EVERYBODY IS ANGRY!

A moment of patience in a moment of anger saves a thousand moments of regret; Anger begins with madness and ends in regret.

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Anger is an intense emotional response that involves a strong uncomfortable and hostile response to a perceived provocation, hurt or threat. Anger can occur when a person feels their personal boundaries are being or are going to be violated.

There is a sharp distinction between anger and aggression (verbal or physical, direct or indirect) even though they mutually influence each other. While anger can activate aggression or increase its probability or intensity, it is neither a necessary nor a sufficient condition for aggression.

There is a part of the brain responsible for identifying threats to our well-being. Part of this responsibility is sending out alarms when a threat is identified and the body responds in many ways depending on how we have wired ourselves.

For those who are impulsive, in an effort to protect themselves, their reactions override the part of the brain responsible for thought and judgment. In other words, although the brain is wired in such a way as to influence us to act before we can properly consider the consequences of our actions, we also have the option and control of processing our reactions.

Anger instigates physiological responses such as increased heart rate, elevated blood pressure, and increased levels of adrenaline and noradrenaline which are stress hormones that our body secrete as a fight or flight response. Also, expression of anger can be found in facial expressions eg clenching of the jaw, body language like clenching of the fist,  and at times subtle acts like the eyes becoming red or even a wry sardonic laugh.

Modern psychologists view anger as a primary, natural, and mature emotion experienced by virtually all humans at times, and as something that has functional value for survival. Uncontrolled anger can, however, negatively affect personal or social well-being and impact negatively on those around them. It is equally challenging to be around an angry person and the impact can also cause psychological/emotional trauma if not dealt with.

Characteristics of Anger

Passive anger

  • Dispassion, such as giving someone the cold shoulder; Evasiveness, such as turning one’s back in a crisis, avoiding conflict; Defeatism, such as setting yourself and others up for failure; Obsessive behavior, such as needing to be inordinately clean and tidy, making a habit of constantly checking things; Psychological manipulation, such as provoking people to aggression and then patronizing them, provoking aggression but staying on the sidelines, emotional blackmail, false tearfulness, feigning illness; Secretive behavior, such as stockpiling resentments that are expressed behind people’s backs, giving the silent treatment or under the breath mutterings, avoiding eye contact; Self-blame, such as apologizing too often, being overly critical, inviting criticism.

Aggressive anger

  • Bullying, such as threatening people directly; Destructiveness, such as destroying objects as in vandalism, harming animals, child abuse, destroying a relationship, reckless driving, substance abuse; Grandiosity, such as showing off; Hurtfulness, such as violence, including sexual abuse and rape, verbal abuse; Manic behavior, such as speaking too fast, walking too fast, driving too fast, reckless spending; Selfishness, such as ignoring others’ needs, not responding to requests for help, queue jumping; Threats, such as frightening people by saying how one could harm them; Unjust blaming, such as accusing other people for one’s own mistakes; Unpredictability, such as explosive rages over minor frustrations, attacking indiscriminately; Vengeance, such as being over-punitive. This differs from retributive justice.

Assertive anger

  • Blame, Punishment, and Sternness, such as making them feel bad repeatedly and depriving them of some things you see as comforts and calling out a person on their behavior, with voice raised with utter disapproval/disappointment.

ANGER MANAGEMENT

  1.  Identify what initially triggered the anger
  2. Reflect on how you related to the triggering situation e.g., what did you say to yourself about it.
  3. Identify all of the specific emotional and behavioral responses that followed.

Enhanced Personal Awareness

In order to stay less angry, you must have a clear sense of your anger and other people’s anger

Where and when does the anger occur? Why does anger occur (what events or situations lead to the anger)? What kinds of memories or images trigger the anger? How do you feel when you become angry (emotionally and physically)? What are you thinking when you are angry? How do you handle the situation that made you angry? Do you always behave the same way? If not, why not? What do others do when you become angry?

Anger Disruption by Avoidance and Removal

These techniques lead to interruption of anger by removing you, mentally or physically, from the situation.

Create simple strategies that can disrupt anger and give yourself time and distance to calm down, then approach the situation differently, at a later time. This enhances your self-awareness. Drinking water has a good therapeutic effect and in the Islamic religion, performing ablution is recommended as a remedy.

