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Lifestyle, screening key to tackle colon cancer



About 80 per cent of Nigerians who are diagnosed with colon cancer die from it, even though the disease is preventable. Experts said rectal bleeding, fresh blood in the stool, unexplained constipation, diarrhoea alternating with constipation are among the indicators of colon cancer. APPOLONI A ADEYEMI reports


News about the death of the Zimbabwean opposition leader Morgan Tsvangirai who died from colon cancer at the age of 65, is another indication of how late stage cancers could increase mortality.


Reports showed that Tsvangirai who was the president of the Movement for Democratic Change in Zimbabwe, had been suffering from colon cancer for at least two years, but his condition deteriorated rapidly shortly before his death, despite treatment in neighbouring South Africa.


The death of Tsvangirai on February 14 may have brought colon cancer death to the consciousness of Nigerians; sensitisation about this condition has been in the front burner. As far back as 2016, the Society for Gastroenterology and Hepatology in Nigeria (SOGHIN), had raised the alarm that Nigeria was contending with heavy burden of colon cancer. According to SOGHIN, “More Nigerians above 40 were coming down with colon cancer, which is also known as colorectal cancer and bowel cancer.”


In spite of this background, most Nigerians may not be aware of colon cancer; yet it is one of the most common cancers, globally. Colon cancer is the third most common cancer in Nigerian men, after prostate and liver cancer and the fourth most common cancer in Nigerian women, after breast, cervical and liver cancer. Colon cancer is the development of cancer from the colon or rectum (parts of the large intestine).

The human colon, or large intestine, is a muscular, tube-shaped organ measuring about four feet long. It extends from the end of the small bowel to the rectum.


Its functions include to digest and absorb nutrients from food, to concentrate fecal material by absorbing fluid (and dissolved salts, also called electrolytes) from it, and to store and control evacuation of fecal material. Most colon cancers develop slowly, over ten (10) to fifteen (15) years. It usually begins as a small non-cancerous growth, called polyp on the inner lining of the colon or rectum.


The World Health Organisation (WHO) estimates that every two hours a Nigerian is diagnosed of colon cancer.


The Chairman, National Consultative Committee on Cancer Control in Nigeria, Prof. Francis Abayomi Durosinmi-Etti told the New Telegraph that more Nigerians were coming down with colon cancer. “We are noticing an unusual increase in the incidence of colon cancer. “This last week alone, I saw three colon cancer patients at the clinic at the Lagos University Teaching Hospital (LUTH).”



“On what his clinical experience has been like Durosinmi-Etti said from the rate at which affected persons turn up in the clinics, we can conveniently say colon cancer ranks among the first five common cancers in both men and women in the country presently.”


Nigeria records an estimated 102,000 new cancer cases including colon cancer annually, according to data from the Federal Ministry of Health (FMOH). Similarly, cancer is responsible for 72,000 deaths in Nigeria every year.


Sadly about 80 per cent of all Nigerians who are diagnosed of colon cancer die from it, said Dr. Abia Nzelu, a fellow and consultant of the West African College of Surgeons and the National Postgraduate Medical College of Nigeria.


Nzelu who is also the Executive Secretary, Committee Encouraging Corporate Philanthropy (CECP-Nigeria), said, “This is very unfortunate given the fact that colon cancer is one of the cancers that is virtually 100 per cent preventable.” Examples of personalities that survived colon cancers are Justice Ruth Joan Ginsburg, the oldest and only female Justice of US Supreme Court who marked her 82nd birthday on March 15, 2015.


She developed colon cancer in 1999. During the treatment, she did not miss a day on the bench. In 2009, she again had successful treatment for pancreatic cancer and did not miss any oral arguments in court. Similarly, Queen Elizabeth the Queen mother, survived colon cancer and breast cancer at ages of 66 and 83 years respectively.



She died cancer-free at the age of 101. Furthermore, Pope John Paul II, the second longest serving pope in history, survived colon cancer and later became a patron of the Global Campaign for Prevention of Digestive Cancers.


These success stories are a result of availability of infrastructure for screening and treatment of cancer in the respective countries of the survivors. Symptoms On factors that indicate the existence of colon cancer in a person, Durosinmi-Etti said people who experience rectal bleeding must see the medical doctor urgently.


