-old fashion designer, Remi Osholake, a popularly known as Remi Lagos, and the late Sam Ojebode, ex-Green Eagles football star, died after futile battle with cancer.
A Nollywood personality, Taiwo Bello, also succumbed to cancer last year. She was a movie producer and director. She co-wrote the movie, Jenifa, with Funke Akindele, produced and directed the 2010 movie, Omije Mi.
In December, 2010, Yusuf Jibo, former Zonal Director of the NTA, died of colon cancer. So also were the ace journalist, Sele Eradiri and the civil rights activists, Dr Beko Ransome-Kuti.
On September 5, 2009, Human Rights lawyer and activist, Chief Gani Fawehinmi, lost the battle to cancer. Remi Abiola, actress and wife of the late business mogul and politician, Chief M.K.O. Abiola, as well as Alaere Alaibe, wife of the former helsman of the Niger Delta Development Commission (NDDC), Timi Alaibe, died of cancer.
NTA ace broadcaster, Yinka Craig, 60, died on September 23, 2008 as a result of cancer of the blood (leukemia), so was the Information Specialist, World Health Organisation, Oghide Austin, while musician-turned evangelist, Sonny Okosun, lost the battle to cancer of the colon on May 24, 2008 at the age of 61.
The list is inexhaustible. Mrs Comfort Ponnle, of MicCom Cables and Alexander Ibru, Chairman and Publisher of The Guardian Newspaper, died of cancer. Chief Sub-Editor, Vanguard Newspaper, Dayo Aminu, died of cancer as well.
The former Chairman of the Advertising Practitioners of Nigeria (APCON), Dr May Nzeribe, died of Prostate Cancer.
Former President of Performing Musician Association of Nigeria (PMAN), Mustapha Amego, fondly called Musky, died of colon cancer; Mrs Kofoworola Orija of the Bloom Cancer Foundation also died of breast cancer.
In Nigeria, cancer incidences are common. No week passes without a Nigerian dying of the dreaded disease. Hundreds of thousands are dying silently. There are a few survivors though. This shows that it can be treated. Head of Department, College of Medicine, University of Lagos (CMUL), Idi Araba, Prof Olukemi Odukoya, is a survivor.
It is a class of disease characterised by out-of-control cell growth. There are over 100 different types, and each can be classified by the type of cell it initially affected.
Cancer ultimately, is the result of cells that uncontrollably grow and do not die. Normal cells in the body follow an orderly path of growth, division, and death. Programmed cell death is called apoptosis, and when this process breaks down, cancer begins to form. Unlike regular cells, cancer cells do not experience programmatic death, instead they continue to grow and divide. This leads to a mass of abnormal cells that grow out of control.
If the balance of cell division and death is disturbed, a tumor may form.
How cancer spreads
Scientists reported in a publication, Nature Communications (October 2012 issue), that they have discovered an important clue why cancer cells spread. According to them, it has something to do with their adhesion (stickiness) properties. Certain molecular interactions between cells and the scaffolding that holds them in place (extracellular matrix) cause them to become unstuck at the original tumor site; they become dislodged, move on and then re-attach themselves at a new site.
The researchers said this discovery is important because cancer mortality is mainly due to metastatic tumors; those that grow from cells that have traveled from their original site to another part of the body. Only 10 per cent of cancer deaths are caused by the primary tumors.
Signs or symptoms of cancer
Signs and symptoms are both signals of injury, illness, disease, or that something is not right in the body. A sign is a signal that can be seen by someone else-maybe a loved one, or a doctor, nurse, or other health care professional. For example, fever, fast breathing, and abnormal lung sounds heard through a stethoscope may be signs of pneumonia. A symptom is a signal that is felt or noticed by the person who has it, but may not be easily seen by anyone else. For example, weakness, aching, and feeling short of breath may be symptoms of pneumonia.
Symptoms depend on the type and location of the tumor. For example, lung tumors may cause coughing, shortness of breath, or chest pain. Tumors of the colon can cause weight loss, diarrhea, constipation, iron deficiency anemia, and blood in the stool.
Some tumors may not have any symptoms. In certain tumors, such as pancreatic cancer, symptoms often do not start until the disease has reached an advanced stage.
A few patients show no signs or symptoms until the cancer has far advanced. However, there are some signs and symptoms, although not specific, which usually occur in most cancer patients that are fairly easy for the person to detect.
There are over 200 types of cancer. Anything that may cause a normal body cell to develop abnormally potentially can cause cancer.
Why Nigerians are dying of cancer?
According to a professor of Radiation, Prof Moses Aweda, radiations have been proven to impair human cells thereby causing cancer.
“I have proven with mice that when the human system is exposed to a certain degree of radiation, cancers can occour. Food cooked with Microwave should not be eaten at all, because it has been denatured and same can lead to cancer as well,” he said.
According to a Public Health Physician, Community Health Department, Lagos University Teaching Hospital (LUTH), Idi Araba, Dr. Nasir Ariyibi , another cause of cancer is late presentation to the hospital, “a lot of people go late to the hospital despite improvement in diagnosis.