Relaxation Coping Skills

Anger is often marked by increased emotional and physical excitement. Relaxation coping skills target this excitement and can help you calm down when angered.

Relaxation skills include slow deep breathing, slowly repeating a calming word or phrase, picturing a personal relaxation image, or focusing on muscle tension and consciously letting it go.

Attitude and Cognitive Change

When angry, people often make bad situations worse by the way they think about them. For example, angry individuals tend to demand that things should be, ought to be, or have to be, their way—rather than just wanting or preferring them to be a certain way. Often, they call other people insulting, sometimes obscene, names. The problem situation is often seen as awful or catastrophic, rather than simply difficult, frustrating, or truly disappointing. By thinking about bad situations in this way, natural

Things should not, ought not, or have to be your way. You shouldn’t call other people insulting, sometimes obscene, names. Don’t see a problematic situation as awful or catastrophic, rather, see it as a salvageable task. By thinking about bad situations in this way, natural frustrations, hurts, and disappointments that seem much larger and lead to increased in anger can be dealth with objectively.

Acceptance and Forgiveness

Many things that others do simply can not be helped. For example, children spill drinks;  Spouses sometimes forget about issues that are important to their partners.

Thinking that others have intentionally set out to cause problems is almost always wrong. Thinking that they could have acted differently, if they really wanted to, ignores other causes of behavior. Thinking that the bad behavior of others is always intentional just increases anger and does little to solve problems. Understanding that some behaviors are caused by biology or genetics, or normal development, or economic stressors, is more realistic.

Communication Skill 

Some people experience anger because they do not have the necessary skills to negotiate common interpersonal hassles and conflicts.

Fighting with a spouse, for example, may occur when one partner has a poor negotiating skill and because such persons may also not know how to communicate well about family budgets and many other things, they resort to unconventional methods that may be provocative or aggressive over time. The Anger here has escalated because of insufficient skill at resolving the situation.

Monkeypox Outbreak

Monkeypox is a viral disease similar to smallpox and chickenpox transmitted majorly by rodents. The virus can spread both from animal to human and from human to human.

On the 22nd of September, 2017, the Nigeria Centre for Disease Control (NCDC) was notified of a case of suspected Monkeypox.

The case was identified in an 11-year-old male patient who was presented to the Niger Delta University Teaching Hospital (NDUTH) in Yenagoa, Bayelsa State in Nigeria.

Subsequently, 11 other cases were identified. All the cases are currently receiving appropriate medical care. All the patients are improving clinically and there have been no deaths.

A medical doctor and 10 persons who came down with the monkeypox had been quarantined in an isolation centre at the Niger Delta University Teaching Hospital, Okolobiri, in Yenagoa Local Government Area of the state.

As at 1st October 2017, 32 close contacts of the cases have been identified, advised appropriately and are being monitored.

Infection from animal to human can occur via an animal bite or by direct contact with an infected animal’s bodily fluids. The virus can spread from human to human by both respiratory (airborne) contact and contact with infected person’s bodily fluids.

Risk factors for transmission

  • close contact with infected persons eg- sharing a bed, room
  • using the same utensils as an infected person
  • Eating inadequately cooked meat of infected animals
  • Anything that favors the introduction of the virus to the oral mucosa.

Incubation period

It takes about 5-21 days but ideally it is 10–14 days. symptoms of monkeypox are similar to smallpox, although it is often milder.

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Signs and symptoms

A distinctive feature of monkeypox compared to other similar diseases is that some patients develop severe lymphadenopathy (swollen lymph nodes) before the appearance of the rash.

The infection can be divided into two periods:

  • The invasion period (0-5 days) characterized by fever, intense headache, lymphadenopathy (swelling of the lymph node), back pain, myalgia (muscle ache) and an intense asthenia (lack of energy);
  • The skin eruption period (within 1-3 days after the appearance of fever) where the various stages of the rash appear.

