World Cancer Day: Only 8 teaching hospitals have radiotherapy machines

• Disease kills 280,000 Nigerians in 4 years

There are only eight teaching hospitals in Nigeria that have radiotherapy machines for tackling cancer which has become a menace across the 36 states of the federation, Daily Trust reports.

The hospitals are: Lagos University Teaching Hospital, Idi-Araba; University of Benin Teaching Hospital, Benin; Usmanu Danfodiyo Teaching Hospital, Sokoto; and the Federal Teaching Hospital, Gombe; University College Hospital, Ibadan; National Hospital Abuja, Ahmadu Bello University Teaching Hospital, Zaria; and University of Nigeria Teaching Hospital, Enugu.

Even then, the machines in some of the hospitals are not functioning, thereby further slimming the chances of survival of patients across the country.

As Nigerians mark the 2020 World Cancer Day, available figures show that no fewer than 281,308 citizens have lost their lives to the disease in the last four years.

The figure did not include thousands of unreported cases as a result of cultural and other factors. Many people died of the disease because they could not afford treatment.

So far, findings show that 464,000 cases have also been recorded from 2016 to date. Hundreds of thousands of people in the 774 local government areas of the country suffer the pains in silence as only a few have access to the treatment facilities because of distance and their poor financial standing.

Data obtained from the International Agency for Research on Cancer (IARC) in its 2019 report said in 2018 alone, 70,327 deaths were recorded from cancer in the country. The total number of new cases for both males and females recorded was 115, 950 cases, it said.

According to the Nigerian Cancer Society, more than 80,000 deaths from cancer are recorded annually in Nigeria. President of the society Prof Sani Abubakar Malami said 250,000 new cancer cases are recorded in the country each year.

The cancer disease

Cancer is a disease in which abnormal cells grow and reproduce uncontrollably and invade nearby tissues by spreading to other parts of the body, the society said.

The three most common cancers in Nigeria are breast cancer, cervical cancer and prostate cancer. Prostate cancer is the leading cause of deaths from the disease in Nigerian men.

Other common cancers in the country are liver and colorectal cancer; while common cancers in children in are retinoblastoma and leukaemia.

Daily Trust investigations revealed that late presentation for medical care by cancer patients was affecting their survival and hampering efforts towards controlling the disease in the country.

A large number of Nigerian men who were diagnosed with prostate cancer, presented late at stages III or IV, when the prostate cancer had spread to other vital organs of the body. Medical experts observe that though cancer is treatable at the early stages, many seek medical attention very late.

Cancer treatment facilities/framework weak

Checks by out correspondents revealed that out of the eight teaching hospitals that have facilities, only two are working well as others have been breaking down from time to time or have packed up completely.

In the last one year, it was gathered that only the National Hospital Abuja and the Lagos University Teaching Hospital (LUTH) have acquired more radiotherapy machines and improved services.

The radiotherapy machines at the University of Benin Teaching Hospital (UBTH) are obsolete and not working, Daily Trust learnt, with sources saying the cancer treatment machines at the hospital have broken down.

A medic who craved anonymity said the federal government was working towards establishing a brachytherapy centre for cancer treatment at the hospital.

The radiotherapy machine at Usmanu Danfodio University Teaching Hospital (UDUTH) is also not working at present, it was learnt.

Last year, the National Hospital in Abuja installed a linear accelerator machine donated to it by the federal government a year earlier, and another one donated to it SNEPCO Nigeria Limited, a subsidiary of the Nigerian National Petroleum Corporation (NNPC), as part of their social responsibility to Nigerians.

The Nigeria Sovereign Investment Authority (NSIA) built a $10m facility under the Build, Operate and Transfer (BOT) agreement for a modern Radiotherapy Centre (Oncology) at the Lagos University Teaching Hospital (LUTH), last year.

While services have improved there, patients complained that the services are now more expensive.

Before the facility was commissioned, N1,050 was paid asfor consultation fee and N200,000 for radiotherapy. However, with the new cancer centre, the price has skyrocketed to N800,000 for radiotherapy.

