Lack of adequate medical professionals, insufficient treatment centers, and missing crucial diagnostic tools to properly identify lung cancer in its initial phases is contributing significantly to the mortality rate among those afflicted with the illness, according to an investigation by Daily Trust.
According to Daily Trust, numerous Nigerians are being quietly devastated by this illness as it frequently goes unrecognized or is identified too late. Often, those affected do not learn about their condition until they seek medical help overseas following an extended period of unsuccessful attempts to diagnose and treat them within Nigeria.
The World Health Organization (WHO) states that lung cancer begins with the development of irregular cells growing uncontrollably within the lungs. This condition poses significant risks and has potential fatal consequences.
Lung cancer can manifest with persistent coughing, discomfort in the chest area, and difficulty breathing.
Prof. Kelechi Okonta, a consultant cardiothoracic surgeon at the University of Port Harcourt Teaching Hospital, and lecturer at the University of Port Harcourt, said lung cancer is one of the five top cancers killing people in the country; and also among the top ten most common cancers in Nigeria.
He also mentioned that gathering and maintaining records for lung cancer remains a challenge in Nigeria.
Professor Okonta and fellow researchers in their publication in the Journal of the Pan African Thoracic Society noted that although there is undeniable proof linking smoking with lung cancer, newer findings indicate an increase in lung cancer rates among those who have never smoked, particularly within African-descended communities. Local statistics from Nigeria also support this changing trend.
They mentioned that clinical diagnosis plays a crucial part in the trio since lung cancer often exhibits similarities with numerous common acute and chronic pulmonary infections in Nigeria. Thus, precise recognition heavily relies on the experience, diagnostic skills, and proficiency of the initial treating doctor.
In the study called "Management of Lung Cancer in Africa: Underdiagnosis and Poor Access to Treatment — A Close Look at Nigeria," the investigators noted that for numerous individuals, the initial step is often their nearby healthcare center, where the capability to facilitate early detection and deliver suitable care typically does not exist.
According to experts, although there are fully certified thoracic surgeons and pulmonologists trained both domestically and internationally practicing at various centers throughout the nation, specialists such as super-specialized pathologists, molecular scientists, radiologists, medical oncologists, and radiotherapists—who concentrate mainly on lung cancer—are scarce.
Experiences of some Nigerians
Ms. Onama Ladi, aged 51, who was battling lung cancer, succumbed to the illness.
After undergoing numerous tests and scans for more than a year at both private and public medical facilities across the nation, she was finally diagnosed with tuberculosis.
According to her relatives, Onama had never smoked throughout her entire life; however, she was diagnosed with lung cancer just mere weeks before her passing.
She was severely ill and extremely frail back then. The physician informed us that the illness had reached an advanced stage. This came as a shock since she takes her health seriously; she consistently visits the hospital and diligently follows her medication regimen. However, neither the medical professionals nor the healthcare facilities detected her condition until she was near death, rendering further treatment ineffective," shared a close friend who wished to remain anonymous.
Al-Hassan Yakubu attended routine medical examinations at the clinic but received diagnoses only for his persistent cough, recurring bouts of malaria, and chest discomfort. Despite these intermittent health issues, he continued to experience recurrent illnesses. Eventually, he chose to go on vacation to the United Kingdom.
His daughter recounted that he became sick once more and was found to have lung cancer. He passed away less than two months later.
Describing his journey with lung cancer, Julius Akinyemi, aged 59, mentioned that it took half a year of numerous tests and switching hospitals before he was finally diagnosed with lung cancer.
He mentioned that he had spent more than 5 million naira solely on tests and scans, and even though his present physicians indicated a certain timeline for recovery, he felt extremely fortunate to have received an early diagnosis, which significantly improved the prospects of successful treatment.
Akinyemi mentioned that initially, he was incorrectly diagnosed with chronic obstructive pulmonary disease (COPD) at a major hospital in Abuja, where he underwent treatment but saw no improvement.
Previously, he received treatment at a private facility where he was merely diagnosed with a cough.
