Impact of 10-Day Fulbright Specialist Program and Project Pink Blue Education Sessions on Medical Oncology Knowledge Among Physicians Who Treat Cancer in Nigeria.

Despite an estimated population of over 201 million and over 115,950 yearly diagnosed new cases of cancer, Nigeria does not have dedicated medical oncologists. Most oncology care is delivered through surgical and clinical oncologists, who are trained in both radiation and medical oncology and they number fewer than 50 in the country. With a limited number of oncology professionals, cancer patients in Nigeria experience poor health outcomes, with an estimated cancer mortality rate of 75,000 deaths per year. Participants from 15 Nigerian states were selected to attend the medical oncology training. Through the support of Fulbright Specialist Program and Project PINK BLUE, two of the authors delivered 10 days of lectures based on ASCO, ESMO, and NCCN guidelines. Mean scores of both the pre- and post-course tests as well as a 1-year follow-up test were compared using GraphPad Prism 7.0a by paired t-tests. Forty-four clinical oncologists were selected for participation. Twenty-five (57%) completed the pre- and post-course tests. Of the 25 that completed both tests, percentage of correct answers increased from 45 to 59% (2-sided p-value < 0.0001). Improvements were seen in attending doctors 45 to 59% (p = 0.0046) and resident doctors 45 to 59% (0.0007). Eleven doctors responded to the 1-year follow-up test. Although not statistically significant, a numerical pattern for the benefits was maintained 1 year after the program (45% pre-course versus 52% post-course correct answers, Fisher's exact, p = 0.4185). In the short term, the training improved medical oncology knowledge in Nigeria, regardless of the participant's carrier stage. Long-term benefits were not sustained in a small sample of participants, and continuing education strategies are necessary. Similar models may be employed across Africa.

"Over and under exposures of radiotherapy patients at the A. B. U. Teaching Hospital, Zaria, Nigeria: case reports".

BACKGROUND: The Radiotherapy and Oncology Centre at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria, commenced services with technical cooperation support from the International Atomic Energy Agency, Vienna, Austria in 1995. Brachytherapy services used to be offered at the ABUTH, Tudun-Wada, Zaria since 1995. Teletherapy and other Oncological services commenced at its Permanent Site, Shika- Zariaon Monday July, 2000. OBJECTIVE/METHODS: This is an incidental report of radiation over and under dose of 331 patients treated with Cobalt-60 machine (CIRUS) from July, 2000-December, 2002. RESULTS: 105 (31.7%) of the patients received 10-20% higher doses than prescribed, 161 (48.6%) received about the prescribed dose while 65 (19.7%) of the patients received under dose. CONCLUSION: The purpose of the report is to highlight that incidents and accidents can occur with the radiotherapy equipment at any centre despite trained staff operating the equipment. Any incident or accident should be reported to the appropriate national and international atomic energy agencies.

A short course postoperative radiotherapy regime for keloid scars in Nigeria.

The unsatisfactory high rate of recurrence following the traditional approach for the radiotherapy of keloid scars in Nigeria, led to the design of this study which employed a short course post operative radiotherapy regime. Two hundred and forty four patients with four hundred and fifty four (454) keloidal scars treated with superficial X-ray therapy within 72 hours following surgical excision at the Lagos University Teaching Hospital Lagos, Nigeria, between January, 1984 and December, 1988 were analyzed. The commonest site treated was the ear lobe (36.8%). Radiation dose ranged between 5-6Gy in single sessions and 12-15Gy in 3 fractions over 5 days. A complete response rate of 93% at 24 months was achieved. The treatment was well tolerated with no serious complications reported to date.

Influence of size of primary breast tumour on local control.

Four hundred and five (405) patients with histologically proven primary breast carcinoma were analysed in this study. There was complete response of 64.2% after surgery and radiotherapy. This is a better result in comparison with developing countries, for example, Nigeria where over 90% of cancer patients report at a late stage before treatment and inadequate radiotherapy facilities lead to long waiting list. A tumour regression rate (complete and partial) of 98.3% was obtained. This work has shown that most women with breast cancer could be cured when the lesions are detected very early and sizes smaller.