Childhood cancer is becoming an epidemic in Nigeria but highly under reported.
Data shared by medical experts show that a high number of children have been diagnosed with the ailment.
About 40, 000 Nigerian children are diagnosed of different types of childhood cancers every year, out of which 80 per cent die due to poor detection and clinical treatment.
The founder of Medicaid Cancer Foundation, and First Lady of Kebbi State, Dr. Zainab-Shinkafi Bagudu, revealed this recently in Abuja, shortly after a roundtable meeting organised by the foundation to mark this year’s childhood cancer month.
She said about 80 per cent of the cases in Nigeria and other low income countries end up in deaths unlike the high income countries where the cure rate of cancer in children is now about 85 per cent.
Unfortunately, the developing countries bear the greatest burden of childhood cancers as over 90 per cent of the world’s children live in these countries.
Childhood cancer in most instances is curable, but many children die from cancer because most children live in developing countries without access to adequate treatment due to high cost of treatment and poor organisation in these countries.
Recently in Nigeria, a non profit organisation Lions Club has taken the initiative
to increase cancer care which include establishment of standard cancer care centres, manpower training, establishment of standardised management protocols, procurements of standard drugs and collaboration with international organisations.
Cancer is a major cause of morbidity and mortality not only amongst children, but also in adults. It is estimated that 8.1 million new cases of cancer occur annually, representing an annual increase incidence of 2.1 per cent which is faster than the annual growth rate of 1.7 per cent.
In the developed world, cancer affects 1 in 600 children before their 15 th birthday. Data on cancer incidence are scanty in developing countries. Most of them are hospital-based statistics and of little value due to inadequate cancer registry and records keeping in developing countries. Cancer is a major killer of children in developed countries probably being surpassed only by trauma. In developing countries, as significant progress is made in combating common childhood killers like malaria, measles, gastroenteritis, other infectious diseases and nutritional deficiencies, cancer and trauma are emerging as major childhood killers.
It is obvious that whatever strategies that are geared towards improving the health of people living in the developing countries must include strategies for the control of childhood cancers.
Information obtained from the African Journal of Pediatric Surgery indicates that with more than 90 per cent of the world’s children living in developing countries, these countries bear the greatest burden of childhood cancers.
It is pertinent to note that childhood cancers in most instances are highly treatable and in established paediatric oncology centres in developed countries, more than 70 per cent of these children can be cured of their cancers.
Unfortunately, less than 20 per cent of the world’s children have access to and can afford these curative treatment services and therefore more than 80 per cent of these children die because they live in developing countries and therefore have no access to or cannot even afford to pay for the treatment of their cancers.
It has been estimated that US$103,250.00 is needed to cure one child with leukaemia.
More people today live in poverty than 20 years ago and it has been estimated that about 1.3 billion persons (one-fifth of the world population) live on less than US$1 per day. With these staggering financial implications for the treatment of childhood cancers, it is obvious that there are very few families that would afford to pay for these costs in developing countries.
Besides, other considerations such as scarcity of specialized centres and facilities, including personnel, definitely add to the misery of children living with cancer in developing countries. On the state level, the delivery of oncological services is challenging because it would have to compete with other services on the scarce resources available.
In Nigeria experts have raised alarm about the growing incidence of childhood cancers as they expressed fears that an epidemic is in the making.
They stated that less than 2 out of 10 cancer cases in children aged 0-19 are diagnosed each year in the country, an indication that an epidemic of childhood cancer is imminent.
Confirming the surge in childhood cancers, a Consultant Oncologist and Specialist in Paediatric cancer at the Lagos University Teaching Hospital, LUTH, Prof Edamisan Temiye, in 2019, said major problems of cancer care in the country include lack of diagnosis, misdiagnosis or delayed diagnosis, high cost and abandonment of treatment.
“Cancer in children has been there as long as human beings have existed but what happened is that most of them were misdiagnosed or not diagnosed at all,” Temiye remarked.
Noting that most cancers in children kill very fast, usually within six months to one year and are therefore missed because doctors are not looking for them, Temiye said almost 99 percent of cancers in children kill very fast.
