By Promise Eze
In 2018, Ugonna Okere, a 30-year-old professional makeup artist based in Abuja, Nigeria’s Federal Capital was diagnosed with breast cancer. It marked the lowest point of her life. “I was plunged into depression when the doctor told me I had triple-negative breast cancer. I just couldn’t believe my ears,” Okere said in an interview.
Hearing such life-altering news with no empathy from the doctor left Okere even more distraught.
“The doctor who broke the news to me was harsh. She didn’t take the time to explain what having cancer meant. She just told me that I either choose to go for chemotherapy or continue living with the illness, Okere recalled.
Breast cancer is the most common type of cancer, projected to become a ‘public health issue in the next millennium’. According to the National Cancer Institute, when cancer attacks its victim, it causes body cells to grow uncontrollably and spread to other parts of the body, which may cause tumor growth and without early treatment could result in death. This was Okere’s new reality. But her worst fears stemmed from not knowing what to expect and the lack of support from the doctor caused her to imagine death.
“Breast cancer, if allowed to fester, could lead to the death of its victim, says Dr. Oge Illegbune Lakeshore, a doctor at the Lakeshore Cancer Center, Lagos.
Describing the effect of cancer on humans, Dr illegbune explained that human beings are made up of cells, and the cells grow and die. But when someone has cancer, the cells begin to grow abnormally in the body.
She submitted that when a cancerous lump is detected early, the doctor may choose to remove it or cut off the breast partially or entirely to ensure that cancer does not spread and to save the life of the victim.
In Nigeria, it is reported that over 124,815 people were diagnosed with different forms of cancer in 2020. Of these numbers, it is estimated that 20,000 cancer patients are at risk of severe mental health disorders because of cancer diagnosis, and less than 2% of these patients have ever received any professional psychological support after cancer diagnosis and during treatment.
These mental health disorders may affect cancer treatment, as well as the quality of life. “Breast cancer may be a physical problem but when someone learns that they have the disease they are going to be troubled emotionally and mentally, especially in our society where cancer is seen as a death sentence.
“When people think of cancer they think of death, and this could prevent them from accessing treatment. They may think it’s not necessary to get treatment when they may die anytime soon,” Dr. Oge Illegbune said.
It is not just the fear of death that destabilizes the mental health of cancer patients. Cancer patients who have received a mastectomy ( the removal of the breast) suffer from physical and cognitive impairments, changes in body image and sexuality, fear of recurrences, economic stress, poor social support, and even stigma. Cancer-related stigma can badly affect their depression levels, according to a study.
Hope glitters in the dark
After almost losing all hopes of surviving cancer, Okere came in contact with Project Pink Blue, a nonprofit cancer organization that supports people battling cancer, sometime in 2019.
Okere told Social Voices that though she didn’t receive any financial assistance from the nonprofit she got mental health support that prompted her to begin proper treatments. She has now undergone radiotherapy and chemotherapy. These treatments are meant to destroy rapidly growing cells in the body.
Project Pink Blue providing psychological support, cancer awareness, free cancer screenings, patient navigation, advocacy, fundraising for cancer patients and cancer research is a direct response to the increasing cases of cancer in Nigeria.
In 2015 it launched the first patient navigation program in the country which is named the Breast Cancer Navigation Programme (BCNP). Under this programme, healthcare workers are trained to ensure cancer patients’ needs are effectively addressed, and so far it has trained 44 Nigerian healthcare workers.
It also launched a telephone support center for cancer care via which people can call in for information on cancer, referral on breast cancer diagnosis, treatment, palliative care, support and link up to breast cancer survivors.
However, providing free support to traumatized cancer patients is the main goal of the organization. This is against a backdrop of a country where about 75 percent of the people who need to access mental healthcare are unable to reach it as there is a shortage of clinical facilities.
“We provide mental succor to cancer patients because we realised that beyond treatment a cancer diagnosis can be mentally destabilizing. Some patients suffer depression and panic attacks which normal drugs cannot cure” said Gloria Okwu, the program coordinator of Project Pink Blue.
The nonprofit runs a support center led by clinical psychologists who offer one-on-one counseling with patients who are going through trauma. Periodically oncologists and doctors are invited to interact with people living with cancer. And interactive seminars are also held online from time to time.
‘The cancer support group is my lifeline
According to its records, Project Pink Blue has a support group with a strength of about 150 members. The group, known as the Abuja Breast Cancer Support Group, connects people impacted by cancer to support, educate, empower and propel each other to become champions.
The group also has a WhatsApp platform where cancer patients could share their burdens or worries. Members of the group sometimes raise funds for those who cannot afford treatment.
The support group has been a lifeline to many traumatized cancer patients, and one of them is Nwosu-Zitta Theodora.
Theodora lost her mom to cancer in 2016, a year after she lost her immediate younger sister to the same disease. But this was not the only close shave Theodora, a middle-aged Nigerian Immigration officer, had with the disease. In 2011 she too was diagnosed with cancer, and the news came as a shock to her.
“I started noticing a lump in my breast. A lot of people told me that it was normal but when I went to the hospital the diagnosis showed that I had breast cancer,” she recalled.
Even after undergoing a mastectomy—a surgery to remove all breast tissue from a breast as a way to treat breast cancer— in 2015, four years later cancer would spread to her upper arm. It was at this point in her fight against cancer that she found Project Pink Blue. And being a member of the support group helped her believe that there was hope for her to survive.
“I fought cancer alone for five years before I met the nonprofit. But when I joined the support group I met cancer survivors. We even play games once in a while. This fueled the hope of survival inside me. I have even remarried and I now have a four-year-old daughter,” Theodora, who now advocates for the rights of people living with cancer, said.
On how members of the support group are selected, Gloria Okwu told Social Voices that admission is free for everyone battling cancer.
But there are tons of challenges
The nonprofit is not spared of challenges, prominent of which is funding. “Funding is a big challenge because everyone who is battling cancer needs money to go to the hospital. And we usually don’t have enough money to sponsor cancer treatments in Nigeria,” Okwu said.
The cost of treatment is very expensive and not affordable for an average Nigerian.
Chemotherapy, a cancer treatment, costs between N600,000 to N1.5 million per session. Cancer drugs are also expensive, costing as much as N300,000 per month.
The Nigerian government’s response to cancer care is also not encouraging. The country reportedly has about 19 approved chemotherapy centers. But only four of the centers are fully functional.
Another significant challenge is convincing cancer patients that their mental health outcomes can affect their overall well-being. However, despite the plethora of limitations it faces the organization is bent on changing the way Africans think about cancer.
“Project Pink Blue has given us reasons to keep living,” said Gloria Orji, a cancer survivor and support group member.
Any Lessons to learn?
Providing mental health support will help cancer patients manage the anxiety and stress of their cancer diagnosis and treatments, navigate relationship concerns during the cancer journey, including communication and intimacy challenges, and coping with depression during cancer treatment and recovery.
There are a good number of organizations in Nigeria that make advocacy for cancer but Project Pink Blue is different because it focuses on psychological support centers for cancer patients. Cancer will not be a death sentence if people living with the illness are given the necessary support.
This story was produced in partnership with Nigeria Health Watch through the Solutions Journalism Network, a nonprofit organisation dedicated to rigorous and compelling reporting about responses to social problems.