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Prevention, Detection, Care For Cancer (II)

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Minister of Health, Dr. Isaac Adewole

Minister of Health, Dr. Isaac Adewole

This is the concluding part of this article first published on the 10th of February, 2016

According to the latest
analysis released on World Cancer Day by Cancer Research, United Kingdom, cancer death rate has fallen by almost 10 per cent in the last 10 years. In 2013, 284 out of every 100,000 people in the UK died from cancer – around 162,000 people. A decade ago, this was 312 in every 100, 000. Similarly, the World Hepatitis Alliance said that 80% of liver cancer deaths can be prevented, saving hundreds of thousands of lives each year globally, and called for the establishment of comprehensive hepatitis strategies to help prevent the 800,000 liver cancer deaths each year.
While marking the World Cancer Day, The Hope Light Foundation launched the “Beacons of Hope” project to unite lighthouses throughout the world to work together in the fight against cancer, just as the Irish Cancer Society used the occasion of the celebration to call on the public to support its message: “We can shape policy change” by working with influencers to close the cancer gap.
The Health and Environment Alliance (HEAL), also called on Europe’s most influential cancer societies to urge governments to put an immediate ban on glyphosate, a chemical used as a herbicide. In a letter sent on World Cancer Day, HEAL’s President, Dr Peter van den Hazel, reminded leading national cancer groups that a ban on glyphosate represents a significant opportunity in cancer prevention.
In Nigeria, a litany of events have been held in different cities, including Port Harcourt, Lagos, Abuja, Enugu, Asaba, and elsewhere, to draw attention to the rampaging effects of cancer, and how, as a people, we can prevent its spread through early testing, detection, treatment and care. More events are still being organized to enhance public awareness on the disease.
At an event in Abuja, National Coordinator, Cancer Control Programme, Dr Ramatu Hassan, said that the Federal Government has concluded plans to upgrade the programme to National Agency for Control of Cancer. In addition, Chairman, National Committee on Cancer Control, Prof Francis Durosinmi-Etti, emphasized the need for more private-public partnership to boost access to cancer care across the country. Both also called for greater awareness amongst Nigerians of the urgency for concerted action to curb the menace of cancer in our national life by committing to early preventive care, testing, detection, treatment and support for survivors.
In Rivers State, Chief Medical Director, Hospitals Management Board, Dr Dorathy Oko called for synergy among all stakeholders to increase awareness, boost testing and detection, and encourage requisite treatment, further stressing that there was need to use knowledge to demystify cancer. She listed free cancer screening and testing centres in the state to include the Braithwaite Memorial Specialist Hospital (BMSH) and University of Port Harcourt Teaching Hospital (UPTH).
For the avoidance of doubt, it is important to note the link between lifestyle and cancer risk. According to WHO, four non-communicable diseases (NCDs) – cancers, cardiovascular diseases, respiratory diseases and diabetes – are responsible for 80% of all deaths from NCDs worldwide. This is despite the fact that there is a clear link between lifestyle and non-communicable diseases. Indeed, about a third of the most common cancers can be prevented through diet, maintaining a healthy weight and taking regular physical activity. Therefore, behaviour change is key to the prevention and control of non-communicable diseases, particularly as the number of cancer cases are expected to rise globally over the next two decades.
However, there are 10 cancer prevention recommendations generally accepted by experts globally. There cover body fatness; physical activity; foods and drinks that promote weight gain; plant and animal foods; alcoholic drinks; preservation, processing, preparation; dietary supplements; breastfeeding; and cancer survivors.
The first is to be as lean as possible without becoming underweight. In fact, research shows that there is strong evidence that weight gain, overweight and obesity increases the risk of a number of cancers, including bowel, breast (postmenopause), prostate (advanced cancer), pancreatic, endometrial, kidney, liver, gallbladder, oesophageal (adenocarcinoma) and ovarian cancers. Therefore, maintaining a healthy weight – through a balanced diet and regular physical activity – helps reduce the risk of developing cancer. Thus, ensure you are as lean as possible within the normal range of body weight. It is vital to ensure that your median adult body mass index (BMI) is between 21 and 23, depending on the normal range for different populations. Also ensure that body weight through childhood and adolescent growth projects towards the lower end of the normal BMI range at age 21. Maintain body weight within the normal range, and avoid weight gain and increases in waist circumference throughout adulthood.
The second is physical activity. Experts advise physical activity for, at least, 30 minutes every day. Be moderately physically active, equivalent to brisk walking, for at least, 30 minutes every day. As fitness improves, aim for 60 minutes or more of moderate, or for 30 minutes or more of vigorous, physical activity every day. Limit sedentary habits such as watching television.
The third is to avoid foods and drinks that promote weight gain. In fact, it is necessary to limit consumption of energy-dense foods, especially foods that are high in fats and/or have added sugars and/or low in fibre) and avoid sugary drinks. Ensure that the average energy density of diets are lowered towards 125kcal per 100g, just as you consume energy-dense foods sparingly, particularly “fast foods”, if at all.
The fourth is to eat more of plant foods, especially a variety of vegetables, fruits, whole grains, and pulses such as beans. Specifically, it is advised to eat, at least, five portions/servings (at least 400g or 14oz) of a variety of non-starchy vegetables and of fruits every day. Eat relatively unprocessed cereals (grains) and/or pulses (legumes) with every meal, and of course, limit refined starchy foods. However, those who consume starchy roots or tubers as staples should also ensure intake of sufficient non-starchy vegetables, fruits, and pulses (legumes).
While the fifth is to avoid animal foods, and if not possible, limit consumption of red meats (such as beef, pork and lamb) and also avoid processed meats, the sixth suggests drastic reduction in the intake of alcoholic drinks. In fact, if alcoholic drinks are to be consumed at all, limit consumption to no more than two drinks a day for men and one drink a day for women.
It is also necessary to limit consumption of salt and avoid mouldy grains and cereals, by limiting intake of salty foods and foods processed with salt (sodium). Minimise exposure to aflatoxins from mouldy cereals (grains) or pulses (legumes). Particularly avoid salt-preserved, salted, or salty foods; preserve foods without using salt, and limit consumption of processed foods with added salt to ensure an intake of less than 6g (2.4g sodium) a day.
Furthermore, do not use dietary supplements to protect against cancer, but aim to meet nutritional needs through diet alone. This is because dietary supplements are not recommended for cancer prevention. Also, breastfeeding is best strategy to prevent cancer. It is best for mothers to breastfeed exclusively for up to 6 months, and then, add other liquids and foods as complementary thereafter. Reasons: Breastfeeding protects both mother and child from diseases, including cancer. Lastly, after treatment, cancer survivors should strictly follow the recommendations for cancer prevention, and ensure they receive nutritional care from an appropriately trained professional. If able to do so, and unless otherwise advised, aim to follow the recommendations for diet, healthy weight, and physical activity.
To achieve a cancer-free society, therefore, it is vital that we inspire and take action; make healthy lifestyle choices; prevent cancer; understand that early detection saves lives; challenge perceptions; and ask for support. Besides, we must create healthy environments; support others to overcome; help improve access to cancer care; take control of our individual cancer journey; help build a quality cancer workforce; pursue love, and be loved; and mobilise our networks to drive progress. We also have to have confidence in ourselves; work assiduously to shape policy change; return to work when we are fit; make the case for investing in cancer control; share our story; work together for increased impact; and speak out against those things that promote cancer epidemic.
Let’s go for counselling, and follow up with testing. That will enable detection, treatment and care that we desperately desire.
Susan Serekara-Nwikhana