While some of the teaching hospitals offer surgery and chemotherapy cancer services, patients in such states have to be referred or travel to any of the eight centres that have the machines for radiation treatment.  Sometimes all but three machines work at a time, making patients travel to far places and suffer hardships to access care.

For instance, the Jos University Teaching Hospital (JUTH) is offering chemotherapy and other cancer treatment services but has no radiotherapy machine.  Patients said their access to treatment will be better if there is a radiotherapy machine at the hospital.  The patients have to travel to Abuja to access radio therapy treatment.

“We have sold everything we have but the trouble is still with us,” said Aliyu Musa whose wife was diagnosed of cancer two years ago.

“Honestly I have given up, I know I am going to die but my husband insists we must continue going to hospital,” Musa’s wife, Kaltime, said.

The radiotherapy machine at the Federal Teaching Hospital, Gombe, is working, but sometimes it has issues with the radioactive source, which they procure periodically and experience delay while acquiring it, sources at the hospital, said.

Finding also revealed that only two of the cancer centres carry out bone scans in Nigeria, one in University College Hospital, Ibadan, and at the National Hospital, Abuja.

Experts speak on troubles associated with cancer treatment

Dr Bello Abubakar Mohammed, a Clinical and Radiation Oncologist at the National Hospital, in an interview with Daily Trust, said with four radiation machines for the treatment of cancer, Nigeria is still short of the 180 machines recommended by the World Health Organisation (WHO).

Dr Mohammed, who is the president of the African Organisation for Reachout and Treatment of Cancer, said out of 3,000 radiation oncologists needed in Nigeria, only 70 are available; and only 20 work in centres that have facilities.

He, however, expressed optimism on efforts to increase the number of machines to 20 in the next few years.

Prof.  Malami of the Nigerian Cancer Society said while there was increasing awareness about cancer amongst Nigerians, the country still lacks a framework for and a supportive environment for optimal cancer care.

He lamented that Nigeria has continued to record more deaths and new cases because there was no national cancer agency and inadequate cancer dedicated centres and registries.

While saying treatment for the disease is underfunded in Nigeria, he said there is no specific budget line for cancer like that for HIV and some other diseases.

He said the treatment of cancer is also not covered by the National Health Insurance Scheme (NHIS) and as such, patients have to pay out-of-pocket, making them suffer untold hardships.

The expert said the prevention of the disease is not given priority and institutionalised as done in other countries, adding that there is need to address the root problem in order to tackle the disease.

“Government needs to do more in the area of screening and prevention. We should also have a curriculum for teaching and continuous medical education on cancer,” he said.

Prof Malami said the society is proposing a cancer legislation which would be a comprehensive law addressing all areas, from prevention to screening, treatment and palliative care. He said the society is already reaching out to the National Assembly on the matter.

Scary statistics about cancer in Nigeria

The Executive Director, Project Pink Blue, Runcie C.W. Chidebe and a popular advocate of cancer care, said: “Breast cancer kills over 31 Nigerian women every day, cervical cancer is 99% preventable but over 29 women die of cervical cancer every day, and prostate cancer kills about 15 Nigerian men every day. This is alarming!”

He said the country is losing human resources, lamenting that cancer control is managed by a desk at the Federal Ministry of Health. “It is not sustainable and measurable,” he said.

He, however, thanked President Muhammadu Buhari for signing into law, the bill to establish the National Institute on Cancer Research and Treatment on December 29, 2017. “However, painfully, three years now, this bill has not been gazetted nor budgeted for. It is pathetic.”

He called on the federal government to match words with action and save Nigerians from cancer.

Contributions by Ojoma Akor & Olayemi John-Mensah (Abuja), Risikat Ramoni  (Lagos), Isa Sa’idu (Zaria), Rakiya A. Muhammad (Sokoto),  Hameed Oyegbade (Osogbo), Lami Sadiq (Jos),  Tony Adibe (Enugu), Victor Edozie (Port Harcourt), Jude Aguguo Owuamanam (Owerri), Jeremiah Oke (Ibadan), Omirin Olatunji (Maiduguri),  Usman Bello (Benin), Eyo Charles (Calabar) & Haruna Gimba (Gombe)