Understanding the Trajectory of Cancer Diagnosis and Treatment Delay in Nigeria (Published)
Despite the fact that cancer is one of the most important public-health issues in Nigeria, the poor survival rate is not due to the incidence of cancer, but the time interval between the onset of the first recognisable symptom and the initiation of definitive treatment. This paper argues that cancer diagnosis and treatment delay in Nigeria is a multi-faceted process, spanning the appraisal, help-seeking, diagnostic and treatment intervals, and that it is preventable if targeted interventions are coordinated and implemented at the intervals, instead of relying on incidence alone to drive messages. It collates and analyses literature from 2020 to 2026 from both the international and Nigerian context, and suggests that the major drivers to this advanced presentation of cancer in Nigeria are low symptom appraisal and cancer stigma, catastrophic out of pocket expenses and poor diagnostic and radiotherapy infrastructure which work synergistically. The paper argues that the nursing workforce, which is at each point in the chain of care, is the most practical and cost-effective way to shorten these delays, since they can be measured in terms of lives lost for every four-week delay in the process. It finds that formalised nurse navigation, improved oncology and palliative care skills, and increased health-insurance coverage and localised delay research are the key responses.
Keywords: Cancer, diagnostic delay, late-stage presentation. oncology nursing; Nigeria, treatment interval
The Social Issues among Adult Cancer Patients Attending Oncology Clinic at Moi Teaching and Referral Hospital, Eldoret, Kenya (Published)
Cancer diagnosis is associated with increased chance of developing social issues that impact on patient’s health state and medical treatment. The number of people diagnosed with cancer is on the increase every year in the developing countries with no exception of Kenya. The burden of cancer continues to grow. However, as much as social issues among adult cancer patients are well documented in the rest of the world, Kenya has little amount of data in place. A critical part of cancer care is the recognition of the levels of social problems that present among patients with cancer and determination of the appropriate form of intervention, ranging from brief counselling or social interventions and social support to medication and specific coping styles. This paper sought to determine the social issues among adult cancer patients seen at the oncology clinic of Moi Teaching and Referral Hospital (MTRH), Eldoret. Focus was on the social issues that are associated with cancer diagnosis and socio-demographic characteristics and clinical state of the patients diagnosed with cancer. This was a cross-sectional and descriptive study. The respondents included patients diagnosed with cancer who were enrolled and interviewed using researcher designed socio-demographic and clinical questionnaire and the Mini International Neuropsychiatric Interview for adults (M.I.N.I Plus) instruments. A total of 138 respondents participated in the study. The participants were assessed upon an informed consent and ethical approval from Institutional Research and Ethics Committee (IREC) Moi Teaching and Referral Hospital (MTRH) Moi University and Ethics and Research Committee Kenyatta National Hospital/ University of Nairobi.Microsoft excel worksheet and Statistical packages for social sciences (SPSS) version 16.0 were used for analysis. Females represented a higher number of cancer patients than male. Breast cancer and cervical cancer were the most common forms of cancer with most participants being in the advanced stages; between stage III and IV. Social phobia, obsessive compulsive disorder, generalised anxiety disorder, hypomanic episodes and manic episodes were the most observed social disorders.
Keywords: Adjustment, Cancer, Hormonal Therapy, Medical-Chemotherapy, Radiation Therapy, Social Support, Surgical