Temiye stressed that even though only about 0.5 percent of all cancers are childhood cancer, one child takes a lot from the family and childhood cancer has a better cure rate than adult cancer most of the time.
“In LUTH, we see five to seven cases in a month. When you diagnose a case it takes you about 10 months minimum to treat, it can be as long as three years. If blood cancer is involved the treatment period is three years for that child not one week.
So you see a cumulative of cases and when you finished that child’s treatment for three years you have to follow up that child for another five years to give that child a clean bill of health, so it is three years you treat and five years from follow up. Challenges include problems of finance, late presentation, unavailability of modality equipment and drugs.
“However, despite the high burden of the disease, there is no supportive treatment plan for children with such terminal illnesses.
“While the National Health Insurance, NHIS, covers breast cancer, prostate cancer and cervical cancer, childhood cancer is not covered,” he regretted.
According to Temiye, there is no political will to fight the childhood cancer scourge in the country.
He said a basic reason why there are low survival rates has to do with the high cost of treatment.
“In Nigeria, nothing about childhood cancer is covered by government, the family must pay for everything.
Another problem is that patients present to us late. When people present to us in the first and second stage of cancer most times you can cure it but 3rd stage it is difficult and 4th stage is a lost case. In 90 percent of cases 4th stage is lost case either for adult or for children.
“The late presentation and the issues of healthcare workers who don’t have the full knowledge is one of the major problems why we are have low survival rates. The other problem is drugs. The prescriptions are not easily available, sometimes we miss treatment, because the medication is not available and occasionally we have cases of drug contamination.”
In the views of Dr Nneka Nwaobbi, the challenges that children with cancer and their families face are financial and emotional trauma.
Nwaobbi who is the CEO/Founder, Children Living With cancer Foundation, CLWCF, observed that some parents still hide the fact that their child have cancer.
“We have parents who send such children to the village where their friends will not see them because they are ashamed and hope the children die there.
“Sometimes the family structure is broken down completely especially when one parent has to stay in the hospital with the child and the other stays home, that family could be broken completely, except there are very strong family values and the parents are together in whatever they do for their child to get well.
Creating Nationwide Awareness And Intervention
Lions Club District 0404B1 Nigeria now worried about rising cases of cancer among children is spending about N200 million to provide asset treatment support to the Lagos University Teaching Hospital, LUTH, Idiaraba Lagos.
District Governor of the Club Kema Ashibuogwu while outlining her priority projects after her installation, identified childhood cancer as a menace that if not tackled would create a devastating health issue among the growing children population.
Ashibugwu, regretted that despite rising cases of the disease among the children only LUTH has a dedicated ward facility in Nigeria where children with cancer are treated.
She expressed deep worries that despite the threat from spread of cancer among children, little is being done to create the necessary awareness and to develop a policy initiative that will provide support specifically to families that have to contend with the challenges.
According to her, poor parents have to cough out as much as N350,000 to carry out diagnosis in South Africa before returning to start treatment at huge cost at LUTH.
The District Governor, regretted that Nigeria cannot boast of a single Flow Cytometer, (Cancer Detection Machine) that sells for about N64 million or even a Chemotherapy chair of N4 million.
Having identified these challenges and how children die due to absence of treatment facilities, the Club has decided to build a caregiver home at the cost of N100’million at LUTH, Ashibuogwu disclosed at media conference in Lagos on Friday.
In addition, she said, the Club is sourcing for funds to procure a Flow Cytomer and Chemotherapy chair to support cancer treatment in the country.
She called for organisations and philanthropists to support the life saving initiative as she cried out that many children have died of cancer while the society is not fully aware that children suffer cancer at young age.
The Ajao Estate Lion Club, District 404B1, has also deepened sensitisation efforts to parents on childhood cancer awareness and need to protect children against the pandemic.
The Club is also planning a $200,000 intervention towards its care-giver project with about 80 care givers for a start.
The District Governor said that the club came together to create awareness on how to fight against paediatric cancer among children.
She said that the awareness became necessary to sensitise Nigerians and parents particular on rapid increase of childhood cancer.
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