Radiotherapy in Nigeria: the centres, the cost

Cancer treatment through radiotherapy in Nigeria

Cancer is an abnormal mass of tissues with an excessive and uncoordinated rate of growth.

Radiation therapy (radiotherapy) is a cancer treatment that uses radiation to kill cancer cells and shrink tumors.

Radiotherapy is the practice whereby ionizing radiation is administered to patients for the treatment of malignant diseases.

How radiotherapy works against cancer

At high doses, radiotherapy kills cancer cells or slows their growth by damaging their DNA. Cancer cells whose DNA is damaged beyond repair stop dividing or die. When damage cells die, they are broken down and removed by the body. Radiation therapy does not kill cancer cells immediately. It takes days or weeks of treatment before DNA is damaged enough for cancer cells to die. Then, cancer cells keep dying for weeks or months after radiation therapy ends.

common cancers in Nigeria that require radiotherapy as a form of treatment

Radiotherapy has a very useful role in the treatment of the following malignancies:

• cervical cancer
• vaginal cancer
• breast cancer
• uterine cancer
• endometrial cancer
• throat cancer (pharyngeal cancer)
• vulva cancer
• ovarian cancer
• fallopian tube cancer
• prostate cancer
• thyroid cancer
• bone cancer
• skin cancers

preparing for radiotherapy

Prior to commencement of radiotherapy, you will be properly worked up and the cancer staged both clinically and under anaesthesia if necessary. The treatment policy will depend on the stage of the cancer. The tumour volume will be well defined if possible with the aid radiological investigations like lymphangiography, tomograms, ultrasound and computerised axial tomography (CAT scan) so as to assess the size, site and extent of spread of the disease for the purpose of radiation planning. Biopsy must be done to confirm histological diagnosis.

Patients going to receive radiation treatment must be in a reasonably good nutritional state to be able to tolerate treatment well and a high hemoglobin level is essential as the effect of radiation is enhanced by good tumour oxygenation. The radiation response and survival rate are lower in those with low packed cell volume. Blood transfusion may therefore be carried out when necessary and any infection controlled as radiation treatment in an area of infection could lead to severe inflammation and sepsis.

side effects

During radiation treatment for cancers some patients will experience a few side effects which may occasionally lead to interruption of treatment if not controlled. These include skin reactions, vomiting, diarrhoea, radiation cystitis and proctitis. Good skin care, anti-emetics and in extreme cases intravenous fluid replacement will control these symptoms.

the cost of radiotherapy in Nigeria

Radiotherapy can be very expensive. It uses complex machines and involves the services of many health care providers. The exact cost of radiotherapy in Nigeria depends on the facility, the type of radiation therapy, the type of cancer, the number of doses, your clinical state, other treatments needed, drugs, admission (or outpatient), and how many treatments needed.

The National Health Insurance Scheme(NHIS) does not cover cost of radiotherapy treatment but you can utilize the scheme to cover medications, some investigations, blood transfusions, and hospital admission. This will reduce the cost burden on you.

A woman whose daughter had pharyngeal cancer said she paid N800,000 naira for 24 doses of radiotherapy in University College Hospital, Ibadan, Nigeria. This includes accomodation as she came from Edo State.

Another woman said she paid about N400,000 naira for 8 courses of radiation therapy for cervical cancer in Lagos University Teaching Hospital, Lagos, Nigeria.

A breast cancer survivor paid about N600, 000 for her radiation therapy in National Hospital, Abuja, Nigeria.

Radiotherapy centres in Nigeria

The practice of radiotherapy in Nigeria as with other developing countries is fraught with a considerable number of problems. they include lack of essential facilities for investigation and treatment of cancer patient and well trained personnel, inadequate cancer education, poverty and ignorance.

Nigeria, has only 7 radiotherapy machines for radiation treatment despite having an increasing number of citizens suffering from cancer.

There radiotherapy centres are located in:

• National Hospital Abuja
• University College Hospital (UCH), Ibadan
• Uthman Danfodiyyo Teaching Hospital (UDTH), Sokoto
• Lagos University Teaching Hospital (LUTH), Lagos
• Ahmadu Bello Teaching Hospital, Kaduna
• University of Benin Teaching Hospital (UBTH), Benin city, Edo
• University of Nigeria Teaching hospital( UNTH), Enugu
• Eko Hospitals, Lagos- the only private hospital that have facilities for radiotherapy in Nigeria

Sources

National cancer Institute