‘Two per cent of men’s deaths in Nigeria caused by tobacco’

At least two per cent of all deaths of men in Nigeria every year is related to tobacco use, a new global report has shown.

 The 2012 Tobacco Atlas said this is the most preventable cause of death in the country and globally.  $591 million is lost annually by the country to tobacco use in terms of health care and related expenses. Besides, it shows that Nigerians smoke about 17 billion sticks of cigarette annually. 

The Atlas, which is the world’s most comprehensive analysis of tobacco related activities, shows that 21.7 per cent of youths are exposed to second hand smoke in their homes and as such are at risk of cancer and other allied diseases. 

Girls who use tobacco are put at 1.3 per cent, while boys, between ages 13 and 15 who use tobacco, stand at 5.6 per cent. The percentage of men who use tobacco is put at 8. 

Experts say if this trend continues,  the country will soon be dealing with a tobacco epidemic.  A tobacco control activist, Akinbode Oluwafemi said: “ This madness must be stopped before it consumes more people. Imagine the number of people dying annually from the killer products of the tobacco giants. This sure must stop, and a way of doing that is to have the Tobacco Control Bill signed into law and implemented.”

Akinbode added: “We have to prevent a situation where Nigeria will become Europe or America where at least 20 per cent of all male deaths have been blamed on cigarette smoking. In China, tobacco use is the number one killer, causing 1.2 million deaths annually and this is expected to rise to 3.5 million deaths annually by the year 2030. We must not get to this state.”

The report said last year, tobacco use killed about six million people globally, with nearly 80 per cent of these deaths in low- and middle-income countries such as Nigeria. It shows that the industry realises almost $6,000 (Sh498,000) in profit for each death caused by tobacco. 

President, American Cancer Society (ACS) John Seffrin said tobacco giants’ activities in countries like Nigeria calls for concern. Seffrin said they are already growing in developing countries. “We can no longer deny or accept the massive human and economic harm costs by tobacco,” he said.

Chief Executive Officer, World Lung Foundation Peter Baldini  said:”The tobacco industry thrives on ignorance of the true harms of tobacco and using misinformation to subvert health policies that could save millions.” 

The high number of deaths has made the WHO recommend higher cigarette prices to make them unaffordable to children and make the habit expensive for regular smokers. 

A professor of Obstetrics & Gynaecology at the University of Benin, Edo State, Friday Okonofua, said: “Indeed, the rising cases of cancer deaths in Nigeria is becoming a national embarrassment, It is my considered opinion that the government needs to develop a comprehensive policy on cancer prevention and treatment, and set up an emergency task force to implement the related plan of action. Such a policy must be hinged on the tripod of the prevention of cancers, early recognition of the disease and prompt treatment. We must go back to the days of Professor Olikoye Ransome-Kuti when he emphasized the importance of preventative health care. I dare say, our failure to heed his advice has continued to plague our health care system and is the major reason for the continued under-performance of this country in key health indicators.”

The Atlas, produced by the ACS in partnership with  the World Lung Foundation and endorsed by the WHO, noted:  “Worldwide, smoking causes almost 80 per cent of male and nearly 50 per cent of female lung cancer deaths.

 “Uniquely among cancer-causing agents, however, tobacco is a man-made problem that is completely preventable through proven public policies.  These cost-effective policies are among those included in the WHOs Framework Convention on Tobacco Control, a global treaty endorsed by more than 174 countries.”

By Olukorede Yishau,

WHO, rights' groups take on 'Big Tobacco' over smoking

• Two new reports released yesterday in Singapore by the Tobacco Atlas  and the Tobacco Watch Monitoring Countries’ Performance on the Global Treaty, reveal how tobacco companies in Nigeria and other countries lure people to smoke and die slowly, reports OLUKOREDE YISHAU in Singapore

Which does the world prefer: tobacco or health? Expectedly, the global community settled for health, but tobacco companies are doing all they can to lure more people into smoking.  

A report released yesterday by the Tobacco Atlas and Tobacco Watch Monitoring Counties Performance on the Global Treaty painted a graphic picture of the tobacco epidemic, and the progress that has been made in tobacco control.  The report also highlighted the latest products and tactics being deployed by the lucrative tobacco industry such as the new meida, trade litigation and aggressive development of smokeless products to roast control .

