Since the progression of COVID-19 to a pandemic, the Nigerian healthcare systems have experienced severe difficulties coping with patient care for both COVID-19 and other diseases especially non communicable diseases like cancer, LEADERSHIP learnt.
Already, the country’s health sector is bedevilled by weak health systems, ill equipped cancer treatment centres, with obsolete machines and grossly inadequate oncologists required to treat patients with cancer.
It was learnt that there are only eight cancer centres with functional machines, both public and private, in the country as against a minimum of 200 cancer centres or 600 units of radiotherapy machines that Nigeria is expected to have to meet the World Health Organisation (WHO) standard.
WHO said that cancer is one of the leading causes of death globally and accounted for 8.8 million deaths in 2015.
An estimated 116,000 new cases of cancer and 41,000 cancer-related deaths, the world health body said were recorded in Nigeria in 2018 alone.
World Cancer Day is an international event observed every February 4 to raise awareness on the disease and to encourage its prevention, detection and treatment.
Stakeholders insisted that inadequate experts, radiotherapy machines and high cost of treatment have remained a burden to health workers, cancer patients and their families. They attributed the high mortality rate from cancer in Nigeria to the above listed factors, stressing that the situation was compounded by the fact that less than 100 oncologists operate in all the centres in the country.
Mrs Chioma Nnabuchi, a 45 year old lady, diagnosed with stage 1 cancer, couldn’t stop crying while narrating the challenges of getting an oncologist for her treatment.
According to her, she would have done the surgery since last year, but there was never an oncologists at the Lagos State University Teaching Hospital (LASUTH), to attend to her.
Nnabuchi said, “I was diagnosed of stage 1 breast cancer, May, 2020. At that initial stage, I was told, the hospital was not taking new patients, due to the pandemic and that, the old cancer patients were being treated with the help of drugs. A nurse told me that since COVID-19, no surgeries have been done so far. They only administer drugs to the patients. She also told me to go home, as no oncologist would want to attend to me.
“But I kept trying. Anytime I get to the hospital, I was told no oncologist were available to attend to me. So I started traditional treatment, but to no avail, as I still feel serious pain. After the lockdown was lifted, I decided to visit LASUTH and I was told to do
some test and scan. The result shows that, the breast cancer has gone to stage 2. While there is hope and the doctors are available to attend to me, I do not have the financial muscle to finance the process. I however appeal to government and well-meaning Nigerians to come to my aid.”
As for Mr James Okorie, a 66-year-old man with prostate cancer, COVID-19 worsened his situation due to the lockdown last year. He said he lives in Ondo State, while accessing treatment at the Lagos University Teaching Hospital (LUTH).
“I had done two cycles of chemotherapy and my next cycle, was in April, 2020, before the lockdown. When I called my oncologist a week prior to my due date for my third cycle of the treatment, asking if I can travel over to receive the third cycle, he told me there will be
no chemotherapy administration because of the COVID-19 pandemic and I should call him after the outbreak is controlled.
My case has deteriorated before the lockdown was lifted. I thank God that I have started treatment now and there is no much improvement,” he said.
According to a study titled: “Oncology practice in the COVID-19 pandemic: a report of a Nigerian expert panel discussion (oncology care in Nigeria during the COVID-19 pandemic),” the outbreak of the pandemic made patients with cancer not to be able to receive care from
their care givers because such facilities were filled to capacity with COVID-19 patients.
In the unfortunate event that a COVID-19 patient with cancer requires ventilator support from severe respiratory distress, the anecdotal evidence has shown that they were less favoured to receive such essential care due to the cancer co-morbidity, says the study, adding
that, other challenges besides those above include: Which patient should be prioritised or deprioritised for treatment? Which procedure (surgery, radiotherapy and chemotherapy) should continue or be deferred? And what precautionary steps should be taken to protect the
health worker and patient during treatment?
LEADERSHIP checks revealed that barriers to cancer care in the country due to the pandemic, include lockdown/curfew, fear of contracting the virus due to lack of enough personal protective equipment to work with and shutting down of some centres in the hospital due to the pandemic.
An oncologist from Radiation Oncology Department, University College Hospital, Ibadan, Adeniyi Adedayo, said at the early stage of the outbreak of the virus in Nigeria, the possibility that there was delay in treatment of cancer patients is high, due to the fact that all the
out-patient departments, elective surgery, chemotherapy and radiotherapy were shut down.
The President, Commonwealth Medical Association and former President, Nigeria Medical Association (NMA), Dr. Osahon Enabulele, said the number of oncologists are evidently few and far in between, saying that Nigeria currently has about 80 oncologists serving a population of over 200million. Similarly there is a serious dearth of trained oncology nurses and radiotherapy radiographers.
According to him, there was need for government at all levels to address the huge deficit in the number of functional cancer treatment centres and the number of oncologists in the country.
“Indeed, I call for the full integration of all aspects of cancer management into the National Health Insurance Scheme,” he said.
WHO regional director for Africa, Dr. Matshidiso Moeti, noted that cancer cases have more than doubled in the African Region, from 338,000 cases reported in 2002 to almost 846,000 cases in 2020.
She identified the most common forms of cancers as cancers of the breast, cervix, prostate, bowel, colon, rectum and liver. The risk factors, she said include older age and family history, use of tobacco and alcohol, a diet high in sugar, salt and fat, physical inactivity, being overweight, and exposure to specific chemicals, among others.
According to Moeti, “In many communities in African countries, people have limited access to cancer screening and early detection, diagnosis and treatment. For example, only about 30 per cent of African children diagnosed with cancer survive, compared to 80 per cent of children in high-income economies. Challenges in access to cancer care are further compounded in times of crisis, like the current COVID-19 pandemic.