Rash often begins

  • on the face and then spreading elsewhere on the body.
  • The face (in 95% of cases), and palms of the hands and soles of the feet (75%) are most affected.
  • Evolution of the rash begins with lesions with a flat base to vesicles (small fluid-filled blisters), pustules, followed by crusts occurs in approximately 10 days. Three weeks might be necessary before the complete disappearance of the crusts.
  • Rash can also affect oral mucous membranes (in 70% of cases), genitalia (30%), and conjunctivae (eyelid) (20%)

Severe cases occur more commonly among children and are related to the extent of virus exposure, patient health status and severity of complications.

Diagnosis

The differential diagnoses that must be considered include other rash illnesses, such as, smallpox, chickenpox, measles, bacterial skin infections, scabies, syphilis, and medication-associated allergies. Lymphadenopathy during the prodromal stage of illness can be a clinical feature to distinguish it from smallpox.

Monkeypox can only be diagnosed definitively in the laboratory where the virus can be identified by a number of different tests:

  • enzyme-linked immunosorbent assay (ELISA)
  • antigen detection tests
  • polymerase chain reaction (PCR) assay
  • virus isolation by cell culture

Treatment and vaccine

There are no specific treatments or vaccines available for monkeypox infection, but outbreaks can be controlled.

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Vaccination against smallpox is assumed to provide protection against human monkeypox infection however routine smallpox vaccination was discontinued following the apparent eradication of smallpox.

Prevention

Any human that might have come into contact with an infected animal/human should be quarantined, handled with standard precautions and observed for monkeypox symptoms for 30 days.

Reducing the risk of infection in people

During human monkeypox outbreaks, close contact with other patients is the most significant risk factor for monkeypox virus infection. In the absence of specific treatment or vaccine, the only way to reduce infection in people is by raising awareness of the risk factors and educating people about the measures they can take to reduce exposure to the virus. Surveillance measures and rapid identification of new cases is critical for outbreak containment.

  •  Gloves and protective equipment should be worn when taking care of ill people. Regular hand washing should be carried out after caring for or visiting sick people.
  • Reducing the risk of animal-to-human transmission. Efforts to prevent transmission in endemic regions should focus on thoroughly cooking all animal products (blood, meat) before eating. Gloves and other appropriate protective clothing should be worn while handling sick animals or their infected tissues, and during slaughtering procedures.
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  • Health-care workers caring for patients with suspected or confirmed monkeypox virus infection, or handling specimens from them, should implement standard infection control precautions.
  • Healthcare workers and those treating or exposed to patients with monkeypox or their samples should consider being immunized against smallpox via their national health authorities. Older smallpox vaccines should not be administered to people with comprised immune systems.
  • Samples taken from people and animals with suspected monkeypox virus infection should be handled by trained staff working in suitably equipped laboratories.
"Mad cow, deer tick, monkey pox, what's next?"
“Mad cow, deer tick, monkey pox, what’s next?”

Continue reading “Monkeypox Outbreak”

ECTOPIC PREGNANCY

a rebellious embryo may decide to implant itself outside the uterus!

After the fertilization of the egg by a viable sperm, the resultant embryo travels from the fallopian tube down into the cavity of the uterus. Implantation occurs when the embryo is attached to the uterine wall and continues to develop until full term gestation.

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However, for reasons that are not fully understood, a rebellious embryo may decide to implant itself outside the uterus!

Ectopic Pregnancies (EP) account for about 11:1000 pregnancies. More than 80% of such rebels implant in the fallopian tube, hence the name “Tubal Pregnancy”, often used interchangeably with EP.

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Other recognized locations of EP are the abdominal cavity, ovaries, cervix and cesarean section scar.

Because of the limited space for growth within the tube or other ectopic sites, rupture and severe internal bleeding could occur starting from 6-8weeks. Ruptured EP is a life-threatening condition and one of the major causes of maternal mortality.

What are the risk factors for EP?

  • Previous history of EP
  • Previous history of infertility and its treatment (assisted reproductive techniques)
  • Pelvic inflammatory disease (PID)
  • Intrauterine contraceptive device use at the time of conception
  • Endometriosis (presence of the uterine lining outside of the uterus)
  • Pelvic or tubal surgery
  • Smoking

The only way to ensure prompt diagnosis and treatment of EP is to have a high index of suspicion by recognizing the telltale signs.