These are contained in the Fourth Edition of the Tobacco Atlas unveiled yesterday by the American Cancer, Society (ACS) and World Hung Foundation at the 15th World conference on Tobacco or Health (WCTH) in Singapore.  Before the report was unveiled. 

Akinbode Oluwafemi, director in charge of Corporate Accountability at the Environmental Rights Action (ERA), who is attending the conference, told  reporters at a seminar organised by the Campaign for Tobacco Free Kids (CTFK), that statistics suggests that less people in Nigeria and the rest of Africa smoke cigarett, adding: “This should be good news, but tobacco giants are using this to advantage by focusing attention in Nigeria and the rest of Africa because they are facing heat in the developed world.”

His observations are supported by the Tobacco Atlas  report. The Tobacco Atlas puts the cost of tobacco smoking to the Nigerian economy in terms of losses to treatment and low productivity at $591m annually. It said 17 billion cigarettes are produced in the country annually and showed that more people are getting into tobacco use. 

The Tobacco Atlas said the burden of tobacco cultivation, consumption, illness and death is moving from developed to developing parts of the world and is taking an increased toll on low and middle-income countries to the extent that nearly 80 percent of those who die from tobacco-related illnesses are in low and middle-income countries.

According to the Tobacco Atlas, estimates of revenues from the global tobacco industry likely approach a half trillion U.S. dollars annually. In 2010, the combined profits of the six leading tobacco companies, the British American Tobacco (BAT), which is the market leader in Nigeria, Phillips Morris International, and others, was U.S. $35.1 billion. This, noted the report, is equal to the combined profits of Coca-Cola, Microsoft, and McDonald’s in the same year. 

A statement by ACS said: “If Big Tobacco were a country, it would have a gross domestic product (GDP) of countries like Poland, Saudi Arabia, Sweden and Venezuela.”

The statement added: “In 2011, according to the Tobacco Atlas, tobacco use killed almost six million people, with nearly 80 per cent of these deaths occurring in low and middle-income countries. When considering 2010 deaths with tobacco industry revenue, the tobacco industry realises almost $6,000 in profit for each death caused by tobacco.

“If trends continue, one billion people will die from tobacco use and exposure during the 21st century –one person every six seconds. 

Globally, tobacco-related deaths have nearly tripled  in the past decade, and it is responsible for more than 15 percent of all male deaths and 7percent of female deaths. Tobacco is also a risk factor for the four leading non-communicable diseases (NCDs) –cancer, heart disease, diabetes and chronic respiratory diseases which account for more than 63 percent of global deaths, according to the World Health Organisation (WHO).

“Tobacco use is the number one killer in China, causing 1.2 million deaths annually; this is expected to rise to 3.5 million deaths annually by the year 2030. Tobacco is also responsible for the greatest proportion of male deaths in Turkey (38 percent) and Kazakhstan (35 percent), and the greatest proportion of female deaths in the Maldives (25 percent) and the United States (23 percent).

“Uniquely among cancer-causing agents, however, tobacco is a man-made problem that is completely preventable through proven public policies. Effective measures include tobacco taxes, advertising bans, smoke-free public places, mass media campaigns and effective health warnings. These cost-effective policies are among those included in the WHO’s Framework Convention on Tobacco Control (WHO FCTC), a global treaty endorsed by more than 174 countries, and recommended by the WHO in its MPOWER policy package.”

The Tobacco Atlas shows that countries such as Nigeria, where tobacco giants operate, bear direct costs that arise from health care expenditures for treating smoking-related illnesses and indirect costs as a result of lost productivity and cost of premature deaths. 

Chief Executive of the ACS John Seffrin said: “We can no longer deny nor accept the massive human and economic harm caused by tobacco. This book is a vital tool for not only public health advocates, but also for governments, economists, educators and the media to use to tell the story of how a cohesive, well-funded tobacco industry is systematically causing preventable deaths and crippling economies. We know what needs to be done to counteract these tactics and save up to hundreds of millions of lives.” 

