World AIDS Day : AIDS and Cancer

World AIDS Day takes place on the 1st of December each year. It’s an opportunity for people worldwide to unite in the fight against HIV (Human Immunodeficiency Virus), to show support for people living with HIV, and to commemorate those who have died from an AIDS (Acquired Immunodeficiency Syndrome)-related illness. Founded in 1988, World AIDS Day was the first ever global health day.

This year’s theme is “Everybody counts”: W.H.O. Calls on everyone to advocate for access to safe, effective, quality and affordable medicines.

HIV, the virus that causes AIDS, is known to infect a variety of cell targets, the principal one being the CD4 (T4) helper – inducer lymphocyte subset.

People with AIDS have a heightened cancer risk from immunosuppression. HAART (Highly Active Retroviral Therapy) has been available since 1996. It has reduced AIDS – related mortality, but there are few large scale studies on cancer trends.


Yes, people infected with HIV have a substantially higher risk of some types of cancer compared with uninfected people of same age. “HIV – Associated Cancer” – Kaposis Sarcoma, Aggressive B –cell Non – Hodgkin Lymphoma and Cervical Cancer.

A diagnosis of any of these cancers in someone infected with HIV confirms a diagnosis of AIDS.

Compared with the general population, People infected with HIV are currently about :

500 times more likely to be diagnosed with Kaposi Sarcoma

12 times more likely to be diagnosed with Non – Hodgkin Lymphoma

Women are 3 times more likely to be diagnosed with Cervical Cancer

19 times more likely to be diagnosed with Anal Cancer

3 times as likely to be diagnosed with Liver Cancer

2 times as likely to be diagnosed with Lung Cancer

2 times as likely to be diagnosed with Oral cavity/Pharynx Cancer

8 times more likely to be diagnosed with Hodgkin Lymphoma.

In addition to being linked to an increased risk of cancer, HIV infection is associated with an increased risk of dying from cancer. HIV – infected people with a range of cancer types are more likely to die of their cancer than HIV – uninfected people with these cancers.

Infection with HIV weakens the immune system and reduces the body’s ability to fight viral infections that may lead to cancer. The Viruses that are most likely to cause cancer in people with HIV are:

Kaposi Sarcoma – Associated Herpes Virus (KSHV)
Epstein – Barr Virus (EBV)
Human Papilloma Viruses (HPV)
Hepatitis B Virus (HBV)
Hepatitis C Virus(HCV)

The introduction of Highly Active Retroviral Therapy (HAART) also called Combination Antiretroviral Therapy (c ART) starting in the mid – 1990s greatly reduced the incidence of certain cancers in HIV – infected patients, especially Kaposi Sarcoma and non-Hodgkin Lymphoma. The likely explanation for this reduced incidence is that c ART lowers the amount of HIV circulating in the blood, thereby allowing partial restoration of immune system function to fight the viruses that cause many of these cancers.


Taking c ART as indicated lowers the risk of Kaposi Sarcoma and non-Hodgkin Lymphoma and increase overall survival. The risk of lung, oral, and other cancers can be reduced by quitting smoking
HIV – Infected individuals should know their hepatitis status. Some drugs may be used for both HBV – suppressing therapy and c ART.

HIV – infected women have a higher risk of cervical cancer, so it is important that they are screened regularly for this disease with cervical screening.

KSHV is secreted in saliva, and transmission of this virus may occur through deep kissing, oral –anal sex. Reducing contact through these routes may reduce the chance of being infected with KSHV.

On December 1, 2017, all the above serve as a reminder for all of us on what we must do as individuals and as groups. Knocking HIV/AIDS related-defining malignancies on the head by knocking HIV on the head with all of the above preventive measures but at the same time showing support and understanding for those amongst us who live with HIV/AIDS. Lakeshore Cancer Center remains an advocate for all measures aimed at reducing world wide statistics in all illnesses.

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Early cancer diagnosis

Cancer, a public health problem affects all categories of people all over the world with
Nigerians not an exception. It’s a term used to describe a large group of diseases characterized
by abnormal growth of cells beyond their usual boundaries. Cancer cells can invade adjoining
parts of the body and also spread to other organs.

Good news is some cancers can be found early, before they have had a chance to grow and
spread. Early diagnosis of cancer generally increases the chances for successful treatment
while delayed diagnosis causes lower likelihood of survival, higher costs of care, avoidable
deaths and disability from cancer. Fear of the outcome of diagnosis, religious beliefs, financial
constraints and low awareness of cancer signs, symptoms and facilities are some of the
reasons for delays in cancer diagnosis.