 

The symptoms are variable and non-specific but there is a classical triad reported by many patients:

  1. Missed period (6-8weeks)
  2. Lower abdominal pain
  3. Mild vaginal bleeding or brownish discharge. 

 Other symptoms include:Shoulder tip pain (sign of internal bleeding-ruptured EP),  Sudden collapse (due to severe blood loss)

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    A diagnosis is usually confirmed by identification via ultrasound scan, supported by the level of an early pregnancy hormone known as Human Chorionic Gonadotropin B (BHCG). The modality of treatment depends on the clinical status.

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    *Surgical management – in ruptured EP, with acute severe blood loss, emergency surgical intervention must be done, together with blood transfusion to save the patient. 

    *Medical management – using methotrexate, in clinically stable patients who are compliant 

    *Expectant/Conservative management – in small sized EP and falling BHCG where the body is expected to get rid of the “rebel” by itself. This is reserved for a select few cases.

    Below is a summary of events in a woman with ectopic pregnancy and how the doctor chooses how best to help her.

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    Cervical Cancer

    Cervical Cancer has been attributed to infection with HUMAN PAPILLOMA VIRUS (HPV). HPV infection is usually transmitted sexually.

    …..to her, she was doing this to help her only child whom she gave birth to while in the penultimate year of secondary school.  Regrettably, she said, ‘ i had aborted a couple of pregnancies and had sex with several men while in secondary school and by then i was seventeen because i had to fend for myself as an orphan who had no one to help me, but this child just could not be aborted’.     … that is the result the doctor said. She has stage III cervical cancer at age forty-five…

    Overview

    Womanhood is a world on its own and it takes patience, knowledge, and pity sometimes for one to dabble into such world. They have their own peculiarities in every sphere of life. In the medical world, as cancer remains one monster to deal with, peculiar to women are some cancers like breast, cervical cancer. In this article, I would focus on cervical cancer which from my own little experience most women don’t know about until they come down with it.

    Cervical Cancer

    The cervix ( pronounced: saviks) is the neck or narrow portion of the uterus(womb) where it joins with the vagina. Cancer is simply when cells of a particular tissue undergo uncontrolled (and often rapid) growth. Thus cervical cancer is the cancer of the cervix.

    Cervical cancer is the second commonest malignancy after cancer of the breast in women in developing countries ( Nigeria inclusive) and it remains the leading cause of death in these countries but the third commonest cancer in women in the world. Peak age when women present in Nigeria is 45 to 55 years. However, it is diagnosed in any woman of reproductive age group.

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    The causes have been attributed to

    • Genital infection with human papilloma virus
    • Sex at a young age
    • Multiple sexual partners
    • Promiscus male partners
    • One who had or has a sexually transmitted infections. It is important to point out that HIV infection is associated with a very high increase in risk of cervical cancer.
    • Also, a patient with cervical intra-epithelial neoplasia can progress to cervical cancer

    What makes the Doctor think A patient has it

    *Though, there are some that may not have any symptom but will come to the hospital with abnormal Papanicolaou (Pap smear) result. This is in those that do screening

    * abnormal bleeding from the vagina, majorly after sex

    * bleeding from the vagina between menstrual period or after menopause

    *offensive vaginal discharge which is characteristic

    *pain on pelvic side

    For those women that present late, they may have in addition

    • Backache
    • Leg pain/ swelling
    • Blood in the urine or bloody urine

    Or the doctor investigates by looking at the cervix called colposcopy

    How does the Gynaecologist treat

    The treatment modality depends on the stage of cancer the patient presents with.

    • It may be surgery if it is at the early stage or
    • The use of radiation and chemotherapy for the more advanced cases
    • Or the use of chemotherapy or radiation for palliation for cases that have developed other things from it

    Survival

    There is a similar 5-year survival rates for radiotherapy or surgery for someone with the cancer. This survival also depends on the stage of the cancer. If stage I there is 70-80% survival rate but stage IV has 18% survival rate.

    What is in this for YOU! 

