Breast cancer, a story of survivors

That fateful day, the sun stood still as the doctor read out her diagnosis. It was a malignant tumor in her breast; he referred to as “breast cancer”. “But how could this be,” she thought to herself as a lot of questions raced through her mind. “I am a health conscious person, living a healthy lifestyle, as a breastfeeding mother.”

As a nursing mother and healthy living enthusiast, Abuja-based Favour Etuke said her case stands as a reminder that breast cancer could happen to anyone.

But amidst scary narratives of breast cancer in the country, Weekend Trust in this report tells stories of women who have lived through it.

Breast cancer, according to a 2022 article on barriers to early presentation and diagnosis of breast cancer in Nigeria published by the Indian journal of gynaecologist oncology, is the most occurring cancer and cause of cancer-related deaths in women globally. It reports over 1.7million new cases and 18 per cent death yearly.

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This has left women to confront a fight far bigger than them.

Mrs. Favour Etuke, a middle aged mother, in an interview with Weekend Trust, narrated how she discovered a lump in her left breast six months into breastfeeding her youngest child.

After contacting her doctor, Favour said the physician, without prior examination, dismissed any chances of a lump, stating that it was not possible for a breastfeeding mother to have a lump, but assumed it was  milk coagulation ( liquid milk converted into a solid mass). 

But after a series of tests, it was confirmed to be cancer, she said.

On letting people know about her health status after being skeptical for a while, she said some of her family members and friends advised her to go for alternative treatment, as according to them, chemotherapy kills faster.

“Because I was desperate, I listened to them; I tried all kinds of alternative treatments, some even said they had different treatments for left and right breast, but the cancer kept getting worse; nothing changed,” she said.

She said after her oncologist advised and warned her  against delays, said she was still skeptical.

But chemotherapy being her last option after all failed alternative treatments, she decided to take it, saying, “even if it kills me at least I have tried all I could to save my life.

“I went through with the surgery; I did chemotherapy and radiotherapy, today I can say I am cancer-free.”

Sharing how her family members were her biggest motivation, Mrs. Favour Etuke said even though, it got to a time when she was no longer scared of death, she fought to live for her children’s sake. 

According to her, uncertain about her healing, she had anxiety, but what kept her was her obedience to the doctor’s instructions on things to do and what not to do, while undergoing treatment.  

Mrs. Gloria Chinyere  Okwu is another breast cancer survivor who has been battling the disease. She said she randomly discovered a lump close to her armpit in August 2016, and from that day, her life changed. 

“It took me seven months with different kinds of tests to be sure. In March 2017, I was diagnosed with cancer. I did the operation and had my breast removed.  After that, I was referred for further treatment at the National Hospital Abuja,” she said.

Mrs. Okwu said has been in and out of treatment since 2017. 

She said after she thought she was free, the cancer resurfaced in 2022; it spread to her bone; the liver and the lungs were also affected so as a result, she has remained on treatment.

Also speaking with Weekend Trust is Mrs Ruth Yonah, another breast cancer survivor with a unique case. She said she got to know she had breast cancer following a self-examination.

She said after a scan and biopsy test in Gombe, the result wasn’t clear, so she decided to visit Jos, Plateau State, with the sample, a test was carried out and it was cancer positive.

After she decided to go for the operation as advised by her doctor, she said she had all the necessary support she needed. 

“My parents and entire family where my support system; they encouraged and stood by me all through the journey. They told me not to be afraid that the period will be over,” she said.

She said after the operation, she went back to the hospital for a checkup, then the doctor advised her to go through chemotherapy. 

After chemotherapy, the doctors asked her to go for radiotherapy, but she refused, a decision that angered her doctor, according to her.

“Sometimes I take lemon juice, soursop and honey; those were the only things I took to keep my body fit,” she said. 

Mrs, Yonah said after a while, she went back to the hospital and she tested negative, and since then, she has been cancer free.

Post cancer battles

Mrs., Favor Etuke expressed concern for cancer survivors. She said most times, they are left on their own after six months to one year of routine checkup, except for those who have special relationship with their doctors that they can consult with.

Thriving beyond cancer, Mrs Favor Etuke said most survivors do not like coming out to say they survived breast cancer because people only care about the survivors sharing their stories to encourage and educate people during awareness campaigns, not to know how life is treating them after cancer.