For the Chief Executive Officer of the World Lung Cancer Organisation,  Peter Baldinin, “The tobacco industry thrives on ignorance of the true harms of tobacco use and using misinformation to subvert health policies that could save millions. The Tobacco Atlas graphically illustrates the human toll and massive scale of the tobacco epidemic, breaking the best and most recent evidence out of the research world for an audience that can affect change. We urge advocates, media, governments and health professionals to visit tobaccoatlas.org website and use the available data to expose the deadly harms of tobacco and the industry that benefits from those harms.”

Another report released at the WCTOH, which paints the danger in the tobacco giants is the Tobacco Watch: Monitoring Countries’ Performance on the Global Treaty.

 The report accused BAT, Phillip Morris International and Japan Tobacco of blocking plans in their host countries  to control use of cigarettes.

The Framework Convention Alliance (FCA), which issued the report, said by blocking tobacco control plans, tobacco giants are increasing death rates associated with tobacco use. Tobacco use, said the report, is responsible for the death of nearly six million people annually, 70 percent of them in the developing world. It added that if current trends continue, one billion people will die of tobacco-related causes in the 21st century. The report documents activities in countries that are parties to the first global health treaty, the WHO-FCTC to interfere with regulations.

FCA Director Laurent Huber said: “For example, half of the national NGO partners that collected research indicated that the tobacco industry is running so-called corporate social responsibility (CSR) campaigns in their countries.

“Tobacco industry activities like those reported in Tobacco Watch do more than violate Article 5.3 of the FCTC: they impede progress on implementing all other measures in the Convention, which are proven to be effective and cost-effective.

“In fact, the Political Declaration of the United Nations NCD Summit recognised the key role of tobacco control in combating NCDs –which account for 60 percent of the world’s deaths and specifically recommended accelerating implementation of the FCTC.”  

 Yul Francisco Dorado of Corporate Accountability International said: “This year’s Tobacco Watch reminds us that the primary challenge the treaty faces is not a lack of political or public will, but a defiant, invasive and ultimately deadly industry. Ending tobacco industry interference is paramount to the success of the treaty at large.”

Oluwafemi said: “With more than 170 Parties, the FCTC is one of the most successful international conventions. It includes other specific steps for governments addressing tobacco use, including to:  adopt tax and price measures to reduce tobacco consumption; create smoke-free work and public spaces; put prominent health warnings on tobacco packages; and combat illicit trade in tobacco products. 

“The big tobacco are doing their best to ensure regulations are not enforced in line with the FCTC by using tactics hidden under Corporate Social Responsibility (CSR) to hoodwink people in government into toeing their way at the risk of the people’s health. These tactics include: partnership agreements between government and industry; industry-run programmes claiming to prevent youth smoking; and training for farmers.” 

 Tursan d’Espaignet of the WHO’s Tobacco Free Initiative, in a paper entitled: “Mortality Attributable to Tobacco- a Global Report,” said tobacco is the only legal drug that kills many of its users when used exactly as intended by manufacturers. He said: “Direct tobacco smoking kills five million people per year; second hand smoking kills 600,000 people per year, which means tobacco kills more than tuberculosis, HIV/AIDS and malaria combined.  If effective measures are not urgently taken, tobacco could, in the 21st century, kill over 1 billion people.”

No wonder WHO Director-General Dr. Margaret Chan, in a keynote address at the WCOTH, described tobacco smoking as a drive-by shooting capable of killing even by-standers.

By OLUKOREDE YISHAU 

World conference on tobacco holds in Singapore

The 15th World Conference on Tobacco or Health (WCTOH) will hold in Singapore next week.

The conference, which will start on Monday, will witness events such as a workshop for reporters from over 20 countries of the world.

The conference billed for the Singapore International Convention and Exhibition Centre will also witness the presentation of the  

 Distinguished 2012 Luther L. Terry Awards to nine tobacco control experts from Australia, Brazil, Canada, India, South Africa, and the United Kingdom  for exemplary leadership.

A statement by the American Cancer Society (ACS)  said: “The awards recognise outstanding global achievement in the field of tobacco control in six categories: outstanding individual leadership, outstanding organisation, outstanding research contribution, exemplary leadership by a government ministry, distinguished career, and outstanding community service.

