Healthy living, early presentation help combat cancer

As the world marks Cancer Day today, early presentation of the disease has been said to be the best way to survive it. Patients that present early have a higher chance of survival than those that present late.

Those with family history of cancer have high tendency of being affected, as they have genetic predisposition to the disease. So, this category of people is advised to go for medical check regularly. Also, women above 40 years should go for mammogram and ultrasound cancer screening at least once in two or three years, depending on the age of the person and family background.

To prevent excessive toxic build-up in the system, which might lead to cancer, health experts advise that more fresh fruits and vegetables be consumed. It is also important that people engage in physical exercise, as it helps to reduce body fat, especially for the obese.

Consultant, Clinical and Radiation Oncologist Department of Oncology and Radiotherapy, Lagos University Teaching Hospital (LUTH), Dr. Alabi Adewumi described cancer as an abnormal growth which can be found anywhere in the body.

She explained that prostrate cancer is more common in men, while women are prone to cervical, ovarian, vagina and breast cancers, though some men also develop breast cancer, but it is very rare.

She said: “Different cancers are affecting different parts of the body and at different ages, too. Now, we have childhood cancer. Cancer of the eyes is common in children. The adults tend to have cancer of the kidney and soft tissues, among others. Presently, cancer cases are on the increase and people are daily coming down with the disease in the country, unlike before, when it was only a few people that had the disease.

“So, we advise that men under 40 should also go for prostrate specific antigen (PSA) cancer screening because between the age of 40 to 50, the chances of developing prostrate cancer is very high. And if an individual tested positive, he should try to see a doctor for treatments.”

She listed available treatments in the country to include radiotherapy, chemotherapy and surgery, among others. And fortunately, there are specialists in all these fields, though there might be challenges of inadequate equipment in the hospitals.

Another challenge is that of poverty, as many people cannot afford the treatments. But she believes the National Health Insurance Scheme (NHIS) should be able to cover the expenses of some of the drugs. She, therefore, urged government to try to implement the scheme to reduce cost of treatments.

“We encourage non-governmental organisations (NGOs), which have been very supportive with donation of drugs, and cash gifts to patients. We also advise people that as they grow older, they should eat balanced diets, avoid red meat, reduce alcoholic intake and smoking.

“There are also occupational hazards that we advise people to avoid. These are found in chemical industries, for instance. Exposure to these chemicals can lead to developing one type of cancer or the other and people need to be protected.”

Paediatric hematologist/oncologist at the Lagos University Teaching Hospital (LUTH) Idi-Araba Lagos, Dr. Seye Akinsete explained that childhood cancers occur in children from birth till age 18. It is increasingly becoming a major cause of childhood morbidity and mortality.

He advised parents to know certain danger signs that may be pointers to an underlying cancer. These include repeated fever, hospital admissions and treatment for malaria or infections, repeated blood transfusions. Bleeding from the nostrils or gums, shining eyes like that of a cat in the dark, abdominal swelling, swelling in legs or unexplained swelling on any part of the body. All these are reasons for parents to visit the hospital for medical screening and check ups.

He said: “Childhood cancers do not have causes like adult cancers. Most of the cancers are due to genetic mutations that occur for the first time in the child. Some cancers occur in certain families like Li-Fraumeni Syndrome. There are no known preventive measures in children, except for such general interventions as hepatitis immunisations and human papilloma virus immunisation.

“Treatment modalities include, chemotherapy, radiotherapy, surgery and immunotherapy. Bone marrow transplant is also an established mode of treatment.”

Akinsete said the best places to treat childhood cancers are at comprehensive cancer centres, where most modes of treatment are possible. For instance, Lagos University Teaching Hospital is an established centre for treating childhood cancers. Most of the solid tumours survive, while leukemia patients do not do so well. Most other teaching hospitals also offer treatment for children, including primary healthcare centres and other recognised and registered hospitals.

“Children suffer from cancers and treating them is still a challenge in Nigeria because of poor awareness and late presentation, as well as inadequate infrastructure”, Akinsete said.

Dr. Rufus Wale Ojewola, a consultant urologist, Department of Surgery, Lagos University Teaching Hospital (LUTH), and a lecturer in surgery, College of Medicine of University of Lagos (CMUL), said the prostate is an accessory organ of reproduction found below the bladder in men. Prostate cancer is when cancer develops from the prostate organ.

He said: “Prostate cancer is the commonest cancer in adult males. About one in 36 men will develop the cancer in their lifetime; while one in six afflicted men will die of the disease. Prostate cancer can be aggressive and lead to death, but can also be slow growing, in which case, patients can live long and die of other diseases or causes like complications of diabetes, hypertension, lung diseases or even road traffic accidents or old age.”

“The peak incidence is in the sixth and seventh decades of life. It was rarely diagnosed in men below 50 in the past, but this has changed, as younger men are increasingly being afflicted now,” he explained. “We now diagnose prostate cancer in men around 40 years. This is what we call age migration in cancer, and is not peculiar to prostate cancer alone.

“For example, breast cancers are being diagnosed increasingly in teenagers now. There is a racial predisposition to prostate cancer, as it is an established fact that the disease is commoner and more aggressive in blacks than whites. Men should also know that prostate cancer is curable, if detected at the early stage.”

Ojewola said manifestation of prostate cancer depends on the stage at diagnosis. In the very early stage, it might not manifest with any symptom.

He said: “It is only discovered during screening for prostate cancer. This is the commonest method of detection in the Western world, where there are organised screening programmes for men.

“If not discovered at this stage, it can then progress to manifest as lower urinary tract symptoms. These are symptoms of difficulty in passing urine like urinary frequency, nocturia (frequent urination at night), intermittent stop and start pattern of urination, urgent inability to postpone urination, applying force during urination, incomplete voiding, feeling of urine remaining in the bladder after urination or poor urinary stream. There may also be passage of blood in the urine or bloodstain in the seminal fluid.

“By the time prostate cancer advances, there may be weight loss, loss of appetite or general weakness. There may also be back pains, if it has spread to the back or weakness or paralysis of the legs, if the spinal cord is involved. There may be yellowness of eye and abdominal swelling, if the liver has been involved. There may be cough, chest pains and passage of bloody sputum, if the lungs are affected. The truth is that it can spread to any organ in the body, if not discovered and treated early.

The Founder of Children Living with Cancer Foundation, Dr. Nneka Nwobbi said in developed countries such as UK or US, cancer treatment records 80 per cent success because of early presentation and quality healthcare delivery while in Nigeria it is about 20 percent. She noted that many parents are not aware their children can have cancer. So, by the time they come for treatment, the cancer might have spread making it difficult to cure.

She said: “We want Nigerians to know that cancer can also occur in children. Parents should do the needful and have their child properly investigated and commence treatment as soon as possible. Parents should be willing to open up in such matters, in the sense that they can discuss with others that their children have cancer. Keeping such things secrete is dangerous. It is not unacceptable to many Nigerians that children die of cancer. So, we counsel parents on such issues.”

She said while there are different types of cancers in children, the more common one is glaucoma, which includes the eye, brain and nose. There is also cancer of the muscles among other cancers.

Nwobi said parents should be particularly, when their children start losing hair like an old person or becoming very dark or vomiting. These are early signs of childhood cancer.