There are two major components of early detection of cancer: education and screening.
Education involves improving health literacy and reducing cancer stigma. Increased awareness
of possible warning signs of cancer among health care providers as well as among the general
public and taking prompt action leads to early diagnosis. Some early signs of cancer include
lumps, sores that fail to heal, abnormal bleeding, loss of weight, anemia, persistent
indigestion, and chronic hoarseness.

Screening tests are used to find cancer before a person has any symptoms. Some
recommendations by the American Cancer Society for most adults include: annual breast
cancer screening with mammograms (x-rays of the breast) for women from age 40years,
colonoscopy (for colon and rectal cancer) for men and women from age 50years, a Pap test
(for cervical cancer) for women from age 21years and a PSA test (for prostate cancer) for men
above 45years.

To adopt the motto “Wait and see” is to entertain disaster. Even the suspicion of cancer
demands that all the resources of examination, clinical and laboratory, shall be called into
requisition. But if diagnosis should be early it should also be accurate. Start the process by
having a check-up with Lakeshore Cancer center. Ask about what screenings matter most for
you. What screenings you have and when will depend not only on your age and gender, but
also on other risk factors such as family history.

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Project Pink Blue Cancer Awareness Campaign

Project PINK BLUE, a cancer-fighting organization in collaboration with Dana Air, BellaNaija, Lakeshore Cancer Center and U.S. Embassy in Nigeria hosted Pink October Walk against Cancer, October 7th, 2017 at LTv / Radio Lagos Arena, Ikeja, Lagos in commemoration of International Breast Cancer Awareness Month.

The event started at 8:00am with a 30mins Aerobics session, followed by a walk against breast cancer around ikeja neighborhood which lasted for 1 hour 20mins.The 5km cancer awareness walk kicked off at LTv / Radio Lagos Arena through Allen Roundabout, Ikeja underbridge and back to LTv. It was led by breast cancer survivors- Comfort Oyayi Daniel, Swatkasa Gimba, Khadijat Banwo-Fatai, Nurat Salmon, and Ada Oliver, they were also honored and celebrated with Champions Medals.

Celebrities like Yvonne Jegede, Keme(Ekemini Everett), Uriel Oputa, Rachel Okonkwo, Blossom Chukwujekwu, Miki Omeili and others were also present.

Afterwards breast cancer screening, Cervical cancer screening and Prostate Cancer Screening was conducted by Lakeshore Cancer Center.

A total of 115 people were seen. We recorded 76 normal cases and others had different issues that needed more oncology consultation.

12 men were screened for Prostate cancer with no abnormality seen.

Lakeshore Cancer Center and other organizations talked to the crowd, Dr Yinka Akinyemiju, Palliative care Physician talked about the importance of breast screening and regular breast examination.

The event came to a close at 4:30pm.


Lymphedema is swelling caused by a build-up of lymph fluid in the surface tissues of the body.
This may happen as a result of damage to the lymphatic system because of surgery or radiotherapy to the lymph nodes under the arm (axilla) and surrounding area.
Sometimes lymphedema can be caused by cancer cells blocking the lymph system.
Lymph is made up of water and protein and also contains white blood cells called lymphocytes, which help your body fight infection.
The lymph nodes help fight infection by filtering out waste products like bacteria. They can also filter out cancer cells that have spread from a breast cancer, destroying some of them in the process.


  • Swelling
    Swelling often happens in the arm or chest area immediately after breast surgery. This is part of the healing process and usually settles within a short time without any treatment, but it’s important this is checked by your specialist team.
    Swelling in the hand, fingers, arm, breast or chest can occur on the side of the body you had your surgery or radiotherapy.
  • Tightness
    The arm or breast can feel tight when there is extra fluid in the tissues. Some people feel tightness in the arm without the arm appearing swollen. Gentle exercise can relieve this feeling.
  • Dry skin
    Where there is swelling the skin is stretched and can become dry, flaky, itchy and prone to infection. Try to keep the skin clean by washing gently and avoiding soaps that dry out the skin. Dry your arm and hand thoroughly after washing and use an unperfumed moisturizing cream to help keep the skin supple and moist. This will help protect the skin and ease these symptoms.
  • Arm stiffness
    If your arm is swollen, it may limit movement in the joints. It’s important to exercise your arm and shoulder regularly to reduce stiffness and encourage lymph fluid to drain. If you were given specific exercises after your surgery or radiotherapy, it is very important to continue doing them for as long as recommended.
  • Discomfort
    Some people will experience discomfort with lymphedema. This may be a tight, heavy feeling in the arm or breast, and the discomfort tends to be dull and vague. Discomfort often occurs after strenuous activity.
    To help relieve this, try doing some gentle exercise. When you’re sitting, rest your arm on a pillow or cushion (but not so that it’s above the height of your shoulder). If the discomfort continues or you feel pain, it’s important you contact your specialist team.