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‘How Micro RNA Research Won Nobel Prize’

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Two United States scientists who unraveled the human micro RNA have won the Nobel Prize in Physiology or Medicine 2024.
Victor Ambros and Gary Ruvkun won the coveted  prize for their work on microRNA as their discoveries help explain how complex life emerged on earth and how the human body is made up of a wide variety of different tissues.
MicroRNAs influence how genes – the instructions for life – are controlled inside organisms, including humans.
Every cell in the human body contains the same raw genetic information, locked in our DNA.
However, despite starting with the identical genetic information, the cells of the human body are wildly different in form and function.
The electrical impulses of nerve cells are distinct from the rhythmic beating of heart cells. The metabolic powerhouse that is a liver cell is distinct to a kidney cell, which filters urea out of the blood.
The light-sensing abilities of cells in the retina are different in skillset to white blood cells that produce antibodies to fight infection.
So much variety can arise from the same starting material because of gene expression.
The US scientists were the first to discover microRNAs and how they exerted control on how genes are expressed differently in different tissues.
The medicine and physiology prize winners are selected by the Nobel Assembly of Sweden’s Karolinska Institute.
They said: “Their groundbreaking discovery revealed a completely new principle of gene regulation that turned out to be essential for multicellular organisms, including humans.
“It is now known that the human genome codes for over 1,000 microRNAs.”