    The major cause of this disease has been attributed to infection with HUMAN PAPILLOMA VIRUS (HPV). HPV infection is usually transmitted sexually. Condom use may not prevent the transmission. The HPV 16 and 18 are the major serotypes of the cause. Thus, a lady or woman who has been introduced to sex life should get screened two years into sex life and every 3-5 years. In essence, those who should have PAP SMEAR done are

    • Ladies who have started having sex
    • Or above age 21

    The American Cancer Society, American College of Obstetricians and Gynaecologist recommend that

    • 21-29 years should have pap smear alone every 3 years
    • 30- 65 years pap smear every 3 years or HPV and cytology testing every 5 years
    • Greater than 65 years no screening recommended
    • Less than 25 no screening recommended because women aged 21-24 are at low risk for invasive cervical cancer but they are at high risk for HPV exposure and associated lesions.

    Any Vaccine.

    The joy here is that, one could be vaccinated against the Human Papilloma Virus (which is not only for girls but also available for boys) but for girls majorly. The vaccine is useful in those who have not had the disease and no usefulness in one who already had it. The two HPV vaccines approved in the United States of America are Gardasil and Cervarix.

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    THE GIST HERE is, please go and get PAP SMEAR done today and tell others about it. It is for your future, in other to live a meaningful life insha Allaah. So please present YOURSELF at any Government health care facility for details.

    …. her sex partners were no longer patronizing her since they got to know about her disease as she even was no longer interested in that. She was no more lively, seems no hope for her. Her Chemotherapy drug has made her loose her hair, no beauty to display any longer. The radiotherapy also played it own part on the pelvis. At last, she gave up the ghost with a repentant soul. Don’t ask me if God would accept such repentance.  I leave YOU TO JUDGE…. this woman, this cervical cancer.

    I.O Dada (Haniif ibn Toyin)

    WHEN CANCER ATTACKS THE OVARIES

    The ovaries consist of different cell types, performing different functions. Any of these cells can develop into cancer

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    Ovarian cancer is the leading cause of death from gynecological cancers in the UK and USA. It is the 5th most common cause of cancer deaths in women (after lung, breast, colorectal and pancreatic cancers). Up to 20,000 new cases are diagnosed yearly in the US. The peak incidence is in women aged 75 – 84 years, but it can occur in younger women, and even (rarely) in prepubescent girls too.

     

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    CLASSIFICATION 

    The ovaries consist of different cell types, performing different functions. Any of these cells can develop into cancer, but 90% arise from the epithelial (outermost) cells. Ovarian cancers are classified based on the cluster of cells they originate from:

    • Epithelial
    • Sex cord-stromal
    • Germ cells

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    Different subclasses have been described and each has similar features but different growth behavior and response to treatment.

    RISK FACTORS

    Like most cancers, direct causal factors are largely unknown, but various risk factors have been identified:

    • Nulliparity (no previous viable pregnancy)
    • Early menarche (age at onset of menstruation <11 years)
    • Late menopause (age at cessation of menstruation >52 years)
    • Family history of ovarian, breast or colorectal (bowel) cancers
    • Family history of genetic mutations ( BRCA1, BRCA2, and HNPCC)
    • Previous history of ovarian, breast, endometrial and colorectal cancers (treated)

     SCREENING FOR OVARIAN CANCER

    Not routinely done unless one has strong risk factors.

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    SIGNS AND SYMPTOMS

    Ovarian cancer is a great mimicker as it doesn’t show any specific sign until an advanced stage as been reached. Early symptoms are no different from those attributable to other common diseases. These are:

    • Abdominal pain
    • Abdominal distension and bloating
    • Loss of appetite
    • Constipation or diarrhea (or alternation of both)
    • Abnormal menses or vaginal bleeding

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    Late Symptoms include;

     

    • Abdominal/pelvic mass – detected by palpation and confirmed by radiological tests
    • Significant weight loss
    • Difficulty in passing urine
    • Significant abdominal distension (ascites or solid mass)
    • Generalized body swelling (edema or anasarca)
    • Signs of spread to distant organs – uterus and tubes, urinary tract, bowel, stomach, lymph nodes, etc.

     

    INVESTIGATIONS

    After taking a full history and physical examination, specific tests must be done to confirm the diagnosis, determine the extent of the disease and work up for definitive treatment.