He stated, "Everything began with a persistent cough and extreme tiredness. Previously, I would walk to the gym for workouts, but then I found myself unable to even make it to the gym. Additionally, every time I attempted to go jogging or reached the gym, I experienced severe shortness of breath. Climbing the stairs in my two-story home became increasingly challenging."
He said he visited a private hospital and was prescribed tests and scan but the diagnosis and treatment were mainly for the cough.
Following numerous tests and examinations without improvement, the hospital referred him to the National Hospital in Abuja, where he received a diagnosis of CPD.
He stated, "After being diagnosed with chronic obstructive pulmonary disease, I embraced the reality because smoking has been a significant part of my life. I stick to cigarette smoking and nothing else."
I was informed that it cannot be cured; you can only control it. However, despite investing in medications, tests, and everything else, I did not improve.
He went on to say that despite seeing multiple doctors, he did not improve until he encountered a cardiothoracic surgeon in Abuja. This surgeon opted to conduct more thorough examinations, such as a biopsy, at an additional cost exceeding a million naira. The results of these tests ultimately revealed his diagnosis of lung cancer.
Being diagnosed with lung cancer led him to be unable to receive treatments through the National Health Insurance Scheme (NHIS), forcing him to begin covering costs personally.
Akinyemi mentioned that the public institution at the tertiary level was also unable to handle his condition, which left him with the choice of seeking medical care overseas. Fortunately, he managed to find an oncologist who is currently overseeing his treatment.
He mentioned that his determination for prompt diagnosis and treatment was beneficial since he has completed three out of the seven scheduled chemotherapy sessions so far.
He mentioned that he has been diagnosed with stage one lung cancer and has experienced no negative side effects from the treatment.
"I feel fortunate that my condition was detected at an early stage. Although I've experienced some typical symptoms like hair loss from the treatments, overall I’ve been managing well. Everyone responds differently to these circumstances. The medical expenses are quite high, but the support from my mother and wife has made a significant difference. My physician mentions that I’m a wonder, considering how quickly I'm recovering," he shared.
Causes of elevated death rates, incorrect diagnoses
Professor Okonta, renowned for his comprehensive studies on lung cancer and thoracic injuries, spoke with Daily Trust about the elements contributing to misdiagnoses and higher death rates related to lung cancer within the nation.
He stated, "Initially, we must recognize that awareness about lung cancer within our community isn’t particularly widespread. This is due to the fact that conditions such as tuberculosis, chronic asthma, and various respiratory infections share similar symptoms with lung cancer. Consequently, medical professionals often consider diagnoses like tuberculosis or one of those illnesses before thinking it might be lung cancer."
He emphasized that detecting lung cancer necessitates maintaining a significantly elevated level of doubt.
'Relying on the research I shared at the University of Toronto in 2024, we've begun defining four key indicators known as the tetrad of symptoms. These signs serve as a warning signal for doctors to promptly focus on the possibility of lung cancer. It’s important to note that in certain instances, the manifestation of lung cancer might not follow the usual pattern.'
Some key points from our research indicate that when someone reports symptoms like chest pain, unexplained weight loss, and difficulty breathing—after ruling out tuberculosis—the possibility of lung cancer should be considered next. Additionally, diagnosing lung cancer is increasingly challenging as it requires obtaining tissue samples. Not everyone possesses the skills needed to collect these tissues and conduct pathologic examinations," he explained.
Speaking about the difficulties of diagnosing lung cancer in Nigeria, Caleb Egwuenu, a Lung Cancer Patient Research Advocate and the Executive Director of Move Against Cancer Africa (MACA), stated that lung cancer in Nigeria and across Africa is extremely complex.
He stated, "Imagine having worms in a sealed container; once you take off the lid, numerous worms start emerging. Initially, with the container closed, only a few worms might be visible, but removing the cover reveals many more. In this vein, I think lung cancer in Nigeria and across Africa is like a sealed container of worms obscured by conditions such as tuberculosis, chronic obstructive pulmonary disease, pneumonia, and others."
He mentioned that these conditions exhibit similar symptoms to those of lung cancer and might look indistinguishable from lung cancer when viewed through a scan or an X-ray.
