Omolola Salako

Innovative Breast Cancer Awareness and Advocacy Campaign

Breast cancer is a major disease in Nigeria; in 2012, 27,304 new occurrences were diagnosed, and the number of mortalities was 13,960. Greater than 70% of patients present with advanced disease, which has a poor survival outcome. The mortality rates are high mainly because of a lack of awareness about breast health, screening guidelines, and treatment centers, and because of sociocultural barriers. In Nigeria, health care professionals remain the backbone for the provision of medical information to the public. This is a study of the innovative ways that breast health and cancer awareness were promoted across communities and institutions in Lagos State, Nigeria, in 2015. Several community awareness campaigns were carried out in the forms of health talks, breast cancer screenings, radio and television interviews, and campaigns on social media. Anomalies noticed during the screenings were promptly referred to appropriate hospitals for additional treatment. The campaign culminated in the #12KLLP, or 12,000 people light Lagos pink, which was a Guinness World Record attempt for the largest human awareness ribbon formed for breast cancer. There was a total reach of 28,774,812 people across platforms: 285,318 were on social media, 3,620 were in communities, 7,466,276 were on the website, 20 million were through media events, 12,000 were through publications, 7,598 were verified participants at the Guinness World Record, and approximately 1 million were through blogs. Eighty partnerships were made with various private and government institutions to facilitate different aspects of the campaign. The community members were able to learn about the need for early detection and awareness; volunteerism and corporate social responsibility were promoted among individuals and corporate institutions.

Utilization of Cancer Information System for Breast Cancer Control in Lagos, Nigeria

Introduction There is a substantial increase in the incidence of breast cancer in Nigeria usually with the late stage presentations and subsequent poor rates of survival attributed mainly to a low level of cancer awareness and ignorance amongst patients. Cancer information system (CIS) is now assuming an emerging role in this respect. Methods This was a descriptive study carried out over a one year period using a health communications program comprising of 3 breast help lines. An initial period of public awareness was carried out over a 3 months period after which members of the public were encouraged to call the help lines. Breast cancer information was provided and the socio-demographic characteristics and other relevant data of the callers were recorded by the information specialists. Results A total of 294 people were reached during the study period. Majority of the callers (82%) sought information for themselves while the remaining 18% called on behalf of a loved one or friend. Majority [248 (84.3%)] of callers had no breast abnormality, 38 (13%) called to report breast abnormalities and required information on what to do and 8 (2.7%) were breast cancer patients who required information on how to live and cope as breast cancer survivors. Conclusion The rapid growth of mobile phone use in the Nigeria has presented a unique opportunity and promise to improve cancer care. There is evidence to suggest that mHealth can be used to deliver increased health care services to the increasing population of cancer patients in Nigeria.

Oncology Guidelines Usage in a Low- and Middle-Income Country

Purpose There is a paucity of data about current usage of oncology guidelines in low- and middle-income countries (LMICs), specifically in terms of the availability and quality of those guidelines. Our objective was to determine usage of oncology guidelines and the barriers and facilitators to their usage among radiation oncologists in LMICs. Methods An online cross-sectional survey was conducted among practicing radiation oncologists in Nigeria via e-mail and the social media database of the Association of Radiation and Clinical Oncologists of Nigeria. In addition, paper questionnaires were administered at regional clinical meetings. Results The survey response rate was 53.4% in a sample of 101 radiation oncologists from the database. Sixty-nine percent of respondents were consultants and 30% were residents. Approximately 43% had < 5 years’ experience. All of the respondents were involved in administering chemotherapy during the treatment of patients with cancer, whereas approximately half were involved in diagnosing cancer. Ninety-three percent reported using guidelines in treating patients, the top two guidelines being those from the National Comprehensive Cancer Network (90%) and the American Society of Clinical Oncology (50%). The two major barriers to guideline usage were that facilities were inadequate for proper guideline implementation and that the information in guidelines were too complex to understand. Potential facilitators included providing adequate facilities, developing local guidelines, and increasing awareness of guideline usage. Conclusion Our study shows that clinicians involved in the treatment of patients with cancer in LMICs are aware of cancer treatment guidelines. However, implementation of these guidelines hinders their usage because the facilities are inadequate, guidelines are not applicable to the local setting, and the information in the guidelines is too complex.