“Australia’s Professor Michael Daube, will receive the Distinguished Career award; the Department of Health and Ageing of the Government of Australia will receive the award for Exemplary Leadership by a Government Ministry; Martin Raw, Ph.D., from the United Kingdom/Brazil and Yussuf Saloojee, Ph.D., from South Africa will receive awards for Outstanding Individual Leadership; the United Kingdom’s Action on Smoking and Health will receive the Outstanding Organization award; Canada’s Prabhat Jha, M.D., D.Phil., and Melanie Wakefield, Ph.D., of Australia will receive awards for Outstanding Research Contribution; and Mira Aghi, Ph.D., from India and Stan Shatenstein from Canada will receive awards for Outstanding Community Service.”

 ACS’s Chief Executive Officer John  Seffrin said: “We are pleased to recognise these exemplary individuals who carry on the noble and incredibly important work of ending the deadly spread of tobacco around the globe.

 “The existence of a global tobacco treaty – the Framework Convention on Tobacco Control–covering 90 percent of the world’s population would have been unthinkable in 1964, and would have not become reality had it not been for the outstanding leadership of exceptional individuals and organisations like those receiving this distinguished award.”

The awards are named for the late United States Surgeon General . He identified tobacco use as a cause of lung cancer and other illnesses.

Olukorede Yishau

Reducing Tobacco-Related Deaths

By Ozioma Ubabukoh

African nations seem poised to undergo the highest increase in the rate of tobacco use among developing countries, and nearly 90 per cent of people on the continent, perhaps, remain without meaningful protection from second-hand smoke, according to a new report released at a regional conference recently.
The report, ”Global Voices: Rebutting the Tobacco Industry, Winning Smoke-free Air”, however, tend to point to signs of hope. Several African countries are fighting against the tobacco industry‘s aggressive campaigns to stop public health interventions by putting smoke-free laws into place, probably protecting more than 100 million more people since 2007. This report was published by the Global Smoke-free Partnership.
Recent data suggest that, with current trends, more than half of the region of Africa may double its tobacco consumption within 12 years. And to check this, ”Smoke-free public places are one example of a low-cost and extremely effective intervention that must be implemented now to protect health”, said Dr. Otis W. Brawley, chief medical officer of the American Cancer Society.
In about less than two years, Kenya and Niger Republic have enacted national smoke-free policies, and South Africa, which has been smoke-free since 2007, according to reports by environment reporters, has been termed to play an important role in the region, demonstrating that smoke-free laws could work in Africa. In what seemed as a first for the region, Mauritius recently passed a law that is close to meeting the Framework Convention on Tobacco Control standards, ranking among the most robust anti-smoking measures in the world.
According to the American Cancer Society monitoring team report, implementation remains a challenge in many places, including the Democratic Republic of Congo, Ghana and Uganda. Even with the ban placed on smoking in public places in Abuja, the nation‘s federal capital, in 2008, by its former minister, Alhaji Aliyu Umar Modibbo, the city is seen as most vulnerable to the campaign of ensuring a smoke-free society.
”In Abuja, Nigeria, for example, 55 per cent of school students are not aware that second-hand smoke is harmful to health, and only 1 per cent of Nigeria‘s population is protected by strong smoke-free laws”, the report said.
It also exposes the tobacco industry‘s tactics to hold back legislation and convince African governments that tobacco is important to economic activity; that raising taxes on cigarettes and implementing smoke-free laws will result in revenue and job losses. In Kenya, for instance, it was reported that the tobacco industry issued a legal challenge to a smoke-free law passed by the Parliament. In Zambia equally, the British American Tobacco company has been accused of aiming to dilute proposals for a smoke-free law.
Some people have alleged that the campaign against tobacco smoking, especially in Nigeria, seems to be hindered by some journalists who would rather comment on any other health issue, no matter how agonising, than report or write on the dangers of smoking cigarettes.
According to them, some journalists are of the belief that the best writers are those who smoke and drink. And they have passed this notion to the younger ones planning to take up a career in journalism.
The National Coordinator, Nigeria Tobacco Control Alliance, Mr. Akinbode Oluwafemi, said this might be responsible for deaths of more journalists from tobacco-related ailments.
Oluwafemi, who is also the Programme Manager, Environmental Rights Action and Friends of the Earth, Nigeria, said, ”For how long are we going to be silent? Several Nigerian journalists and activists are aware that they are dying from cancer of the lungs and tobacco-related ailments, yet they have kept the stick burning. On most occasions, they lead the campaign against smoking, and immediately after that you find them lighting the stick. We have lost the likes of Steve the sleek Kadiri, Momoh Kubanji, Yinka Craig and Beko Ransome Kuti to tobacco smoking.
”Cancer control programme should be linked to tobacco control. Journalists should lead on awareness creation. It is time to be open about our friends, brothers and sisters dieing of tobacco- related cancers. Let‘s support the passage of the national tobacco control Bill.”
It is estimated that in 2010 smoking will claim the lives of six million people worldwide, 72 per cent of whom reside in low and middle-income countries, Nigeria inclusive. If current trends continue, tobacco will kill seven million people annually by 2020 and more than 8 million people annually by 2030.