“Cancer is an abnormal increase in the number of cells in the body. It could affect a particular organ of the body, where the organ begins to increase in size, due to unregulated cell division. Normally, every cell undergoes growth. For example the skin sheds off old cells as news ones grows. This mechanism is being regulated. But when it becomes uncontrollable, that means the regulatory mechanism is off,” Dr. Ariyibi said.
Causes
He continued: “There are two types of abnormal growth, benign and malignant. Either can exert pressure on immediate or extended organs. But the most dangerous is malignant growth. That is cancer. It disrupts the organs around that area and grows uninhibited. It can leave where it started off, attack other organs of the body and causes further damages. It is the organ it affects that it is named after. The commonest among women in Nigeria are breast and cervical cancer; leukemia in children while prostate is common among men.”
Dr Ariyibi said experts are of the view that cancer is on the increase in Nigeria because, “there is improvement in diagnosis. “The statistics we are working with now, from the World Health Organisation (WHO) said 250, 000 new cases are seen annually, with 10, 000 deaths per year. Unlike other non communicable diseases (NCDs) that you can say these are the causes, you cannot say that about cancer. We only have predisposing factors,” he said.
Ariyibi continued: “In some types of cancer, way of life is a predisposing factor. For instancer, cancer of the lung resulting from smoking unlike breast cancer that you cannot put your hands on, except perhaps the genes resulting from hereditary; or women who have not sucked in their life or women do not suck adequately.
“When you look at some of these factors, we say they are non modifiable. Non modifiable are factors that cannot be influenced, such as breast cancer in women and prostate cancer in men. Not that some men don’t have breast cancer, but the female genders due to presence of hormones such as Estrogens are at higher risk. Age is also a non modifiable factor. Genetics/hereditary, i.e. a person’s make up; race like being a Caucasian for instance are non modifiable factors.
“The modifiable risk factors are the ones we can change or influence or play a role in. Lifestyle is a major risk factor. Smoking, drinking alcohols or abusing drugs; do you eat junk, i.e. empty calorie food; do you over eat or eat less. Are you predisposed to germs, for instance Hepatitis B that can be contracted from sexual partners, and which manipulate lung cancer growth? Exposed to multiple sexual partners or engaging in early sexual activities that can aid contracting papilloma virus which causes cervical cancer. Every two minutes, a woman develops cervical cancer.
“Diet is a huge predisposing factor. How healthy are we eating today? Noodles and pasta, fizzy drinks Do we take fruits that contain anti oxidants that mop up free radicals? Free radicals, also known simply as radicals, are organic molecules responsible for aging, tissue damage, and possibly some diseases. These molecules are very unstable, therefore, they look to bond with other molecules, destroying their health and further continuing the damaging process. Antioxidants present in many foods, are molecules that prevent free radicals from harming healthy tissue. Exercise is also good for the body. But how many do that these days.
Prevention
According to Ariyibi, prevention through the modifiable factors is important in preventing cancer. “As physicians, we do now create awareness on best way out. We now educate on lifestyle changes. Making the right life choices in diet, living, and existence. In short, healthy lifestyle. “We want to get to the level where people will be empowered with the right information. And also be involved in their health management. Avoiding injurious substances like Energy drinks. The basic ingredients are sugar and caffeine. Sugar can trigger diabetes while caffeine triggers the body to work excessively,” he said.
He added: “It is good and in order to ensure that good policies are put in place by the government. Nothing stops the government from having a policy on all local government areas to have cervical cancer screening and treatment centres.
“You see, most non communicable diseases do not give signs. They are just there developing. Because they are asymptomatic, screening and testing for them are the best way to pick them up easily.
“For instance, breast cancer can be detected through mammogram, cervical cancer through pap smear. For changes would have been taken place at a cellular level. And if detected at that level, it can be treated. At least, one can do Self Breast Examination (SBE) in picking up breast cancer. Any lump that is detected can be further examined.
He said people should educated on the advantages of going to the hospital early when they feel any illness or abnormality in their body. “They should not be going to spiritual homes or traditional healers. First come to the hospital, get the condition diagnosed and treated. People need to know that it is not arrow from the enemy,” he said.
He added: “We have the facility and expertise to detect, treat, manage and rehabilitate cancer cases in Nigeria. There is no need to travel overseas to treat cancer. We have measures like mammogram for breast cancer; papsmear at our Community Out clinic at LUTH.”
“Assuming cervical cancer is detected, we have Obys and Gyn department. Radiotherapy at its advanced stage is available in the hospital. Do not put a cost to your health. Just have an aim- to get well. People may want to stay away because they consider some of these treatments expensive, but no money can replace a lost live. With a N3, 500, papsmear can be done,” he said.
He, however, noted that people spend more on Aso Ebi and drinks at Beer parlous and other frivolities. “Mammography is below N50, 000. People should know that the treatments are available and are so cheap. They should not wait till things get worse. Because even at the best of centres, advanced cancer is not treatable.
“Screening is essential. People who are passive smokers should avoid cigarette smoke. Both active and passive smokers are liable to developing cancer; even passive smokers are at greater risk. Government policy of not smoking in public places is commendable, but implementation is important. People should adhere to the law,” Ariyibi said.
