Michael Olatunde Oni is a professor of radiation and health physics and a former dean of the Ladoke Akintola University of Technology’s Faculty of Pure and Applied Sciences in Ogbomoso, Oyo State. He discusses what Nigeria should do to provide access to affordable cancer care in this discussion with SADE OGUNTOLA. He was requested to elaborate on this novel treatment approach because he is providing a fresh viewpoint on the fight against cancer. He claimed that because cancer affects people worldwide, a more radical approach is needed than what is currently being provided in Nigeria and Africa as a whole. Since the turn of the twenty-first century, there has been a significant advancement in cancer therapy in many industrialized nations with high Human Development Index ratings, making many diseases curable.
According to records, 63 percent of the 76 million cancer deaths that take place worldwide each year, including those in Africa, come from poor nations. The constant effort to advance existing facilities and treatment modalities, such as radiotherapy (RT), has advanced from 2D to 3D attainable in 1990; stereotactic RT, intensity modulated RT, image guided RT, in 2000; volumetric modulated arc therapy, tomotherapy, cyberknife, LINAC MR, and ion beam therapy, in 2020 – all to ensure a maximum radiation dose sufficient to cure cancer (OAR).
Radiation therapy remains an important component in cancer treatment.
Unfortunately, cancer treatment with dose conformity to imaging anatomic target in 3D/4D radiotherapy and OAR sparing is still relatively rare in Nigeria and other African nations. This is due to the fact that, with the exception of a relatively small number of private medical facilities, the treatment equipment still primarily uses 2D and 3D scales from the year 1990. It should be mentioned that radiation therapy, one of the main cancer treatment modalities, continues to play a significant role. About half of all cancer patients receive radiation therapy at some point in their illness, and RT accounts for 40% of cancer cures.
Insufficient RT centres around the globe demonstrate the lack of treatment facilities in Lower and Middle Income Countries (LMICs), including Nigeria and other sub-Saharan African countries. The expense of purchasing and maintaining the treatment devices and related software is one of the factors limiting RT resources. The treatment planning software is restricted and proprietary. He is advocating for the integration and/or adoption of open-access Monte Carlo (MC) simulation software that have been evaluated and benchmarked for use in radioprotection, treatment monitoring, and external and internal RT.
Will the treatment option be applicable to all cancer types?
Yes, if used effectively, this option can provide early cancer detection for all cancer types, imaging and dose planning, and treatment simulation with integrated quality control, assessment, and assurance for both external and internal RT. Chemotherapy and radiotherapy are still viable options. It aims to increase the availability and affordability of radiotherapy, and if the early detection mode of it is adequately harnessed and exploited, early and self-detection of tumors is conceivable with this option. If cancer is diagnosed early enough, it is curable.
Adoption of new technology can occasionally be hampered in many developing nations by issues with electricity, machine cost, and manpower. Does this alternative, in your opinion, have a chance of being implemented in Nigeria? The difficulties that Nigeria and other LMICs are currently having with cancer detection and treatment include all of the elements that you listed. Adopting the open access MC simulation technology makes it independent of local power supplies because it is mobile and cloud-based, and because it is open access, its use is very flexible and affordable.
The nation should face cancer treatment radically.
Many cancers are treatable in nations with high human development indicents thanks to significant advancements in cancer treatment and understanding. What needs to be changed in Nigeria to guarantee that many cancers are also treatable? Nigeria needs to implement radical cancer treatment. Increase the number of treatment facilities and furnish them with modern hardware and software. Adopt open access technology and encourage its use in research, education, and cancer detection and treatment. Encourage the clinic’s practitioners and the researchers to stop the brain drain from this specialized field. The country’s various levels of government ought to participate actively. He is extremely optimistic that the number of successful cancer treatment cases will rise if every local government region provides facilities and support for cancer research, early identification, and treatment, as was done during the COVID-19 epidemic.
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