SOURCE

15 cigarettes: all it takes to harm genes

-Steve Connor

Study reveals the genetic mutations suffered by smokers who go on to develop lung cancer

One genetic mutation occurs on average for every 15 cigarettes that a typical lung-cancer patient smokes, according to a study that has identified for the first time all of the mutations acquired during the lifetime of a cancer patient.

Scientists have completed a full genetic analysis of the genomes of cancer patients, and hope the information will lead to a fundamental understanding of the causes of cancer – and possibly drugs and treatments – by identifying the mutations that turn a healthy cell into a cancerous tumour cell.

They studied a lung-cancer victim who had built up about 23,000 DNA mutations in his lung cells that were linked with exposure to the toxins found in cigarette smoke and had accumulated over his lifetime.

They also looked at a patient with malignant melanoma, the most dangerous form of skin cancer, who had acquired 30,000 specific genetic mutations known to be associated with exposure to sunlight.

Scientists believe this new insight into the genetics of cancer will eventually lead to new drugs and tailor-made treatments that target the specific changes to the gene that help to trigger the disease, as well as new techniques for identifying secondary cancers that have evaded treatment in other parts of the body.

"For the first time, we have a comprehensive map of all mutations in a cancer cell," said Dr Peter Campbell of the Wellcome Trust Sanger Institute in Cambridge, which led the Cancer Genome project to decipher the entire DNA sequence of tumour cells in order to identify the mutations.

"The profile of mutations we observed [in the lung-cancer patient] is exactly that expected from tobacco, suggesting that the majority of the 23,000 we found are caused by the cocktail of chemicals found in cigarettes. On the basis of average estimates, we can say that one mutation is fixed in the genome for every 15 cigarettes smoked," Dr Campbell said.

The study, published in the journal Nature, involved the sequencing of the entire genome of a lung-cancer cell 60 times in order to be sure that all of the smallest mutations were identified. The scientists then compared the genome sequence with that of a healthy cell taken from the same patient.

A similar procedure was performed on the cells of a patient with skin cancer, which is how the researchers were able to show that the malignant skin cells contained changes that resulted from exposure to ultraviolet light, said Professor Mike Stratton at the Sanger Institute.

"These are the two main cancers in the developed world for which we know the primary exposure. For lung cancer it is cigarette smoke, and for malignant melanoma it is exposure to sunlight," Professor Stratton said.

"With these genome sequences, we have been able to explore deep into the past of each tumour, uncovering with remarkable clarity the imprints of these environmental mutagens [mutation-causing agents] on DNA, which occurred years before the tumour became apparent," he said.

