Prof. Edamisan Temiye is a paediatric haematologist and oncologist, Lagos University Teaching Hospital, Idi Araba, Lagos. He sheds more light on childhood cancer in Nigeria in this interview with Ademola Olonilua
Why is there no database on childhood cancer patients in Nigeria?
It is because the country has no records of childhood cancer patients. There should be what we call cancer registry and it should be national based. What we have on the ground is not functional and all efforts to make it functional in Nigeria have proved abortive. We don’t have a good data on cancer patients for both the adults and children. There should be a centralised database and every country should have a functional cancer registry but we don’t have that and it is a problem.
What steps have you and your colleagues as experts in the field made to ensure that there is a centralised cancer registry in the country?
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We have tried our best and such a project should be coordinated by the Federal Ministry of Health. Individuals are trying but this data should be linked and centralised so that it would be available for everyone. That is not what is on the ground. The few individuals that are putting in efforts are not coordinated.
But some people are not even aware that children are susceptible to having cancer…
It is the ignorance of Nigerians. Even when you talk to them, they tell you that they reject it in Jesus name. They often live in self denial. Anything that is not malaria or any ailment that doesn’t spend a few days and goes is believed to be a spiritual attack or witchcraft. When you talk about cancer to them, they look at you as if you are the devil. More so, efforts are being made to sensitise the people that cancer occurs in children but it is not coordinated by the government. The government does not talk about it and what they do not talk about does not seem to exist. All we hear the government talk about is polio, measles, and that is all and people feel that anything beyond that is not in existence.
Are childhood cancer cases on the increase in the country?
When we don’t have an original cancer registry, it is difficult to determine if it is on the increase or decreasing. What is actually happening is that the awareness is increasing and more people are coming to the hospital; therefore it may appear as if it is increasing.
Other African countries are partnering with hospitals in developed countries to combat childhood cancer but Nigeria has not?
I cannot answer for the government but I can answer for us. We are making efforts to link up with some childhood cancer centres abroad. What is slowing down the process is that we have to fulfil some requirements before the deal can be made. Because the government has no interest in childhood cancer, the process is very slow.
Why do you say that the government has no interest in childhood cancer?
I am sorry to say but the government does not have interest in the health of Nigerians. It is not just about childhood cancer. For instance, HIV/AIDS treatment is becoming difficult in Nigeria because the foreign partners that were helping are withdrawing. In a country as small as Mozambique, the government took over the treatment of their people from the beginning and they are faring well. There is no such thing in Nigeria and the government is not committed to the health of Nigerians and that is our major problem. We hear a lot of noise about malaria treatment but it is because UNICEF, WHO and other developmental partners have interest in it. If they withdraw today, you will think malaria does not exist in Nigeria anymore. Nigeria is still behaving like a ‘beggar nation.’ Without support from foreign partners, they don’t do anything about the health of the populace.
What are the factors that cause cancer in children?
Cancer is a genetic disease; it is an error in the gene of a particular cell in a person, whether an adult of a child. We don’t know exactly what triggers some cancer but when you look at the gene, you will see it has been corrupted and that is what makes the person develop cancer. For example in children, if a lady is pregnant and the unborn child was exposed to radiation, maybe she went for x-ray, it can lead to cancer including blood cancer in children. That is basic. Some few infections are known to be associated with cancer like estimbal virus infection has been detected in some children that has some cancer. It causes burkitt lymphoma which is the commonest cancer in children in Nigeria. If you have a wound on your lower limb on your leg, you can have swelling at the groin. The places where the swelling occurs are where the white cells that fight infections in our body are stored. The ones that are called lymphocytes are what become cancerous in burkitt lymphoma. They make the face, abdomen, kidney, liver or wherever the tumor is to swell up. That is the commonest case of childhood cancer in Nigeria.
What other kinds of cancer are common in children?
We have retinoblastoma which is the cancer of the eyes and it is treatable if discovered early but most Nigerians don’t want to hear about it. They run away until it becomes very late.
What are the chances of survival for a child diagnosed with cancer?
For now in Nigeria, the survival rate is poor. It is poor because people report cancer cases very late. They would have gone to churches, mosques and herbalist shrines before coming. On some occasions, they may have come before but once they hear cancer, they run away. Unfortunately there are a lot of deceptions out there. By the time they come back, it is late and cancer in children grows very rapidly. An adult can have lymphoma and still live for 10 years but if a child should have it, he would die that year if it is not treated. Within six months, most children who have cancer would die, at most the child would live for a year. Cancer in children grows rapidly so they have what we call acute cancer. If you identify the cancer early and treat them on time, many children survive it. In developed countries, children seem to have a higher survival chance than adults if they are treated on time. In developed countries where children have Acute Lymphoblastic Leukemia, they have 80 per cent survival rate. In some centres abroad, children diagnosed with cancer of the kidney have about 80 per cent survival rate. We have a fairly good report here in Nigeria also about the cancer of the kidney, especially in Lagos.
What can be done to alert the government that childhood cancer is silently killing children in the country?
One of the ways forward is what we are doing now. We are sensitising people to let them know that it exists. We are also alerting supporting agencies that childhood cancer exists. If we have all the necessary facilities, we can treat it. We need to educate the parents that once they see something unusual in their children, they should come quickly to the hospital so that it can be identified and treated on time. If you treat cancer early to cure it is still possible and some of our children survive it. The cost of cancer should not be solely the parents’ burden because it is too expensive. The society and the government should support. The government should have policies that support cancer patients for them to be able to afford treatment. The government should also equip our hospitals and make them good enough to treat cancer patients.
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