    • Full blood count
    • Kidney function test
    • Liver function test
    • Tumor markers – CA125, CEA, CA19.9, etc.
    • Imaging: ultrasound, CT scan, MRI, chest x-ray, etc

     

    MANAGEMENT 

    1. SURGERY: This is both diagnostic and therapeutic. In early stages, the ovaries, uterus, tubes and adjacent lymph nodes will be removed at once. In advanced stages, initial surgery is done to “stage” cancer (to know what stage it is). Subsequent operations may be needed depending on the result of the first surgery and response or recurrence.
    2. CHEMOTHERAPY: The different combination of anti-cancer drugs are available depending on the cell types involved. The platinum-based therapy is given in up to 6 cycles every 3 weeks. Side effects of the drugs include severe vomiting, hair loss, kidney damage, diarrhea etc. These can also be managed and ameliorated.
    3. NOVEL AGENTS: New drugs are being investigated through clinical trials. These include antibodies against cancer-promoting factors in the body (VEGF, EGFR and TKI’s)
    4. SUPPORTIVE TREATMENT: These are palliative measures put in place to alleviate the excruciating pain and suffering associated with advanced ovarian cancer. Such as drainage of ascites, painkillers (strong opioids usually, morphine), emotional support, hospice care, etc.

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    FOLLOW UP IS OFTEN CONTINUED LIFELONG.

    5-year survival rate ranges from 90% to less than 20% depending on the stage of cancer before treatment is commenced.
    PREVENTION 

    It is said that the only way to not have cancer is not to be born. Ovarian cancer can not be predicted 100% but individuals with strong risk factors can be followed closely so as to detect the disease early. They can also opt for prophylactic oophorectomy (removal of the ovaries) after completing their reproductive career (cf. Angelina Jolie). For younger women, eggs can be harvested, frozen and used for IVF when they’re ready to get pregnant later.

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    General healthy lifestyle helps to prevent cancer among other things – healthy diet, regular exercise, quitting alcohol and smoking, etc.

    Childhood Cancers

    To nurse one child in Nigeria with cancer, you need about N2 million on the average in a period of about two years

    By Drs. Azeezah Shopeyin and Ajayi Abass 

    Childhood cancers occur in children less than 15 years. They are devastating not only to the children but their entire family. In Nigeria, it creates a huge financial burden on the family as there is no supportive treatment plan for children and the cost of treatment is very high.

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    Cancer leads to abandonment of treatment and consequently death of children. Hence, prevention of childhood cancers cannot be over emphasized. It’s important to note that in most fields of medicine, pediatrics have been found to be of significant challenge, because of communication challenges, and caregiver support.

    Burden to public health

    The international agency for research on cancer stated in 2004 that worldwide 160,000 children under 15 years get childhood cancers and 90,000 will die from it every year. In 2007, 71.2 of every 1 million Nigerian children below 15 years had childhood cancers.

    Due to the lack of data in Nigeria, and the paucity of studies on childhood cancers, it is not easy to appreciate the burden of childhood cancers, this might be due to the preoccupation with infectious diseases which are said to cause about 25% of childhood deaths.

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    In an 11year retrospective study conducted in northern Nigeria, by A. Mohammed and A.U Aliyu, it was noticed that childhood cancers were 8.44% of cancers diagnosed within that period. A male: female ratio of 1.5:1.

    In 2014, Consultant Paediatrician, Oncology/Haematology Unit of the Lagos University Teaching Hospital, LUTH, Dr. Adebola Akinsulirie, said about four or five cases of childhood cancer are seen monthly at the LUTH. That will give you about 50 children in a year. That is big as far as cancer in children is concerned in Nigeria. To nurse one child with cancer, you need about N2 million on the average in a period of about two years.

    Types of childhood cancers

    The most common childhood cancers accounting for childhood deaths in Lagos  include kidney cancer (nephroblastoma) and blood cancer (Acute lymphoblastic leukemia and Acute myeloid leukemia)

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    Lymphomas (solid cancer of white blood cells) are also quite common childhood malignancies and neuroblastoma (cancer of nerve cells), others include leukemias, bone and muscle tumors.

    Causal or pre-disposing factors

    The cause of most childhood cancers are unknown in about 75-90% of cases, 5-15% are due to familial and genetic factors( intrauterine viral infections, parental occupational/ radiation exposures, war-torn regions and disasters, elderly maternal age above 35, parental especially maternal smoking and alcohol consumption.