SOURCES 1, 2 ,3 , 4 , 5

Revolutionary case against tobacco use in Nigeria

-Alexander Chiejina

…Tobacco control bill yet to be passed by National Assembly Without a doubt, the health, economic, social, and environmental consequences of tobacco use in Nigeria and the continent are enormous.
Little wonder the World Health Organisation (WHO) recently revealed that African countries are experiencing a 4.3 percent annual increase in the rate of tobacco consumption. This has resulted in an upsurge of lung cancer and related cases which are now prevalent in the society.
It was against this background that experts, at a recent training for health reporters on cancer reporting organised by Journalists Advocacy on Tobacco and Health held recently at Ogba, Lagos urged that the trend should be checked.
Speaking at the event, Akinbode Oluwafemi, programme manager, Environmental Rights Action/Friends of the Earth (FoEN), noted that tobacco smoking is responsible for more than 85 percent of lung cancers. This, he explained, is because smoking-related cancer accounts for 30 percent of cancer-related deaths, adding that renowned journalists in the country like Steve Kadiri, Yinka Craig, Momoh Kubanji, Tina Onwudinwe and Beko Ransome Kuti lost their lives due to the health hazards associated with the consumption of cigarettes.
“Research findings have it that there are about 599 approved additives in a stick of cigarette. However, cigarette smoke has been proven to contain over 4000 toxic and cancer causing chemicals; carbon monoxide, nitrogen oxides, hydrogen cyanide, ammonia, to name but a few,” Oluwafemi disclosed. According to him, cigarette advertising, promotion and sponsorship such as ‘Welcome to London, cool feeling’ have made cigarette smoking appealing to a lot of youths, without some of these tobacco companies apprising the public of dangers associated with smoking.
Lending his view, Tosin Orogun, programme manager, Communications and IT, Africa Tobacco Control Regional Initiative (ATCRI), declared that the rise in cigarette smoking in the society is traceable to tobacco companies which increasingly target the developing world as barriers rise and smoking rates fall in more mature markets. “What we (ATCRI) have been trying to do is to facilitate the adoption, implementation and enforcement of effective in-country tobacco control policies, legislation and programs in Nigeria and across the continent,”
Orogun revealed. Already, a 2009 report on the implementation of smoke-free environments aimed at combating Global Tobacco Epidemic shows that five more countries (Djibouti, Egypt, Islamic Republic of Iran, Malaysia and Mauritius) meet the best practices for health warnings on cigarette packages. Three other countries (Israel, Romania and the United Arab Emirates), meanwhile, offer comprehensive help in the drive to eradicate tobacco consumption. In the same vein, only Panama has joined the small group of countries that ban all forms of tobacco advertising, promotion and sponsorship, even as more than 90 percent of people lack protection from tobacco industry marketing. Six more countries (Czech Republic, Estonia, Fiji, Finland, the Netherlands and Seychelles) have levied tobacco taxes higher than 75 percent of retail price.
Lastly, of the world’s 100 most populous cities, 22 are smoke-free. Sadly, though, reports from the recently concluded media summit hosted by the American Cancer Society ahead of the AORTIC cancer in Africa, stated that 55 percent of school students are not aware that secondhand smoke is harmful to health, and only 1 percent of Nigeria’s population are protected by strong smoke-free laws. This lays bare the fact that if nothing is done to hastily check public smoking in the country, the rising figures of cancer and other non-communicable diseases may remain.
The bill to ban cigarette smoking in public places which had its public hearing before the National Assembly 19 July this year should quickly be passed into law. A part of the bill which seeks to protect people from secondhand smoke, raise taxes on tobacco, enforce a level of ban on tobacco advertising, promotion and sponsorship would in the long run, save Nigerians from self- inducing cancer types.

