Fear can be tormenting and deeply devastating, especially when attached to a cancer diagnosis. But for many survivors, confronting that fear, seeking treatment and finding support can transform a terrifying diagnosis into a story of survival.
“Cancer made me discover a new passion in life,” said Tosin Adewale, a 32-year-old man who was diagnosed with colorectal cancer in 2023. “It gave me a new direction in awareness and advocacy. Before my diagnosis, I never knew I had that talent for encouraging others about early detection. But after going through a series of treatments, I developed an interest in speaking publicly about my cancer journey, reaching out to people for support and raising awareness about early detection.”
Like Adewale, an estimated 130,000 Nigerians are diagnosed with cancer annually, with breast and prostate cancers being the most prevalent, followed by cervical and colorectal cancers, according to data from the International Agency for Research on Cancer (IARC).
The good news is that “cancer is no longer a death sentence”, says the Regional Coordinator, National Institute for Cancer Research and Treatment (NICRAT), Professor Olusegun Alatise. He stressed that improving the quality of care and promoting early detection are crucial to survival.
Mrs Benita Egone, a middle-aged breast cancer survivor who almost declined treatment because of misconceptions about chemotherapy, later narrated how she overcame her fear, underwent treatment and survived the disease.
“I took my drugs consistently for one year. But while taking my drugs, in June 2024, I had issues back home, and I had complications that resulted in bleeding and a ruptured ovary. The result indicated fibroids. So, I was eventually scheduled for a 14-day radiation session.
“I did all that. And this is me here today because I took my drugs. I recovered my life from cancer, and I’m happy to be alive,” she shared enthusiastically.
Aside from discovering a new passion, Adewale also shared how the love and care of his loved ones, coupled with his faith and dogged determination to overcome the disease, kept him going, even at the most difficult moments.
“The incredible faith I had in God, myself and what I was doing were big pillars of support for me. Also, health has taught me that courage is not just the absence of fear. Courage is about moving forward despite obstacles.”
The World Health Organisation (WHO) also echoes the message of hope to people living with cancer, assuring them that a cancer diagnosis does not necessarily mean the end of life. It estimates that about 30 to 50 per cent of cancer deaths could be prevented through lifestyle modification, avoidance of risk factors and the implementation of existing evidence-based preventive strategies.
Misdiagnosis: A major barrier to early detection
With campaigns on early detection as a pathway to improved cancer survival gaining momentum, the stories of many patients point to misdiagnosis as a major contributor to late presentation. This signals a health-system challenge that requires urgent attention. Adewale and Egone also encountered diagnostic challenges during their journeys, but their resilience helped them persist until they received appropriate care.
“My journey started in 2020, with a lump on my breast, so I decided to go for a check-up,” Egone narrated. “The first surgeon I consulted directed me to go for a scan. Thereafter, he told me something funny, and then I left. I met another surgeon who did a wrong biopsy on me. So, after the wrong biopsy, he was shocked that I thought it was cancer stage one, when the biopsy that was done wrongly resulted in a lump because it was done wrongly.”
The WHO identifies diagnostic errors as a global patient-safety problem and specifically recognises cancer as a condition in which delayed diagnosis can be harmful and costly.
Adewale, a colorectal cancer warrior, encountered a similar situation.
“Initially, I had no idea of what was happening to me. I had symptoms of malaria, constipation, blood in my stool, persistent stomach pain and so on,” he said. “Until I was rushed to the hospital, when I became anaemic and unconscious. Even the doctors were confused; they didn’t have an idea of what was happening to me. Being a primary healthcare centre, I was treated based on the symptoms I had. But when I went back home, I felt something seemed not right.”
While a paucity of data on cancer misdiagnosis remains another challenge, a recent multicentre study in Kano and Ibadan found that misdiagnosis and inconclusive results were prevalent health-system contributors to delayed diagnosis, with a median five-month interval between first presentation to a formal healthcare professional and cancer diagnosis.
In an exclusive interview with Pharmanews, Dr Olaiya Popoola, a clinical oncologist at Bell Oncology Specialist Hospital, corroborated the earlier accounts, describing diagnostic error in cancer care as a systemic issue involving different specialists and procedures.
He explained that cancer diagnosis involves several stages, from biopsy and tissue preservation to pathological assessment, meaning that an error at any point can affect the final diagnosis.
“If there’s a problem, there could be a misdiagnosis along the line,” he said.
Shortage of oncologists, fear of chemotherapy
These challenges underscore the need for the leadership of the healthcare system to expedite action on improving cancer diagnosis through the establishment of adequate diagnostic facilities, provision of equipment for timely testing and recruitment of more oncologists across the states of the federation.
Such measures would ease patients’ burden in accessing timely care, although the financial burden of treatment remains another major challenge.
Egone’s story shows how the absence of an oncologist in Delta State worsened her situation, as she had to travel to Rivers State for diagnosis and treatment and subsequently to Lagos State for further care.
“We don’t have an oncologist in Delta State, not even one,” she lamented.
Worse still, it is alarming to know that 16 states in the country have no radiation or clinical oncologist, according to the President of the Nigerian Cancer Society (NCS), Professor Abidemi Omonisi. The situation raises questions about what more can be done to address the shortage.
“So, when my case was finally diagnosed, I didn’t go for chemotherapy. I was scared because of the too many things people had said about it,” Egone said.
She initially turned to supplements and remained on them from 2020 to 2022, but her condition deteriorated. After being referred to a private hospital in Lagos, she began chemotherapy. She said the oncologist’s explanation of the treatment changed her perception of chemotherapy.
Psychosocial support from practitioners and families
Experts acknowledge the importance of psychosocial care in cancer treatment, noting that it can significantly influence patients’ survival experience and quality of life. The WHO Regional Office for Africa, International Agency for Research on Cancer (IARC) and American Society of Clinical Oncology (ASCO) have all emphasised the importance of psycho-oncology as part of comprehensive cancer care, addressing patients’ physical, psychosocial and spiritual well-being.
This is reflected in the experiences of the survivors, who attributed part of their ability to overcome the disease to the love and support of caregivers and family members, alongside medical treatment.
Egone recalled how, through her brother, she encountered an NGO that supported her financially and emotionally.
“I met an NGO online through my brother, and I registered with them. And they introduced me to what I would call my God-sent oncologist.”
Adewale also affirmed the importance of the support he received from people and healthcare practitioners throughout his journey.
“At each point along my journey, I reached out to people for physical and financial assistance, and they have been a great pillar of support for me. For instance, when I was to do my immunohistochemistry, it was funding assistance that saw me through.”
Dr Popoola upheld the same view, stressing that patients need considerable psychosocial support from their families and other members of society.
He argued that when patients or survivors are rejected or stigmatised at home, they may feel abandoned and worthless, but when they are accepted, cherished and treated properly, they are better positioned to cope with the disease and maintain a better quality of life.
Adewale sums up his experience in simple terms: “Courage is not just the absence of fear. Courage is about moving forward despite obstacles.”