     

    and <5-10 % are due to known environmental exposures and exogenous factors (food, radiation, dyes, infections like intrauterine viral infection Epstein-Barr virus and leukemias/ lymphomas etc). It’s important though to note that cancers generally are caused by a variety of factors and are not limited to a single causative agent.

    How to recognize childhood cancers early

    Complaints about any of the following that does not go away in a child:

    • Feeling of an unusual lump or swelling
    • Unexpected paleness and loss of energy
    • Easy Bruising
    • An ongoing pain in one area of the body
    • Limping
    • Unexplained fever or illness that doesn’t go away
    • Frequent headaches, often with vomiting
    • Sudden eye or vision changes
    • Sudden unexplained weight loss

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    Prevention of childhood cancers

    1. Avoidance of chewing or smoking tobacco.
    2. Protection from sunlight.
    3. Limiting fats in diet
    4. A healthy diet with at least 5 portions of fruits and vegetables per day.

    Management of childhood cancers

    Childhood cancers are managed by a team of specialized pediatric cancer care specialists, including pediatric oncologists, pathologists, radiologists, surgeons, radiotherapists, nurses and support staff include the nutritionist, social workers, pharmacists and other medical specialists. First, a correct diagnosis is made; depending on the stage of the disease from Investigations carried out, the child is given drugs,  and surgical intervention or radiation therapy may be necessary.

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    The challenges in pediatric cancer are numerous but surmountable if there is the will. These are

    1. Recognition of symptoms by parents
    2. Time of presentation/ late presentation
    3. Lack of funds by caregivers
    4. Limited diagnostic equipment/ facilities
    5. High cost of diagnostic investigations
    6. High cost of treatment
    7. Effects of cytotoxic drugs/radiation therapy
    8. Lack of political standing of their own as such children are forgotten in most policies.

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    The above challenges can be solved if

    1. Adequate awareness is provided about childhood cancers
    2. Children are exclusively included in the NHIS
    3. Funding is provided for research into childhood cancers
    4. Facilities for diagnosis and treatment are provided.
    5. Provision of psychological support and social welfare services.

    In summary

    Childhood cancers are a source of significant burden to the child, parents, and caregivers; as such a lot of support is needed; financial, psychological, and spiritual. The distress from the disease, the financial implications, and stress of accessing treatment including the toxicity of the cytotoxic agents is of significant concern, however, children are more likely to recover from cancers when they are detected early and commenced on therapy as quick as possible.

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    Dr. Azeezah Shopeyin graduated from the University of Lagos, college of medicine.With several years experience, she also has a master degree in public health. She’s interested in health education and promotion. She’s a wife and mother of two kids and she enjoys making people happy,

    Dr. Ajayi Abass Oluwaseyi graduated from Ahmadu Bello University in Zaria. Also known as Juggernaut bn Yusuf, he is also a writer, an aspiring Neurosurgeon, and a Farmer. He currently works at the federal teaching hospital in Gombe.

    ENGAGING CANCER

    Cancer starts from errors in coding as a result of mutations which could occur naturally by heredity when cells are multiplying or induced by an external agent

    Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. Not all tumors are cancerous and benign tumors do not spread to other parts of the body.

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    Today, millions of people will march all over the world to commemorate the world cancer day. Irrespective of our religion, tribe, nation and political views, this is the day we highlight to fight this menace that has claimed the lives of millions and shattered the hope of many families.

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    To explain cancer in simpler terms, biology has taught us all living things are made up of cells, be it unicellular (one) as the case of some microorganisms and multicellular (plenty) as the case of humans. The cell is the basic unit of life. Our cells contain the genetic material “genes” located in the DNA. These genes are made up of simple coding which defines the function of the cell.

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     The interactions of these gene replaces cells when they are damaged or need to grow. These lead to the formation and functionality of tissues, organs and different systems in our body. Just like a computer, made up with various coding and algorithms which help different softwares to work and at the long run function in tandem as a computer.