TOBACCO SMOKING - a sure way to contract LUNG CANCER

CANCER: Experts cite smoking as a cause

Time to nail breast cancer

By Olukorede Yishau

Betty Anyanwu-Akeredolu woke up one day and had no cause to feel anything was wrong with her. She felt great and naturally had no reason to believe anything was amiss with her health. Then, she decided to have her bath. And her world came crashing like a ceiling that caved into a severe storm. It was in 1997. As she was having her bath, her fingers touched something on her. A lump? She told herself it could not be. It was a denial she did not even believe herself. Her emotions ran riot and fear took over her entire being.
For one week, she kept it to herself. She could not share the fear that she had breast cancer with anyone. Not even her husband or family doctor. She was under terrific emotional trauma. Not even her husband’s belief that she was withdrawn could draw her out.
But an angel soon came. The angel came via the a cable show. According to her, "I tuned to cable TV and chose UK living and there was Rolanda’s show tilted "this programme can save your life." It surely did, for it was about breast cancer survivors. That programme gave me what I needed most at that point in time hope that I could be a survivor too. It was the greatest spiritual upliftment I have ever had in my entire life."
She said: "By the following week, I summoned courage and went to an Alumna (University of Nigeria), Dr. Ubah at University College Hospital, Ibadan for palpation. She at last confirmed the presence of a lump. Cold reality. Numb shock. What kind of lump? Benign or malignant? It was rather too early to conclude as biopsy was yet to be carried out. However, it is pertinent to mention that by the time of confirmation of the malignancy, I had gathered myself, shut out emotions and was ready for whatever it would take to make me free of the affliction. My emotional preparedness, I want to believe, helped a lot in dealing with the problem. Without delay, on April 29, 1997, I had surgery at the University College Hospital, Ibadan successfully performed by a most caring team of doctors led by Dr. O.O. Akute (FRCS- Fellow Royal College of Surgeons). The best part of the good news was that my cancer was at stage 1 with the axillary nodes free of cancer cells."
Thanks to Rolanda’s Show, Anyanwu-Akeredolu came out of her quietude. But there are thousands of women and men currently groaning in silence over breast cancer and other forms of cancer in different parts of Nigeria.
Many are confused and find themselves pacing up and down, with beads of perspiration forming beneath their collars. Anyanwu-Akeredolu, who after surviving her ordeal founded Breast Cancer Association of Nigeria (BRECAN), said it is not unusual for people to groan in silence.
"While in the hospital, I noted the generally high level of fear, apprehension and secrecy among breast cancer patients. Nobody wanted to talk about it. Majority of the patients, due to ignorance and poverty were at the late stages of the disease when little help could be given. The lucky ones who had successful treatment shied away from discussing their experience. They simply got treated and walked away with sealed lips. Some that I managed to engage in discussions disclosed that their husbands would never let them go public about their experience with breast cancer, apparently fearing stigmatisation," she said.
It is in order to stop the silence associated with breast cancer that the month of October has been set aside worldwide to create awareness about the disease. In Nigeria, where the pandemic is on the increase, non-governmental organisations working in the area of cancer have used the month to hold events aimed at improving the awareness about breast cancer, the need for government to provide test centers and treatment facilities. Some have also used it to promote the need for legislations, which promote healthy living.
Interestingly, the need to pass the National Tobacco Control Bill, which is before the Senate has also found a space this month. The Senate Committee on Health led by Iyabo Obasanjo-Bello has held a public hearing on it, after it passed the second reading. The passage of this bill automatically means a domestication of the World Health Organisation’s Framework Convention on Tobacco Control (FCTC), a global treaty which Nigeria has ratified and is obligated to domesticate. The FCTC prescribes measures that discourage smoking and promote healthy living.
Though the causes of breast cancer have not been conclusively found, tobacco use is associated with many forms of cancer and causes 90 percent of lung cancer. Tobacco smoke contains over fifty known carcinogens, including nitrosamines and polycyclic aromatic hydrocarbons. Tobacco is responsible for about one in three of all cancer deaths in the developed world, and about one in five worldwide.
This is why the Programme Manager of Environmental Rights Action (ERA), Akinbode Oluwafemi, said it was time the Senate passed the National Tobacco Control Bill.
Akinbode told a press conference that "nobody at the public hearing, including tobacco industry lobbyists contended the lethal consequences of smoking."
He said: "Tobacco currently kills over 5.4 million people annually, over 70 per cent of those deaths occur in developing countries. Also, nobody at the public hearing (again including the tobacco companies) objected to the passage of the bill. The tobacco companies only raised a few inconsequential and unsubstantiated objections to a few provisions. Those objections were roundly defended through our presentations.