“If you see any sign of fresh blood in your stool you need to see a doctor,” he said, adding that it was important to have such fresh blood checked by the medical team to ensure that was not colon cancer.


He advised people that experience unexplained constipation, stooling that is excreted in very small, narrow form, rather than being excreted in bulk, unexplained weight loss or weight gain, to see the doctor urgently, adding “These are all indicators of colon cancer.”


Durosinmi-Etti asserted that experiencing all these does not necessarily mean that the one has colon cancer, but advised affected persons to see the doctor that would recommend necessary tests to determine the health status of the patient visà- vis colon cancer.


Other symptoms of colon cancer include change in bowel habit such as diarrhoea, constipation, or diarrhoea alternating with constipation that lasts for more than a few days, a feeling that one needs to pass stool that is not relieved by doing so (tenesmus).


Tenesmus is a continual or recurrent inclination to evacuate the bowels, caused by disorder of the rectum or other illness. Other symptoms are blood in the stool, cramping or belly pain, weakness and fatigue.


“It is noteworthy that colon cancer may not have obvious signs and symptoms in the early stages. So, people should not wait for symptoms,” Nzelu advised. Risk factors Factors that can affect a person’s risk for developing colon cancer include several modifiable lifestyle habits such as diet, weight, exercise, smoking and heavy alcohol intake as well as non-modifiable factors like age, family history of colon cancer or polyp; type 2 diabetes.


Race and ethnicity also play a role. For example, in the United States (US), of all racial groups, African Americans have the highest incidence and mortality rates of colon cancer.


Of these risk factors, the link between diet, weight and exercise and colon cancer risk are some of the strongest for any other type of cancer. Prevention According to Nzelu, with lifestyle modification (including regular medical screening) most cases of colon cancer can be prevented.


The recommended measures include the intake of diet high in fibre such as fruits, vegetables and whole grains, diet low in red meat (such as beef, pork, lamb or liver) and processed meat (such as hot dogs and sausage) as well as liberal intake of water. She said, “It is important to note that fibre supplements have not been shown to be helpful in reducing risk of colon cancers. “Rather, the emphasis should be on dietary sources of fibre, such as oat bran, wheat bran, legumes (beans), green leafy vegetables, carrots, oranges, bananas and other fruits and vegetables.


“Avoidance of excessive weight, smoking and excessive alcohol intake while increasing the intensity and amount of physical activity, also helps to reduce colon cancer risk.”


Above all, eligible individuals, people who are 40 years and above, should undergo screening as recommended. Nzelu said regular colon screening is one of the most powerful weapons for preventing the cancer.


“This can in many cases, prevent colon cancer, altogether. This is because, with regular screening, most polyps can be found and removed before they become cancers.


Screening can also result in finding colon cancer early, when it is highly curable.” Available tests Screening tests for colon cancer include stool test, endoscopy (sigmoidoscopy, colonoscopy), as well as x-ray (double contrast barium enema and CT colonography).


According to Nzelu, an important advantage of colonoscopy is that polyps that are found during the procedure could be clipped off on the spot.


In addition, it only needs to be repeated every ten (10) years if the result was normal. “The recommended age for commencement of screening in the western world is 50 years.


However, anecdotal evidence shows that the peak age of diagnosis of colon cancer in Nigerians is about 44 years.


“This is highlighted by the relative youthfulness of some prominent Nigerians that have fallen victim to colon cancer, according to recent media reports.


For this reason, Nigerians should commence screening from the age of 40.” Those with a family history should commence screening ten (10) years before that age at which the affected family member was diagnosed.


On his part, Durosinmi- Etti said most of the patients diagnosed with this condition in the country presently were persons living sedentary lifestyles, for example people in jobs requiring them to sit down all day long.


“What is also significant, according to Durosinmi- Etti is that now there’s more non-governmental organisations involved in raising awareness about colon cancer as well as providing free screening for Nigerians. “This development paves way for more persons afflicted with the disease to be picked up early for medical attention,” he added.

