Around my final year, one of my options for specialization was “Surgical Oncology”. However, doing House Job (HJ) I was able to rotate through Paediatrics Haemoncology, Gynecological oncology and General surgery – oncology and I most say, it wasn’t a sweet experience. I don’t know how many of my patients from those postings – over the last one year – are still living “an average stable life”. Its either they are dead or their health has deteriorated so badly.
Now, I’m torn between continuing on the line of my chosen specialty or not. Some of my colleagues would always say that my exposure to those oncology units was not by chance but all for a purpose – which could be as well for the purpose of warning me to stay away from anything oncology.
I can’t continue to manage patients, while waiting for their death daily. It’s draining and devastating but this is what oncology care has become here in Nigeria, maybe other countries would have better practice for physicians and to save lives.
This is because there are too many factors leading to our bad prognosis (outcome) in Nigeria, some of these include;
- Late presentation: When the lump or sign appears, the patient first neglect it, then go around self medicating, from chemist to home nurse to another chemist to spiritual home to church. They only come back to the hospital when the signs have escalated and gotten so bad, and there is no where else to go.
- Not giving consent or giving consent late: Some will not consent to the available options of management till it’s already very late and the management options can only achieve next to nothing for their case.
- Limited management modalities: Our modalities of management are very limited. Currently in Nigeria, how many centers in how many states can boost of doing consistent radiotherapy and or other oncological interventions? Very very few.
Truth is, part of the way to make this better is through rigorous health education on routine screening for any unusual growth/swelling and early presentation to actual healthcare facilities (hospitals) at the level of the communities, faith homes and religious houses; with investment by the government, well-meaning organizations and individuals into the oncology healthcare sector (especially for diagnosis and management of cancers), for readily available affordable care and accessible referrals.
About Author:
Dr. Caleb Anulaobi completed his Housemanship at the Federal Medical Centre, Umuahia.