"In addition, the Public Hearing was the biggest opportunity to unpack some of the lies being peddled in the media about possible negative consequences of the bill. The bill as appropriately titled is to control tobacco consumption so as to reduce the deaths, ill-health, social, economic and environmental costs associated with tobacco use. The bill has no provision about outlawing or forcefully closing down tobacco factories as being circulated in a section of the media. At the public hearing, the tobacco industry and their agents finally put paid to their widely peddled fairy tale of massive job losses if the nation implement effectives tobacco control laws."
He further explained that "In fact, the British American Tobacco Company Nigeria, the company which controls over 82 per cent of the Nigerian cigarette market, in its presentation at the public hearing, allayed all fears of massive job losses when it disclosed in the presence of distinguished Senators that it has 850 staff. To further debunk the massive job loss propaganda, the Association of Tobacco Wholesalers and Association of Tobacco Retailers put their combined staff strength at about 4,000. Thanks to the public hearing and the Senate Committee on Health, Nigerians now know for a fact that the 300,000 or 500,000 job propaganda is huge lie."
He said the only way forward is that "Senator Obasanjo-Bello and members of the committee should fire at full speed to present the Bill before the Senate plenary. We urge the Senate to complement the success recorded by the Health Committee and the example shown by the Osun State House of Assembly by fast tracking the National Tobacco Control Bill. Nigerians are dying by the seconds due to tobacco addiction while tobacco manufacturers smile to the banks. Every delay is more deaths, more ill-health. Nigerians and indeed the entire world are watching. We are waiting."
While the waiting game continues, experts have pointed out that though women may be more affected, but breast cancer is not exclusive to women. In fact, experts say it kills men faster because they are flat-chested. Statistics from the Nigerian Institute of Medical Research (NIMR) shows that men account for 20 percent of cancer cases in the country. This means one in every hundred men, as against two in every hundred women, are affected by breast cancer.
The statistics are generally glooming. Of all cancer cases that have been recorded in Nigeria, breast cancer is the leading killer, with over 30,000 cases recorded annually. Globally, not less than 400,000 women are lost to breast cancer annually.
No wonder the Executive Director of International Union Against Cancer, Isabel Mortara, said "each year, the number of women diagnosed with breast cancer and dying from it rises and the gap in survival rates between developed and developing countries widens."
It is for this reason that Anyanwu-Akeredolu said: "Cancer in general is a word that strikes fear into the heart of everyone. It is a sure killer if allowed to take control."
Another breast cancer survivor and promoter of Bloom Cancer Care and Support Centre, Dr. Kofoworola Orija, said "our personal experience of breast cancer is indeed a social issue. Every woman battles through her disease so as to bounce back in life striving to be part once more of an inclusive society."
For breast cancer patient, there are stages of cancer, which basically indicate how far cancer cells have spread within the breast to nearby tissue and other organs. Carcinoma in situ refers to the condition when cancer is static in the ducts and has not spread to other organs of the body. It has two types known as Lobular Carcinoma in Situ and Ductal Carcinoma.
Stage 0 is that stage when the cancer cells are still within the duct. By the time it gets to stages 1 and 2, the cancer has invaded nearby tissue. At stage one, the cancer is two centimetres and once it has gone beyond two centimetres, it has entered the second stage and might have spread to the lymph nodes under the armpit. At these two stages, it is not yet critical.
The critical stages begin from stage three when the cancer has grown beyond five centimetres and have spread to the lymph nodes. It is also possible that it would have spread to the chest wall, inside the chest and the skin.
As for stage four, the cancer has invaded the lungs and the bones, aside spreading to the lymph nodes. Both stages three and four are critical.
As a way of catching the lump early and killing it, the American Cancer Society (ACS) recommends annual mammogram from age 40. Mammogram is a test carried out to detect lump. ACS also recommended clinical breast examination every three years for women in their 20s and 30s and older. Also, it advises women to know how their breasts normally feel and report any change to healthcare providers. "Women at risk should talk with their doctors regularly about the benefits and limitations of starting mammography earlier, having additional tests or having more frequent exams," the ACS recommends.
It also prescribes breast self-examination (BSE) for women starting from their 20s.
BSE, says Ebunola Anozie, who is the co-ordinator of Care Organisation Public Enlightenment, is the primary weapon through which cancer can be detected early.
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