By Jemi Ekunkunbor

Ebun Anozie is the  Chief Executive Officer at C.O.P.E., an organization she set up more than 20 years ago. She shares her vision and  fears o n the prevalence of Cancer.

How does C.O.P.E. operate and what do you offer people who come to you?
C.O.P.E. operates on the mission and goals of:
·               Eliminating breast cancer as a major health issue.
·               Enlightening and creating awareness about the dangers inherent in breast cancer in men and women in Nigeria through information, counselling, examination and early detection techniques.

Would you say there is greater awareness of cancer and how to treat?
Sure, there is greater awareness of breast cancer but we try as much as possible to encourage women to avail themselves monthly screening – from breast self-examination to clinical breast examination, breast ultrasound scan, mammogram and magnetic resonance imaging.  When we talk about treatment, it’s obviously not one size fits all, bearing in mind that cancer is an individual and capricious disease. The presentation will determine the type of treatment: whether surgery, chemotherapy, radiotherapy or immunotherapy. Gladly, new treatments are being invented in some developed countries which we use here as well.

Is there still a high rate of mortality or is there a reduction as a result of the activities of NGOs like yours?
Unfortunately, the mortality rate is relatively high due to late presentation but with breast awareness activities, women are getting educated about the disease. Thankfully, we have more NGOs creating the much needed awareness as well.
In the past, women shied away from this topic which was regarded as a taboo. By dint of hard work, controlled efforts and encouragement, our support group members openly talk about it which has drastically reduced stigmatization. Breast cancer is not a respecter of class, religion, sex or age. As long as you are a woman and getting older, one is at a risk. Predisposing factors come to play here.

Your organization recently screened 40 women. What was the outcome of that screening?
Every third Saturday of the month, we offer to women highly subsidized clinical breast examination and breast ultrasound scan from 10 a.m. to 2 p.m. This is to avoid congestion which also gives women a lee-way to screening due to different menstrual cycles; it’s quite affordable I must say.
The result of the screening session was discouraging which was of great concern to us because we have never had it this bad. Out of 40 women screened, 19 women were seen to have lumps in either or both breasts and more.
We were able to counsel and encourage them to do the needful as we are aware that not all lumps in the breast are cancerous. We should also take into cognizance that a lump has no business in your breast. If detected, should be probed by going for lumpectomy, a minor surgery which lasts not more than an hour under local anaesthesia. The lump is removed and sent to the laboratory for histology to determine the status; if it is benign or malignant.

Looking at the statistics, what does that tell you is happening now?
What it tells me is that women are being more aware which is a good thing but we need government’s intervention. We, unfortunately, have adopted and adapted to Western lifestyles.
From my little experience and data, one out of every 12 women is likely have breast cancer.
We seriously need to change our foreign orientation. Farming has always been a major source of our resources but it was badly neglected; we are hopeful that it will gradually pick up with government’s intervention. It is a country that does not have food in excess that will get involved in genetically modified organisms (GMO). GMO should not be encouraged in Nigeria. We need to go back to the basics and start investing in our local and original crops and food.
Most of these diseases have a lot to do with our diet. Processed foods have taken over the natural ones. Unfortunately, breast cancer is more prevalent in women in developed countries but the mortality rate is higher in the developing countries like ours due to late presentation and inappropriate medical care. Some of the factors are due to ignorance, fear of the unknown, illiteracy, religious beliefs, delays at the hospitals, poverty and much more.
We need to eat more fruits and vegetables, exercise, drink lots of water, stay away from stress and be forgiving.

Compare this outcome to 15 years ago. Should we be worried?
Honestly, we should be more than worried. Our health care system is abysmal, a total sham. It is crying for help. More than 15 years ago, we had dedicated doctors with well equipped facilities one would be proud of. One was assured that one’s problem was over at the mere sight of the doctor and hospitals were spick and span.
Doctors were dedicated and proud to be doctors. Government made sure they were properly remunerated. It was not dog eat dog and business as usual. Oh what a big shame! Sad to say, “a rich country with poor minds!”

How should this be tackled?
You are asking me for an unending answer. Let me give it a shot. There are so many ways to tackle this deadly disease. For instance, we are crying for 6 comprehensive cancer centres in Nigeria. This ‘political will’ syndrome should stop. Let us do the needful. Stolen monies are being recovered which can be put into good use.
It boggles the mind that we are in this mess. The Giant of Africa that does not have a functional radiotherapy machine to its name? Medical tourism is the order of the day while the nobodies can jump into the lake. Let us fear God and realize that what goes up must come down; no man is taking “nothing” when it is time.
In our own little way, with the support of a few companies and well-meaning Nigerians, we have, over the years, positively impacted on the lives of thousands of Nigerians by:

Increased Awareness Campaigns:
At the moment, C.O.P. E. is inviting companies or wealthy individuals to join us in taking a stand against the disease through a campaign called #THEBIG10 – to help raise awareness and early detection. Companies get to make an impact through corporate social responsibility by donating financially; women get vouchers to have a free clinical breast examination and breast ultrasound scan. These gift vouchers can be distributed to their members of staff or customers to show they care for their well- being.

What is your best armour against cancer?
Early detection and treatment.

What role has government played in ensuring that cancer is reduced in the country?
Absolutely nothing is being done. But I must give kudos to Lagos State Ministry of Health. They are trying despite the daunting issues they are facing as Lagos State is a cosmopolitan state. Thankfully, they partner with us occasionally.

What should be your treatment options from the moment of diagnosis in terms of steps to take?
Treatment options will depend on each presentation as it is an individual disease.

From your experience, what is the survival rate of victims?
There really isn’t a word like victims in terms of breast cancer. We refer to them as SURVIVORS. The definition of survivor varies. Some believe it is from the moment cancer begins or diagnosed. Some also say it is when curative treatment has been completed while others say you must have lived for 5 years or more beyond diagnosis.
If presented early, it can be cured and you will have the opportunity to treatment options or choices. Stages 1 and 2 are comfortable diagnosis with good prognosis. We need to bear in mind that cancer is a capricious disease and may recur anytime even after being given a “clean bill of health”.

Finally, a word for prevention and what to do quickly if diagnosed.
Go for regular screening, do your breast self-examination. Early detection and treatment can save your life and breasts.