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    Cancer starts from errors in these coding as a result of mutations which could occur naturally by heredity when cells are multiplying or induced by an external agent. Basically, these mutations could occur in genes that control the way cells grow; tumour suppressor genes (TSG) and oncogenes (ONC).

    Tumour suppressor genes function like a break system in a car, it halts the growing of cells while oncogenes function like the accelerator of a car, maintaining the speed or rate at which cells multiply. When either of TSG and ONC is affected, what will happen is either cells multiplying at an abnormal speed leading to the formation of tumour in an organ. This occur due to the inability of TSG ‘brakes’ to reduce the speed or cells multiplying excessively due to much pressure on the accelerator, the ONC.

    Causes of cancer

    Some cancers develop when an individual inherits a bad gene with mutations, an oncogene or a tumour suppressor gene from parents. As the person grows, the mutations increase and finally cancer develops at a particular stage in life. It is like buying a bad computer which eventually develops fault during use.

    Some viruses induce mutations in the coding in these genes leading to cancer. Similar to the way viruses attack our computers leading to the deletion of some important files on the desktop leading to software malfunction and sometimes might affect the hardware.

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    Carcinogens, chemical agents like benzene that can cause cancer when inhaled or consumed can also induce mutations. It is like using a computer to visit bad websites with malwares, installing fake applications or software that is incompatible with your computer. Also, some environmental factors like exposure to radiation can lead to cancer.

    Life style, practices such as smoking can contribute to the induction most cancers. This is similar to personal choices you make with your computer at your own risk, removing a flash drive inappropriately, shutting down your computer unexpectedly or using your computer in an environment where liquids could spill on it. These practices can crash your computer just as a smoker is liable to die young either by lung cancer or other respiratory disorders.

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    Another key risk factor that could initiate cancer is aging. The processes that control cell reproduction malfunctions. This lead to accumulation of toxic reactive oxygen species that damage mitochondria (cell engine). For example, reactive oxygen species above normal levels can oxidize our DNA.

    The cure, Our Hope

    Although we have been blessed with an immune system that could detect and destroy cancer cells, many cancer cells are well equipped to survive and evade these cells. Scientists are left with the option of finding cures for cancer, however, every cancer seems to be different, making it difficult to cure all cancers with one drug. Also, cancers can be well-managed and prevented, telling us cancer is not a death sentence.

    Early detection, you can revive a computer which is dragging or slow as a result of malware or viruses. Install an antivirus as quick as possible, there you go. Taking your car to a mechanic when it flashes check engine, when you notice the grip of the brake has reduced or when the clutch smells will definitely prevent a sudden disaster when driving.

    As well, early detection of cancers will significantly increase the chances of survival. Doctors would administer different form of therapies just like an antivirus in a computer. Cancerous cells would die and in many cases total remission could occur. However, successfully scanning and deleting the virus on your computer does not assure you your computer can not be infected again, hence, Cancer patients who are in remission can also have reoccurrence.

    Some cancers are gender specific, some are age specific, like prostrate cancer and there are recommendations for when to start detecting them.

    Positive lifestyle, practices such as eating fruits and vegetables, exercising, quitting smoking, maintaining a clean environment and avoiding junks can reduce the risk of cancer. Recent studies have discovered that processed meats, canned foods, over cooking food such as brown bread could cause cancer.

    The Future, Cancer will one day be treated like any other disease with significantly reduced mortality rate. The approach to getting a cure is like traffic rules, using camera speed checkers on the road to prevent excessive speeding of cars and arrest those who over-sped by giving them a surprise ticket when they get home. We would one day detect and arrest rouge cells before the progression of cancers. The use of bumps on roads to prevent over-speeding and also slow down drivers, we are already slowing down the rate at which ONC drive our cells to induce cancer. In the nearest future, our immune system will boosted and trained to apprehend bad drivers of our genes.

    Mahmud Abdullah Opekitan attended Obafemi Awolowo University, Ile-Ife, Osun state, Nigeria between 2008 and 2011 bagging a B.Sc Hons Microbiology with a Second Class, Upper Division. He Also has a Master of Biomedical Science degree in Biomolecular Science- With Distinction. He’s currently wrapping up his Phd in Cancer Biology from Strathclyde Institute Of Pharmacy And Biomedical Sciences.