The aim of treatment for lymphedema is to encourage lymph fluid to move away from the swollen area, to try and improve symptoms and stop them getting worse. The way this is done will depend on how severe your lymphedema is, but your treatment may include some, or all, of the following approaches at different times. You can do quite a lot of these yourself alongside any professional treatment you are having

  •  Skincare
    Skincare is important because having excess lymph fluid in the arm or chest area, together with having fewer infection-fighting lymph nodes, increases the risk of infection. Small breaks in or damage to the skin, or some skin conditions which cause the skin to become red and sore, can become a site for infection. Dry, flaky or cracked skin can also lead to infection and make controlling any swelling more difficult. If an infection develops it can lead to further damage to the lymph system due to scarring, and may make the lymphedema worse.
  • Exercise
    Exercise will keep your joints supple and encourage muscle activity which is very important for lymph drainage. Although you may already use your arm actively in your everyday life or work and get plenty of exercise in this way, swelling can sometimes restrict movement of the arm and extra exercises may be helpful.
    Sport and fitness Sports and activities that you did before you developed lymphedema and those you wish to take up now are still possible, as long as you return to/start them slowly and stop if you have any discomfort or you notice further swelling. If you want to increase your activity levels or take up a new sport, make sure you do it gradually. Research suggests that exercise is helpful when you have lymphedema and does not make the lymphedema worse.
    General activities try not to use the affected arm for lengthy, strenuous activities such as lifting, carrying heavy objects or pushing heavy equipment like lawn mowers. If you need to do these activities, try to do other things in between to break up the length of time spent on them.
  • Maintaining a healthy body weight
    Being overweight can affect how you respond to treatment for lymphedema, so it’s important to try to keep your weight within normal limits. There’s no specific diet that will help but if you are overweight, try to follow a healthy, well-balanced eating plan and a regular exercise programme
  • Compression garments
    If the swelling is in your arm and/or hand you may be fitted with a compression garment in the form of a sleeve and/or glove to help control your lymphedema. If the swelling is in your breast or chest wall area, you may be fitted with a compression bra or vest. Your lymphedema specialist will assess which size and type of garment is best for you and this will usually be available on prescription.
    Compression garments are designed to reduce existing swelling and prevent further swelling by encouraging lymph fluid to drain away from the affected arm. The garment provides a firm resistance against which the lymph vessels are squeezed by the muscles during activity. This allows the lymph fluid to move up the arm more effectively. Wearing the garment may feel quite strange at first but it should feel comfortable and supportive. You will normally be provided with two garments so that one can be washed while the other is being worn.
    The average life span of a compression garment is about six months, after which it loses some of its elasticity and effectiveness. Therefore, make sure you contact your breast care nurse or lymphedema specialist to request new garments.
    If you find the garment difficult to cope with, and your lymphedema specialist has checked that it fits correctly, try wearing it when you are most active and then take it off when you are least active. The compression garment is most useful when your muscles are working actively and least useful during rest. Evidence is limited to support the use of compression garments during air flight in people with lymphedema.

Management of Pain with Cancer

Most patients with advanced cancer, and up to 60% of patients with any stage of the disease, experience significant pain. The World Health Organization (WHO) estimates that 25% of all cancer patients die with unrelieved pain. Although pain can be  adequately in most cancer patients, it remains under-treated because of unfounded fears of opioid addiction, unavailability of analgesics from pharmacies, and cultural factors; however, it is the responsibility of healthcare professionals to address these barriers. Despite nearly 2 decades of awareness, medical oncologists continue to see poor pain management education during training, inadequate pain assessment, reluctance to prescribe opioids, and regulatory barriers. These trends are documented in every care setting, including designated cancer centers, where one-third of cancer patients continue to receive an inadequate dose of analgesics. Minority and elderly cancer patients continue to be more likely to have inadequate pain management, including administration of analgesics and palliative radiotherapy. The management of cancer-related pain is an ethical responsibility of healthcare professionals to relieve unnecessary suffering, as part of the duty to care.

Pain Symptoms: Cancer pain syndromes vary by tumor type and are related to patterns of tumor growth and metastasis. Pain may also be related to anti-neoplastic therapy. Many patients have pain caused by other co-morbid nonmalignant conditions, such as arthritis. Thorough evaluation is needed to distinguish cancer-related from non–cancer-related pains.

