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Experts list ways to check cancer

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healthcare• Say more Nigerians die of disease, urge subsidised treatment

PERTURBED by the rising incidence of cancer in the country, health experts have suggested some measures to check the disease.

Medical practitioners under the aegis of the Nigeria Medical Association (NMA) and pharmacists under the umbrella of the Pharmaceutical Society of Nigeria (PSN) have listed lack of access to information about prevention, early detection, and treatment in developing countries, inadequate medical and public health infrastructure as some of the key reasons cancer is taking a much higher toll in Nigeria.

In separate statements to mark the World Cancer Day Monday, NMA and PSN said unless urgent action was taken to raise awareness about cancer and adopt cost-effective, proven strategies to reverse the tide of this disease, millions of Nigerians would continue to suffer needlessly and lose their lives.

President, NMA, Dr. Osahon Enabulele, said: “Cancer is a generic term for a large group of diseases that can affect any part of the body. Other terms used are malignant tumours and neoplasm. One defining feature of cancer is the rapid creation of abnormal cells that grow beyond their usual boundaries, and which can then invade adjoining parts of the body and spread to other organs. This process is referred to as metastasis. Metastases are the major cause of death from cancer.”

Enabulele continued: “Cancer arises from one single cell. The transformation from a normal cell into a tumour cell is a multistage process, typically a progression from a pre-cancerous lesion to malignant tumours. These changes are the results of the interaction between a person’s genetic factors and three categories of external agents, including: physical carcinogens, such as ultraviolet and ionizing radiation; chemical carcinogens, such as asbestos, components of tobacco smoke, aflatoxin (a food contaminant) and arsenic (a drinking water contaminant); and biological carcinogens, such as infections from certain viruses, bacteria or parasites.”

According to President, PSN, Mr. Olumide Akintayo, ageing is another fundamental factor for the development of cancer. “The incidence of cancer rises dramatically with age, most likely due to a build- up of risks for specific cancers that increase with age. The overall risk accumulation is combined with the tendency for cellular repair mechanisms to be less effective as a person grows older,” he said.

Akintayo identified tobacco use, alcohol use, unhealthy diet and physical inactivity as the main cancer risk factors worldwide. “Chronic infections from hepatitis B (HBV), hepatitis C virus (HCV) and some types of Human Papilloma Virus (HPV) are leading risk factors for cancer in low- and middle-income countries. Cervical cancer, which is caused by HPV, is a leading cause of cancer death among women in low-income countries,” the PSN President said.

How can the burden of cancer be reduced? Akintayo said: “Knowledge about the causes of cancer, and interventions to prevent and manage the disease is extensive. Cancer can be reduced and controlled by implementing evidence-based strategies for cancer prevention, early detection of cancer and management of patients with cancer. Many cancers have a high chance of cure if detected early and treated adequately.”

Meanwhile, stakeholders including cancer victims in Edo State have appealed to government at all levels to provide adequate funding for the health sector with particular emphasis on the need to subsidize cancer treatment.

At an event to mark the day in Benin City and the opening of the Benin City Cancer Centre (BCCC) organised by Senator Daisy Danjuma in collaboration with the National Cancers Prevention Programme (NCPP), they observed that the over 120 cancer screening centres in the country were built and being operated by non-governmental organisations and private individuals.

Danjuma, who was represented by Mrs. Mabel Oghosa-Obanor, said the failure of government to subsidise cancer treatment was responsible for the over 80 per cent of cancer deaths in the country.

She said cancer was the most expensive ailment to treat and urged both the federal and state governments to join other NGOs and well-meaning Nigerians to bring the fast-growing ailment among Nigerians to a halt.

She urged women to always go for check-up, adding that early detection and diagnosis as well as first class treatment were the best forms of protection and treatment for cancer.

A consultant and Lagos State Coordinator of NCPP, Dr. Abia Nzelu disclosed that cervical cancer kills one Nigerian woman every hour, adding that breast cancer kills 10,000 Nigerian women every year, while prostate cancer kills 14 Nigerian men every day. Free cancer screening was provided for women and others at the ceremony.

Chief Consultant Radiation Oncologist at the National Hospital, Abuja, Dr. Festus Igbinoba, said in an interview during activities to mark the World Cancer Day that people should be careful with grilled meat and animal fat as a way of preventing cancer.