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Experts advocate increased antenatal attendance by pregnant women



Obstetricians and Gynaecologists on Friday called for increased attendance to Antenatal care by pregnant women to reduce the high rate of infant and maternal mortality in the country.

The experts made the call at a presentation of four books entitled ‘ ‘Step by Step Approach to Obstetrics and Gynaecological Ultrasonography,’  ‘Bullet Point Answers to Exam Questions in Obstetrics,’  ‘Bullet Point Answers to Exam Questions in Gynaecology’  and ‘What Mama Didn’t Tell You About Pregnancy- the Myth, the Truth and the Lie’.

The books were written by Dr. Gregory Ohihoin, a Chief Research Fellow and Consultant Obstetrician and Gynaecologist at the Nigerian Institute of Medical Research (NIMR), Yaba, Lagos.

Prof. Osato Giwa-Osagie, Emeritus Professor of Obstetrics and Gynaecology at the College of Medicine University of Lagos, described the high infant and maternal mortality rate in the country as unacceptable.

Giwa-Osagie said the book which talked about the step by step application of Ultrasonography would help doctors and women understand the peculiarity of  pregnancy and ensure safe delivery.

”This book will have a very wide application as it will help many educated pregnant women. It will save lives of babies and mothers, ” he said.

Also speaking, Prof. Babatunde Salako, Director-General, NIMR said that the books were a veritable source of information for doctors and residents in training as it would facilitate their knowledge ability to handle pregnancies.

”This means that we will produce more knowledgeable obstetricians and gynaecologists who will make correct diagnosis and take appropriate decisions on their patients to enhance delivery of the baby and safety for the mother.

”When our pregnant women attend antenatal these doctors will handle their cases properly and we can also say that this development will reduce the rate of maternal and infant deaths in the country, ” he said.

The Book Reviewer, Dr. Oliver Ezechi, Obstetrician and Gynaecologist at NIMR said that the ‘Old Wife’s Tales’ (Myth) about pregnancy passed down from generation to generation were the greatest challenge in reducing infant and maternal mortality.

 Ezechi said that the book debunked the myth that affected pregnancy outcomes negatively.

”Pregnancy is not a disease, it is a normal physiological process and if women take it serious by registering for Antenatal early and take their doctor’s advice; close to 95 per cent of pregnancies will be successful without complications.

”With Antenatal attendance, doctors will identify problems early and prevent them – prevent infant and maternal deaths, ” Ezechi said.

Also reviewing the book ‘What Mama didn’t tell You about Pregnancy – the Myth, the Truth and the Lie’ , Mrs Rabi Adetoro said that the 100 pages book narrated a beautiful story of pregnancy from conception to delivery and post-delivery stages.

”The book explained the time to register for antenatal, diets during pregnancy, signs, and the role of fathers to secure the health of the mother and the baby, ” she said.

In his remarks, Ohihoin,  the author of the books, said that rate of Antenatal care attendance in Nigeria was 51 per cent, saying that such rate was too low and a major contributor to the high rate of infant and maternal mortality.

He said that the main aim of antenatal care was to ensure a healthy mother and infant at the end of the pregnancy to reduce maternal and child mortality rates.

”I wrote this books to emphasise that antenatal care should be seen as a major preventive health measure aimed at preventing the development of any pregnancy disorders or complications.

”Antenatal care should address the psychosocial and medical needs of the woman within the context of the health care delivery system and the culture in which she lives, ” he said.

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Flying Doctors seeks regional integration for West African health sector



…. says air ambulances can boost health sector

There will be many advantages to regional integration of medical services in the West African sub-region, Flying Doctors Nigeria has said.

Speaking in Banjul, The Gambia, during this year’s West African College of Surgeons (WACS) conference and scientific meeting, Flying Doctors Nigeria Founder, Dr. Ola Brown, stated that regional integration will help the region to develop “medical centres of excellence that can receive large volumes of specialist medical cases,”explaining that these centres will help medical personnel to “develop expertise in very specific areas of medicine.”

The West African College of Surgeons (WACS) annual meeting is one of the most prestigious medical conferences in Africa.

The conference was attended by surgeons from about 22 West African countries. This year’s WACS conference had “Global Surgery Implementation for West Africa” as its theme.