Narrating the struggles, she said many women in Nigeria, who are going through or went through cancer battle, especially breast cancer, are stigmatised.

“Someone once called me half-human”, she said.  

She also said bouncing back to the world after cancer was another struggle. She said most times, people spend everything they have and would have nothing to return to after treatment.

Mrs Gloria Okwu also shared her struggles. She said a lot of factors triggered her anxiety.

“The cost of medication has gone up. I panic a lot from news of the deaths of many patients I knew. I have tried to be positive; I suppress my worry and the mental challenge that comes with the condition. I downplay those negative emotions that try to ruin my day. I live my life knowing that we are all going to die someday; cancer or not. I don’t want to stop living my life because of cancer,” she said.

Support group

Talking about forming a support community in Nigeria, Mrs Ukwu said sharing survival stories will go a long way to support other people.

“Remember, one in 8 women will have breast cancer; it is a pandemic, from what I have seen as a patient, a counselor and as a cancer advocate. Cancer has become a pandemic and unfortunately, it’s affecting young people who have so much to offer,” she said.

She pleaded with the government and the society at large to work together to support those on treatment and create awareness on preventive measures to reduce the risk of breast cancer and also provide an avenue of help those surviving breast cancer.

Mrs Etuke also said a lot of traumatising events happened during the process of treatment, adding that after surviving cancer, the trauma doesn’t just disappear. She said having a support group could help reduce the mental damage.

Understanding breast cancer

In Nigeria, breast cancer has become a devastating health challenge. As of 2018, Neolife report on most common cancer cases in Nigeria, said breast cancer is now the commonest malignancy affecting women. It added that it was likely to become an important public health issue in the next millennium. 

According to the World Health Organization (WHO) in its report on breast cancer, 2.3 million women were diagnosed of breast cancer in 2022 and it caused 670,000 deaths globally in the same year. Approximately 0.5 – 1 per cent of breast cancer occur in men which clearly shows 99 per cent occur in women, it added. 

Dr. Chinedu Simeon Aruah, a senior consultant in radiation, an oncologist, and former head of department at the National Hospital Abuja and senior lecturer at the College of Medicine, University of Abuja, said breast cancer is the most common female cancer globally.  In Nigeria, he said they predominantly see women with breast cancer at the National Hospital Abuja.

“Women should develop what is called health seeking awareness behavior. When they notice something abnormal in their body; they should quickly go to the hospital. There is the primary, secondary and tertiary hospital,” he said.

He said in Nigeria, the Federal Ministry of Health in 2021, created Cancer Health Fund (CHF) which six hospitals were used for testing, namely, Ahmadu Bello University Teaching Hospital (ABUTH), National Hospital Abuja (NHA), University of Benin Teaching Hospital, Benin (UBTH), Federal Teaching Hospital Gombe (FTH) the University of Nigeria Teaching Hospital (UNTH) and the University College Hospital (UCH). He said CHF is a social service aimed at providing health care services and funding to poor cancer patients.

Talking about symptoms, he said there are many signs and symptoms, but sometimes what they feel is painless breast lump, sudden discharge, change of breast texture, one breast becoming bigger than the other, or sometimes, swollen armpit. 

Meanwhile, he said some people do not notice any sign in their body but feel bone pain, “in that case, the cancer must have spread to the back”. 

“When the signs have advanced to such a level that the breast cancer is not a one entity, it is called heterogeneous, that is of multiple dimension. This can be classified into molecular level dividing it into hormone receptor positive, hormone receptor negative, then triple negative and each of them has different ways of responding to treatment.”

On how to prevent breast cancer, he said having babies at the age range of 20-30 gives excellent outcome, adding that at that point, a woman is no longer nulliparous (a female who has not given birth). He said breastfeeding, good dietary control, exercise, less exposure to unnecessary radiation are ways to prevent breast cancer.

He also advised women above 35 years to go for breast ultrasound and mammogram for screening.

Early detection/increased survival rate 

According to Research Gate in its 2023 report, the overall survival rate among Nigerian women with breast cancer is low, but patients with early breast cancer detection tend to have better survival chance than those with advanced disease. The research showed that the survival rates for breast cancer in Nigeria were 68.8% at one year, 50% at three years, 33.3% at five years, and 11.1% at ten years.