Pattern and Predictors of Unmet Supportive Care Needs in Cancer Patients

Background: The incidence of cancers is increasing, and this is associated with an increase in the burden of the disease. Patients with cancer have to deal with reduced physical functioning, emotional instability, difficulty in concentrating, and an overall diminished feeling of well-being. This creates deficits that have not been well catered for by traditional cancer care, leading to an overall dissatisfaction with care, and a reduced quality of life. Aim: This review aims at assessing the pattern of unmet needs in cancer patients and to provide information as to the factors that influence the perception of unmet needs. Methods: Studies directly focused on unmet needs in cancer patients were retrieved from MEDLINE, PubMed, PsychINFO, Embase, and Google Scholar; from the earliest records until 2016. Unmet needs in cancer patients have been measured with a wide variety of tools, with the Supportive Care Needs Survey (SCNS) being the most commonly used as a result of its strong psychometric properties, eas...

The pattern of comorbidities in cancer patients in Lagos, South-Western Nigeria

Purpose Comorbidities have been indicated to influence cancer care and outcome, with strong associations between the presence of comorbidities and patient survival. The objective of this study is to determine the magnitude and pattern of comorbidities in Nigerian cancer populations, and demonstrate the use of comorbidity indices in predicting mortality/survival rates of cancer patients. Methods Using a retrospective study design, data were extracted from hospital reports of patients presenting for oncology care between January 2015 and December 2016 at two tertiary health facilities in Lagos, Nigeria. Patient comorbidities were ranked and weighted using the Charlson comorbidity index (CCI). Results The mean age for the 848 cancer patients identified was 53.9 ± 13.6 years, with 657 (77.5%) females and 191 (22.5%) males. Breast (50.1%), cervical (11.1%) and colorectal (6.3%) cancers occurred most frequently. Comorbidities were present in 228 (26.9%) patients, with the most common being hypertension (20.4%), diabetes (6.7%) and peptic ulcer disease (2.1%). Hypertension-augmented CCI scores were 0 (15.6%), 1–3 (62.1%), 4–6 (21.7%) and ≥7 (0.6%). The mean CCI scores of patients ≤50 years (0.8 ± 0.9) and ≥51 years (3.3 ± 1.2) were significantly different (p < 0.05). Patients with lower mean CCI scores were more likely to receive chemotherapy (2.2 ± 1.6 versus 2.5 ± 1.9; p < 0.05) and/or surgery (2.1 ± 1.5 versus 2.4 ± 1.7; p < 0.05). Conclusion Comorbidities occur significantly in Nigerian cancer patients and influence the prognosis, treatment outcome and survival rates of these patients. There is a need to routinely evaluate cancer patients for comorbidities with the aim of instituting appropriate multidisciplinary management measures where necessary.

A rare case of ovarian dysgerminoma in a 6‑year old child in Lagos: A case report

Dysgerminoma is the most common malignant germ cell tumor in children and adolescents. Most cases occur in the 2nd and 3rd decades of life, but 10% of cases occur in the 1st decade of life. The rarity of this malignancy in prepubertal children and the recognized controversies in its management prompted this case report. The case of a 6-year-old girl who had laparotomy and unilateral adnexectomy with subsequent histological diagnosis of an ovarian dysgerminoma was presented. Prognosis depends on the stage of the tumor at presentation, and conservative surgery should be the aim during the initial treatment. Adoption of multidisciplinary management within an oncology board with joint decision on the need for adjuvant chemotherapy for early stage diseases will confer good prognosis.

Knowledge, perceptions and practice of cervical cancer prevention among female public secondary school teachers in Mushin local government area of Lagos State, Nigeria

Introduction Cervical cancer is the most common gynecological cancer and a leading cause of cancer death in women in Nigeria. This study was aimed to assess the knowledge, perception, and practice of cervical cancer prevention among female public secondary school teachers in Mushin, Lagos. Methods This was a cross-sectional study carried out among female secondary school teachers in Mushin, Lagos. The participants were selected by a two-stage random sampling method and relevant data were collected with the use a self-administered questionnaire. Data entry and analysis were done using Epi-info version 7.2 statistical software and descriptive statistics were computed for all data. Results The knowledge of cervical cancer and its prevention was 100.0% among the respondents. The most commonly known method of cervical cancer screening identified by the respondents was Papanicolaou smear (91.4%). More than half of the women (67.0%) have had at least one cervical cancer screening done previously. Only 2.2% of the respondents have had HPV vaccine given to their female teenage children in the past despite the acceptance rate for HPV vaccination being 76.2%. Conclusion This study, unlike most previous studies in other regions of Nigeria and most part of sub-Saharan Africa, has demonstrated a relatively high level of awareness about cervical cancer, its cause, risk factors and prevention. However, conversely, the absence of a national health programme means that screening and vaccination centers are not available, accessible or affordable.