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