Pathways to health outcomes after cancer diagnosis: A systematic review of cancer survivorship in Nigeria.

OBJECTIVE: With advancements in medicine and technology, more people are surviving cancers. However, cancer mortality in Nigeria remains high. The yearly estimate is 72,000 cancer-related deaths, making cancer one of the leading causes of death in Nigeria. The current study aimed to identify and synthesize factors that facilitate or hinder cancer survivorship in Nigeria and add to our understanding of the patterns of cancer survivorship in LMICs, such as Nigeria. METHOD: Following preferred reporting items for systematic reviews and meta-analyses guidelines, a systematic review was conducted across PubMed, Cochrane, and Scopus databases. We identified 31 peer-reviewed studies that examined cancer treatment, management, care, and survivorship in Nigeria. RESULTS: Eight themes emerged from 31 peer-reviewed studies that examined the factors that facilitate or hinder cancer survivorship among Nigerians. They include themes such as self-care and management, treatment options, availability of pseudo-doctors/pharmacists, and the desire to live. The themes were further grouped into three overarching themes: psychosocial, economic, and health care. CONCLUSION: Cancer survivors in Nigeria face many unique experiences that impact their health outcomes and chances of survivorship. Therefore, understanding cancer survivorship in Nigeria must involve studies on diagnosis, treatment, remission, surveillance, after-cancer care, and end-of-life. With enhanced support, cancer survivors will have improved health, thereby reducing the cancer mortality rate in Nigeria.

WAVE facilitates polarized E-cadherin transport.

Cadherin dynamics drive morphogenesis, while defects in cadherin polarity contribute to diseases, including cancers. However, the forces polarizing cadherin membrane distribution are not well understood. We previously showed that WAVE-dependent branched actin polarizes cadherin distribution and suggested that one mechanism is protein transport. While previous studies suggested that WAVE is enriched at various endocytic organelles, the role of WAVE in protein traffic is understudied. Here we test the model that WAVE regulates cadherin by polarizing its transport. In support of this model we show that 1) endogenously tagged WAVE accumulates in vivo at several endocytic organelles, including recycling endosomes and at the Golgi; 2) likewise, cadherin protein accumulates at recycling endosomes and the Golgi; 3) loss of WAVE components reduces cadherin accumulation at apically directed RAB-11-positive recycling endosomes and increases accumulation at the Golgi. In addition, live imaging illustrates that dynamics and velocity of recycling endosomes enriched for RAB-11::GFP and RFP::RME-1 are reduced in animals depleted of WAVE components and RAB-11::GFP movements are misdirected, suggesting that WAVE powers and directs their movements. This in vivo study demonstrates the importance of WAVE in promoting polarized transport in epithelia and supports a model that WAVE promotes cell-cell adhesion and polarity by promoting cadherin transport.