Speaking further on international collaboration in the region, Brown stated that air ambulance services should be key part of the region’s medical sector cooperation.

She explained that air ambulance services are capable of enhancing the region’s medical collaboration by “facilitating transportation of patients across large distances in very short time frames.”

West Africa has some of the poorest health outcomes in the world in form of high maternal mortality rates, high child mortality rates and high mortality rates from trauma and infectious diseases like malaria.

The healthcare expert stated that air ambulance services can help patients save lives by “circumventing the region’s infrastructural challenges, such as poorly maintained roads common in the region.”

Flying Doctors Nigeria is West Africa’s first and leading air ambulance service organisation based in Nigeria. Established about 10 years ago, the firm airlifts patients across the world in medically equipped aircrafts for specialist medical attention.

Brown explained that air ambulance services make it easier for medical experts to refer patients that cannot be handled in their home countries to other countries in the sub-region where such ailments can effectively be treated.

She further explained that air ambulance services also serve a high percentage of professionals, especially those in oil and gas industry who work in high-risk environments, making it compelling to have air ambulance services for rescue operations in hard-to-reach areas

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UNICEF: Nigeria ranked number one with highest unimmunised children



UNICEF has raised an alarm about the threat that measles pose in Nigeria after the country was ranked number one with the highest children unimmunised against measles coming after India.



In a presentation: “Overview of 2017/2018 measles follow-up SIA” at a media orientation for journalists in Lagos state, which held in Lagos on Monday, Dr. Charles Nwosisi, Health Specialist, UNICEF, said that Nigeria ranked number one for being the most unimmunised for measles vaccine first dose with 3.3 million children as compared to India with 2.9 children. Nwosisi said that Nigeria is also 192 out of 200 countries in global ranking for measles vaccination coverage.


According to him, measles vaccination coverage in 2016 was below the 95 per cent coverage target as Nigeria met 51 per cent coverage.


This is coming as the Lagos State Government on Monday similarly, disclosed that it planned to achieve 95 per cent target in the 2018 Mass Measles Campaign to protect enough children so as to reduce the burden of the disease.


The Lagos Measles Vaccination Campaign which started yesterday, March 15 is scheduled to end on March 29, 2018 in all health facilities in the state and designated posts in communities. Dr. Iyabo Aare, Permanent Secretary, Lagos State Primary Healthcare Board disclosed this during a Media Orientation Programme on Measles on Monday in Lagos.


Aare said that the measles campaign was targeted at immunising children from ages nine months to five years, as well as eligible children irrespective of previous vaccination history.


She said that during the previously measles campaign in 2015, the state met 86.2 per cent out of the 95 per cent coverage target. According to her, the state could not achieve optimal coverage due to some resistant groups including churches , mosques and estates where vaccinators were not allowed to vaccinate children within the area. ‘’This campaign is in collaboration with UNICEF, the World Health Organisation (WHO), the National Primary Healthcare Board Development Agency and other partners.


‘’This campaign is very important for our children to protect them from this killer disease to secure them because they are our future,’’ she said.


Speaking further, Nwosisi said measles vaccination coverage in 2016 was below the 95 per cent coverage target as Nigeria met 51 per cent coverage.


‘’A coverage that is less than 95 per cent means the missed children, meaning that the children with the virus can still transmit the disease to others. ‘’This 2017/2018 campaign has been tagged : ‘’Catch-up’’ campaign ; it is to mopup or reach children that have been missed over the years so as to meet the 95 per cent target coverage, ‘’ he said.


Dr.Olubunmi Akinlade, Immunisation Programme Officer , Lagos State, described measles as a dangerous disease caused by a virus and one of the leading causes of death among young children.


Akinlade said that measles could cause blindness, death and reduce a child’s ability to fight other diseases resulting in frequent illness.


‘’When a child shows signs of measles such as high fever, redness of eyes, running nose and rash; take the child to the nearest health facility immediately,” she said. Mrs. Modupe Owojuyebi, Director, Health Education, Lagos State Primary Healthcare Board, said it was important for children to receive measles immunisation during the campaign to be fully protected against measles.

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