Stressing that cancer is caused by agents called carcinogens present in the environment which when avoided, reduces cancer risks, he said that agents such as tobacco, grilled meat and animal fat among others predisposes one to various forms of cancer and as such should be avoided.

“When these carcinogens act on the human body, eventually they act on the cells, the process through which these agents cause cancer is regarded as carcinogenesis. These agents act on the DNA component of the cell and the cell begins to undergo mutation, when this mutation progresses, it eventually leads to cancer.

“Apart from carcinogens which are found in the environment, some of them may be in form of the chemicals we are exposed to, infections, food we eat, water we drink, the kind of environment we live in, the kind of work we do, the kind of homes we live in, the kind of air we breathe in and even the sun. These carcinogens have the ability to induce or to initiate cancer,” he said.

Igbinoba explained that beyond the carcinogens, other factors such as genetic disposition and the state of the protective genes determine if the cancer would eventually come into being.

According to him, there are many forms of cancers just as there are tissues in the body and to prevent cancers, one must avoid contact with the carcinogens that predispose one to them.

His words: “The carcinogens we have can start from the common one tobacco and it is the tar in the tobacco that makes people susceptible to lung cancer. To avoid lung cancer one of the best things you can do is to avoid smoking, not just avoid smoking, but stay away from smokers so that you don’t inhale cigarette smoke.

“Alcohol again predisposes to cancer of the mouth, the pharynges, and the esophagus: alcohol is also noted for causing liver cancer from cirrhotic liver, cancer would develop. If you can avoid alcohol and tobacco, you have helped yourself a lot in avoiding many of the cancers. Then there are dietary components that also cause cancer like dietary fat: when you eat animal fat anyhow and you accumulate fat, your risk of developing cancer rises.”

The Director of Hospital Services in the Federal Ministry of Health, Dr. Patience Osinubi, who spoke on some activities to mark the World Cancer Day in Abuja, stressed however, that if detected early cervical cancer could be treated.

She said: “Cervical cancer is the easiest to downstage among the cancers” because it can be detected early and treated. “In 10 years, we will not see cervical cancer in Nigeria.”

She also disclosed that mobile cancer treatment trucks would be sent by the ministry to hospitals nationwide.

Osinubi said there were 250,000 new cases of all cancers every year. The minister disclosed that the ministry had upgraded six federal tertiary hospitals as comprehensive centres with one for every geo-political zone. The centres are at University of Port Harcourt; Federal Medical Centre, Ebute-Metta, Lagos; National Obstetric Fistula Centre, Abakaliki; Abubakar Tafawa Balewa, Bauchi; Federal Medical Centre, Keffi; and Federal Medical Centre, Gusau.

On his part, Mr. Benjamin Ogbalor said that the NGO, Inspired 2 Live, was financing efforts around the world to get a cure for the dreaded disease.

The Chief Executive Officer of Inspired 2 Live, Erik Veenendaal, said that his group was working with the best institutions in Europe and America to bring to fruition their goal of finding a cure for cancer.

He explained that the organisation was spurred to move toward a cure for the disease because only eight per cent of patients had access to treatment, saying it was not fair.

Besides, the World Health Organisation (WHO) is set to pre-qualify five Nigerian pharmaceutical industries by June 2013 after a final facilities inspection in April.

With the backing of the National Agency for Food Drug Administration and Control (NAFDAC), the WHO had last year endorsed five Nigeria’s pharmaceutical firms for pre-qualification within two years.

The pharmaceutical firms- Evans Pharmaceuticals, SWIPHA, CHI Pharmaceuticals, May and Baker, and Fidson HealthCare had met most of WHO’s conditions for pre-qualification.

WHO pre-qualification is a prerequisite for any company that wants the WHO and other international agencies to buy their drugs through bulk purchase for distribution for health intervention programmes across the globe.

Director-General NAFDAC, Dr. Paul Orhii, told The Guardian yesterday: “We are on course in our efforts to get Nigerian companies pre-qualified by the WHO. Officials of the WHO have been visiting the companies to ensure they are complying with the directives towards prequalification. With the reports we are getting the companies are set and the WHO officials are happy with the level of compliance.

“The WHO inspection team is set to visit Nigeria between April 22 and 25, 2013 for probably the final inspection of the five pharmaceutical firms. We expect the WHO to make the final declaration on the prequalification status of the firms in June.”

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