He stated, "When people notice these symptoms, the initial thought usually goes to tuberculosis since individuals often experience persistent coughs or difficulty breathing. Some might even consider chronic obstructive pulmonary disease (COPD). Very rarely do they suspect it could be lung cancer. By the time it gets identified, the patient has typically passed away or the condition has reached an advanced stage."
Engineer Dozie Akwarandu, a cancer survivor and the founder of Nest of Hope Advocacy and Support Community, stated that situations where hospitals and medical practitioners treat patients for cancer without conducting necessary examinations or consulting specialists frequently occur.
"Some healthcare providers are hesitant to refer patients for additional tests. Due to what’s known as the 'japa syndrome', numerous public hospitals suffer from a shortage of specialists and necessary medical equipment. Although some physicians working in public facilities are aware of reputable private hospitals capable of diagnosing and treating cancer cases effectively, they avoid doing so under the pretext that it goes against hospital policies. This situation exacerbates patient conditions and sometimes results in fatalities that could have been avoided," he stated.
Way out
As he departed, Professor Okonta advocated for establishing specialized lung cancer clinics, maintaining comprehensive lung cancer registries, and securing governmental backing for conducting tests and providing treatments.
He stated that the government ought to supply specialized tools and setups for both diagnosing and treating patients, mentioning further that access to electricity is crucial as well since advanced equipment requires power.
When asked about the specialists needed for the early detection and treatment of lung cancer, he stated, "Caring for patients with lung cancer involves a multidisciplinary approach and teamwork. However, often there are numerous individuals without proper qualifications venturing into this field simply due to securing a grant or stumbling upon it accidentally. This situation ought not persist. Primarily, one must possess genuine interest since we're talking about treating the lungs. Therefore, the essential professionals include pulmonologists or chest physicians, followed by thoracic surgeons."
A thoracic surgeon specializes in operations involving the chest area. It’s crucial to involve them because they can swiftly obtain tissue samples for biopsies when needed, particularly based on where the tumor is located. Afterward, patients would be referred to oncologists who then promptly start appropriate drug treatments if the diagnosis reveals lung cancer.
When patients arrive at the hospital and you suspect either tuberculosis or lung cancer based on their age, promptly schedule them for an examination and arrange for urgent care with a cardiothoracic surgeon. Once these steps are taken, positive results follow. Additionally, maintaining a robust lung cancer registry is essential.
Professor Okonta mentioned that the training, improvement, and comprehensive development will support current oncology services and help establish high-capability interdisciplinary groups within regional facilities, bringing various advantages.
He emphasized that research initiatives through extensive collaborative efforts across multiple institutions, both within the country and abroad, ought to be promoted.
'This holds significant promise for addressing some of the key research, human resource, and financial gaps needed to achieve high-quality and all-encompassing lung cancer care within the nation,' he further stated.
Additionally, Egwuenu, the advocate, mentioned that it is crucial to educate the public about lung cancer since some individuals mistakenly believe it only impacts those who smoke.
He stated, "There's a lingering stigma associated with lung cancer. Immediately, people assume that someone diagnosed with this illness must be a smoker who brought it upon themselves." However, not all individuals afflicted with lung cancer are smokers. He continued, "Although cigarette use increases the risk of developing lung cancer, various other factors can also lead to the condition—such as exposure to radon gas, which occurs naturally in soils, or asbestos among others."
He emphasized the necessity for training and retraining of healthcare professionals along with the distribution of diagnostic equipment throughout various medical centers. He stated, "When physicians receive additional education, they can consider the possibility of lung cancer and say, ‘I should request further testing,’ rather than following current practices."
He emphasized that it is crucial for administrations at every level to increase their focus on lung cancer.
He emphasized that it is crucial for the National Institute for Cancer Research and Treatment (NICRAT) to focus more on lung cancer. Currently, breast, cervical, and prostate cancers receive priority attention in the nation. While these latter types of cancer are widespread, their survival rates significantly surpass those of lung cancer. Many individuals afflicted with lung cancer frequently succumb due to challenges related to diagnosing and treating this disease within the country.
Provided by SyndiGate Media Inc. Syndigate.info ).
0 Comments:
Post a Comment