Lagos and cancer control

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Gradually, cancer, a non-communicable condition that can be terminal if not detected early is fast becoming a huge health challenge in Nigeria. There are over 200 different types of cancer that affect humans and it is among the three leading causes of adult deaths in developing countries. According to World Health Organization (WHO) and the International Union Against Cancer, by 2020, cancer could kill up to 10 million people annually with the number of new cases increasing to 15.7 million in 2020.

In Nigeria, according to a 2017 WHO statistics, over 100,000 Nigerians are diagnosed with cancer annually, and about 80,000 die from the disease, averaging  240 Nigerians every day or 10 Nigerians every hour, dying from cancer. The Nigerian cancer death ratio of 4 in 5 is one of the worst in the world with the common ones being breast, cervix, uterus, liver, prostrate, colorectal, non Hodgkin lymphoma and pancreatic.  Prostate cancer, the commonest malignancy in men has continued to rise, while breast cancer leads the female cancer incidence and deaths in Nigeria. Also, incidence of cervical cancer continues to increase in young female Nigerians.

It is in order to stem the tide of this deadly epidemic that the Lagos State government has put a number of interventions in place. At the forefront of these interventions is the State Governor, Mr Akinwunmi Ambode, who recently donated a digitally equipped mobile cancer clinic worth 365 million to support the advocacy, diagnosis and treatment of cancer in the State. Lagosians re enjoined to avail themselves with the services provided by this mobile cancer clinic. Schedules of outreaches can be obtained on pinkcruise.org. No doubt, the donation of the Mobile Cancer Centre was a direct and prompt response to the cancer menaces.

The goal of the effort of the State government is to create awareness about cancer among the populace, screen for and detect early cases; and ultimately reduce morbidity and mortality caused by the common cancers, notably breast, cervix and prostate cancers. The methodology is to promote screening of all the common cancers that is Breast cancer, cervical cancer and prostate cancer through Clinical breast examination, Visual Inspection with Acetic acid (VIA), and Prostate Specific Antigen (PSA) Assay and Digital Rectal Examination (DRE) for men. Intensive and sustained public enlightenment and awareness campaign is also ongoing with, free screening at the local government level. Free treatment of affected women captured during the outreach and Appropriate referrals is also in place.

It is good to note that there are designated government facilities for screening and treatment. For instance, seven General Hospitals located at Orile- Agege , Ikorodu,  Lagos,  Epe and Badagry  handle diagnosis while Lagos Island Maternity Hospital is essentially for cervical cancer management and chemotherapy is available at LASUTH with oncologists in attendance.

Since commencement of the State Wellness Week till date, 35,100 women have been screened for Cancer of the Breast, 23,810 women for Cancer of the Cervix and 5,934 men have been screened for Cancer of the Prostate. Collaboration and partnership with relevant agencies have also helped in achieving good outcomes. The Ministry of Women Affairs and Poverty Alleviation has in the past collaborated with the training of more than 80 family planning providers on the cervical cancer screening using visual inspection with Acetic Acid. The Ministry of Health had also provided information booklets on breast cancer to assist spread of information on the need for regular screening for men and women. Other partners that collaborated with the Ministry of Health include NGOs such as COPE, Bloom, Sebeccly, MWAN, BRECAN who provided counselors during the community awareness and screening programme. The message is that early detection can prevent morbidity and mortality.

Also, screenings for vaccination and treatment of Viral Hepatitis, and Wilms tumour in children have commenced while the State government is equally supporting organizations involved in awareness and screening. The long term plan is to have e-mobile centers across the State that would aid early detection, diagnosis and treatment of the disease.

Also, the enactment of a law seeking to establish the Lagos State Cancer Institute to provide for the promotion, aid and coordination of researches relating to cancer and cancer-related illnesses and for connected purposes is part of the measures being taken to institutionalize the campaign against cancer. The plan to establish the Institute is a testament to the determination of the State government to improve the health and welfare of the citizenry.

Essentially, cancers occur as a result of extreme exposure to toxin, pollutants and electro-magnetic light. Obesity, tobacco use, lack of physical activity, and high stress lifestyles that destroy the immune system, poor quality junk food that are full of pesticides, irradiated and genetically modified contents are also risk factors. Some simple lifestyle changes that can make a big difference in cancer prevention include eating healthy diet. A balanced diet is the cornerstone affecting the heart and vascular system. For a healthy diet, enrich your daily diet whit fruit, vegetables, grain products, lean meat and fish as well as limit the consumption of animal fat and processed meat. Also avoid tobacco use. Maintaining a healthy weight might lower the risk of various types of cancer, including cancer of the breast, prostate, lung, colon and kidney. Physical activity counts, too. In addition to helping you control your weight, physical activity on its own might lower the risk of breast cancer and colon cancer. Adults who participate in any amount of physical activity gain some health benefits. As a general goal, include at least 30 minutes of physical activity in your daily routine.

Cancer prevention also includes protection from certain viral infections. Talk to your doctor about immunization and vaccination against Hepatitis B which increases the risk of developing liver cancer, Human papilloma virus (HPV) that can lead to cervical and other genital cancers. Regular self-examinations and screenings for various types of cancers such as cancer of the cervix, prostate and breast can increase your chances of discovering cancer early, when treatment is most likely to be successful.

Some of these screenings are available at designated government facilities in Lagos State. With the upcoming mandatory Lagos State Health Scheme, another window of opportunity is being opened for regular screening of the common cancers for all who enroll under this scheme initiated by the present administration to improve access to qualitative health care. The minimum package of the LSHS costs N8500 annually for an individual and N40000 yearly for a family of 6. On a final note, bearing in mind that government alone cannot win the war against cancer, it is expected that the private sector supports government initiatives by organizing sustainable interventions both in diagnosis and management of the disease. Citizens should also join hands with the State government by adopting and imbibing healthy living habits and going for regular clinical examination for these NCDs.

Salako wrote from Public Affairs Unit, Lagos State Ministry of Health, Alausa, Ikeja, Lagos.