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WHO Begins Regulation On Antibiotic Waste

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The World Health Organisation (WHO) has begun acting to curb effects of antibiotic pollution.
The new guidance on wastewater and solid waste management for antibiotic manufacturing sheds light on this important but neglected challenge ahead of the United Nations General Assembly (UNGA) High-Level Meeting on antimicrobial resistance (AMR) taking place on 26 September 2024.
The emergence and spread of AMR caused by antibiotic pollution could undermine the effectiveness of antibiotics globally, including the medicines produced at the manufacturing sites responsible for the pollution.
Despite high antibiotic pollution levels being widely documented, the issue is largely unregulated and quality assurance criteria typically do not address environmental emissions. In addition, once distributed, there is a lack of information provided to consumers on how to dispose of antibiotics when they are not used, for example, when they expire or when a course is finished but there is still antibiotic left over.
“Pharmaceutical waste from antibiotic manufacturing can facilitate the emergence of new drug-resistant bacteria, which can spread globally and threaten our health. Controlling pollution from antibiotic production contributes to keeping these life-saving medicines effective for everyone,” said Dr Yukiko Nakatani, WHO Assistant Director-General for AMR ad interim.
Globally, there is a lack of accessible information on the environmental damage caused by manufacturing of medicines.

 

“The guidance provides an independent and impartial scientific basis for regulators, procurers, inspectors, and industry themselves to include robust antibiotic pollution control in their standards,” said Dr Maria Neira, Director, Department of Environment, Climate Change and Health, WHO. “Critically, the strong focus on transparency will equip buyers, investors and the general public to make decisions that account for manufacturers’ efforts to control antibiotic pollution.”

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Kebbi Harmonises Doctors’ Salaries To Curb Brain Drain

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In a concerted effort to curb brain drain, the Kebbi State Government has harmonised medical doctors’ salaries to be at par with their colleagues in the federal government’s tertiary health facilities.
Kebbi State Commissioner for Health, Musa Inusa-Isma’il, disclosed this at the handing over of ambulances to the state-owned health facilities at the Ministry of Health in Birnin Kebbi yesterday.
Inusa Isma’il, according to a statement by Ahmed Idris, the Chief Press Secretary to the governor, said the essence of the harmonisation was to retain the existing medical doctors and attract more to the services of the state.
According to him, the doctors across the state had already started enjoying the new salaries from August 2024.
He said the release of the vehicles was in fulfilment of Governor Nasir Idris’ promise to uplift health care services in the state.
“His Excellency said I should inform you, the beneficiaries of this gesture, that the vehicle should be strictly used for the intended purpose. It should not be used for anything else.
“If there is no referral case, each of the vehicles must be parked at the hospital by 6 pm. The governor said you should warn your drivers against reckless driving as well as violating the instructions.
“We should also do everything possible to reciprocate the gesture by working according to the terms and conditions attached,” he advised.
The benefiting health facilities included Sir Yahaya Memorial Hospital, Birnin Kebbi; State Teaching Hospital, Kalgo; General Hospital, Argungu; General Hospital, Yauri; General Hospital, Zuru; and General Hospital, Bunza.

 

 

In his speech, the permanent secretary of the ministry, Dr Shehu Koko, recalled that the ambulances were handed over to the ministry last Friday by the governor for the onward handover to the benefiting hospitals.
He observed that the ambulances would go a long way in improving the referral system in the state, adding that delays in reaching the secondary and tertiary facilities would be eliminated.
The permanent secretary attributed the high rate of maternal mortality in the country to delays in getting to the health facilities for proper medical care.
“We believe with the provision of these ambulances, part of the gaps we have in our referral system will be addressed, whereby patients who require secondary healthcare could be easily transported to secondary and tertiary health centres, where they can get such help,” he said.
In a goodwill message, Commissioner for Information and Culture Alhaji Yakubu Ahmed expressed gratitude to the governor for the support he has given to the ministry to excel.
While advising the beneficiaries to use the vehicles judiciously, the commissioner advised that services and maintenance of the vehicles must be prompt to derive the maximum benefits from the vehicles.
The commissioner also highlighted some achievements recorded by the government in the last year, including beautification of the state capital, completion of a multimillion-naira ultramodern state secretariat, road construction, construction and renovation of classrooms and upgrading of some health facilities, among others.

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