BWS Experience in Integrating Cancer Care

Abstract

Background and context: Nigeria, being the most populous African country has the highest cancer burden. Fragmentation of healthcare services leads to late presentation, inappropriate navigation, delay in diagnosis, intervention and an increased loss to follow-up. Aim: To have a harmonized and fast-tracked cancer diagnosis and management via providing an integrated cancer care and effective navigation to tertiary hospitals, when required. Strategy/Tactics: We set up a center to screen, diagnose and treat cancers in partnership with collaborators, at low cost to patients. Program/Policy process: The BWS (Breast Without Spot) Screening and Wellness Centre was set up in 2016 to offer cancer/NCD education, screening services for cancers and other noncommunicable diseases. A multidisciplinary volunteer team takes care of diagnostic ultrasound, ultrasound-guided biopsies, cryotherapy of premalignant cervical lesions, histopathology and chemotherapy. Where radiotherapy and surgery are indicated, patients are navigated appropriately to our collaborators in tertiary hospitals. Outcomes: 721 persons were seen. 112 men and 609 women, 14 men had PSA/DRE and 411 women had VIA and CBE. 58 women had sonomammography while 9 with suspicious masses had ultrasound-guided biopsies followed by histologic diagnosis and IHC for proven malignancy. In the women with proven breast cancer, 7 underwent chemotherapy while 8 were navigated to radiation therapy and surgery. What was learned: There is improved patient experience and compliance when there is an accessible “one stop” facility for their care. Early detection, prompt diagnosis and facilitated treatment improves prognosis. With prompt access to care, patients feel supported and eager to go through the entire cancer care process.