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There is no magic for late presentation of cancer - Prof Ajekigbe

By The Citizen

Professor Aderemi Ajekigbe, Head of Oncology and Radiology, Lagos University Teaching Hospital, LUTH, in this interview with Sola Ogundipe, Health Editor, says late stage cancer has no cure.  Ajekigbe adds that it is erroneous to think only females are susceptible to breast cancer.  Men too, according to him, are prone to the cancer of the breast.

Potential epidemic
Cancer is currently ravaging the country.  There is nobody who doesn't know somebody who has either died from cancer or is suffering from cancer. Cancer is assuming epidemic proportions in Nigeria. Currently, there are not less than two million people suffering from cancer and not less than 100,000 new cases every year.   Of the 100,000 new cases, only few have access to treatment because there are just three functional cancer centres and treatment is very expensive.

Late presentation
Here in LUTH, we see an average of 15-20 cases daily and up to 75 percent of the cases are presented very late - stages III and IV. Of the new cases, nine will be breast cancer in women. Breast cancer is still the leading cancer in Nigeria. Cancer may be a very bad disease, but it is curable if the patient presents early. Where these patients normally first go to is what we do not understand, and this is what we often tell our churches and mosques not to continue deceiving the people that they can do this or do that about the condition.

If the patient goes to hospital, the church can pray for them, but keeping a suspected cancer for 15 months before going to hospital may be disastrous. We need people to help educate the churches. If you come late, it may be disastrous. Late stage cancer has no cure, what we do is to manage the condition to reduce the complications. There is no magic for late-stage cancer, only palliative care. This is a warning to others. The earlier the better, examine your body and if you find anything wrong, give a shout. Then people will come to your assistance.

Breast cancer
Breast cancer often starts from the axilla in the armpit. The axilla and the breast are related. I call them first cousins. If something happens to the breast, most of the time it will stretch to the armpit near it, and what happens to the breast may come from the armpit because they are so related. It is called the lymphatic drainage system. The upper part of the breast drains into the system. If a doctor examines your breast for whatever reason, the doctor must also look into the armpit to see if there is anything there. The doctor must check the lymph nodes.

Men too, have breast cancer
Several years ago, former President Olusegun Obasanjo was at LUTH to commission the cancer screening machine. He was shocked when I showed him the picture of a male patient with cancer of the breast. He asked if men too suffer breast cancer and I said yes. Males also have breast cancer because males have breasts. He was so sober and serious that day. So men too need to be palpating their breasts. Occasionally, when breast cancer spreads to the axilla, it blocks the lymphatic drainage system. When the fluid is blocked, it cannot go back, hence the swollen arm, cause of the blockage. We advise patients to alleviate that part as often as possible.

Causes of cancer
Cancer has been in existence before creation, and we know man is the last creature of God. Other creatures came before us. The bodies of extinct animals that were dug up centuries later showed that the animals had cancer in their lifetime. Traces of cancer metastasis have been found in the bones of pre-historic animals. What I'm trying to say is that cancer has been with us for long and will continue to be with us. We do not know the reason for this, and we do not know the cause. Cancer is genetic. It arises from the stem cells, that is, what makes us up. When I'm asked what causes cancer, I just say GOK (God Only Knows), but there are etiological causes that can increase the chances, and if you have these factors, you are more at risk.

Know your risk
There are also genetic factors. There are controllable and uncontrollable causes. There are social factors too, such as smoking, alcoholism, promiscuity, diet and certain socio-economic issues.

Lifestyle factors are controllable. You can choose not to smoke or to engage in sedentary lifestyle. But you can not choose your parents. We did not ask to be born. We were born of two persons whose coded messages are unfolding as we are ageing. There are genetic factors and environmental factors. If your mother and blood sisters have cancer of the breast, your chances of developing breast cancer are higher than those of colleagues whose mothers do not have the disease.

Early diagnosis is key
There are women in the UK and Europe that are now removing their breasts prophylactically,   because they have done tests which show that they also carry the cancer gene.   If five ladies are born at the same time, it is on record that those who start their menses early have a higher chance of developing cancer of the breast. The situation is beyond the woman. However, the message here is that of early diagnosis. When caught early, breast and cervical cancers are easily treatable and the treatment would not be too expensive. Also the chances of survival are higher and there wouldn't be a need to go abroad. Through screenings and early treatment, cancer is not likely to progress. But we need more facilities. Vanguard.