Elements of Management:

First and foremost, elements of cancer pain management include adequate management of symptoms to relieve suffering while undertaking a diagnostic evaluation that determines the cause of the pain. Once the cause of the pain is determined, specific interventions are selected to target it to provide durable pain relief and prevent potential cancer-related morbidity, such as pathologic fracture and spinal cord compression. Interventions to relieve cancer pain should be chosen according to the:

(1) cause of the pain

(2) patient prognosis and performance status

(3) prior therapies; and, most important

(4) the preferences of the patient in the context of overall goals of care

Ongoing care is needed to monitor the efficacy of the pain management plan relative to the evolution of other symptoms during treatment or to later disease progression. Recurrent pain or new sites of pain often are the first indications of cancer progression and should be promptly evaluated.



Dietary Supplements and Cancer

The idea of adding multivitamin to our diet has being an age-long practice. Be it on self-medication ground or by a clinician prescription has also posed a great challenge to health both to the sick and the healthy.

These multivitamin are trace body nutrients gotten from manufactured drugs or supplements needed by the body in minute quantities to support good body functions such as: cells metabolic activities, growth, proliferation etc. Vitamins and dietary supplements come as pills, tablets or a liquid and as well as water-soluble and fat-soluble.

Some complementary or alternative therapists also use injections of dietary supplements. However, these food supplements in the case of cancer might be needed in low levels of calcium and vitamin D nutrient as seen in hormone therapy (often used for breast and prostate cancer) which are known to weaken bones. Nevertheless, there is no reliable evidence that any dietary supplement can help to prevent cancer. But there is evidence that a healthy diet with plenty of fruit and vegetables can reduce your cancer risk.

Some research has looked at whether particular vitamins and dietary supplements can help to prevent cancer in certain groups of people. One of such large study in the USA found that giving vitamin E supplements to male smokers reduced their risk of prostate cancer.

It also found that giving beta carotene which is the active ingredient in vitamin A supplements to men with low levels of it in their diet reduced their risk of prostate cancer. But the supplements had no effect for non-smokers or men who had normal levels of beta carotene from their diet.

Furthermore, eating foods that contain beta carotene such as carrot can help to reduce the risk of lung cancer. But taking beta carotene supplements does not seem to have the same effect.

Some dietary supplements can cause skin sensitivity and severe reactions when taken during radiotherapy treatment. Some vitamins or minerals could interfere with how well cancer drugs work. Antioxidant supplements which is known to eat up the free radicals that destroys cells such as co enzyme Q10, selenium and the vitamins A, C and E can help to prevent cell damage.

The Royal College of Radiologists advises that people with cancer should not have high doses of antioxidant supplements during their cancer treatment.

Finally, supplements can be good if taken when needed with a need-assessment information prior to its commencement as high doses of some supplements can be counter-productive to its intended purpose. Regular visit to your Oncologist for a professional guide will help a lot.


Many patients with cancer rely on spiritual or religious beliefs and practices to help them cope with their disease. This is called spiritual coping. Many caregivers also rely on spiritual coping. Each person may have different spiritual needs, depending on cultural and religious traditions.

For some seriously ill patients, spiritual well-being may affect how much anxiety they feel about death. For others, it may affect what they decide about end-of-life treatments. Some patients and their family caregivers may want doctors to talk about spiritual concerns, but may feel unsure about how to bring up the subject.

Spirituality and religion can be important to the well-being of people who have cancer, enabling them to better cope with the disease. Spirituality and religion may help patients and families find deeper meaning and experience a sense of personal growth during cancer treatment, while living with cancer, and as a cancer survivor.
Spirituality versus Religion

Spirituality is the relationship people have with a force or power beyond themselves that helps them feel connected and enrich their lives. Religion is a specific set of beliefs or practices usually connected to an organized group. Some people find spirituality by practicing their religious beliefs, while others find it outside of an organized religion.

Many cancer patients would describe themselves as spiritual, but not necessarily religious, experts say.

People who are already religious often become more deeply religious being diagnosed with cancer, whereas others who were not religious sometimes seek spirituality and a connection to a power outside themselves after the diagnosis.

Often people return to the religious traditions of their childhood, experts say. But others may find comfort in a new tradition, such as meditation.

“Spirituality is a chance to be reconnected to God, a religious tradition, and a community that provides hope and strength for the cancer patient”

Spirituality and Quality of Life for Cancer Patients

Experts say that spiritual or religious practices can help you adjust to the effects of cancer and its treatment. Patients who rely on their faith or spirituality tend to experience increased hope and optimism, freedom from regret, higher satisfaction with life, and feelings of inner peace. In addition, patients who practice a religious tradition or are in touch with their spirituality tend to be more compliant with treatment and live a healthier lifestyle.

Studies show spirituality also can have a direct impact on quality of life by contributing to your physical health. Among the benefits shown in studies are:

  • Decreased feelings of anxiety, depression, and anger
  • Decreased feelings of loneliness
  • Decreased alcohol and drug abuse
  • Lowered blood pressure
  • Better control of pain, nausea, and discomfort

Spirituality may help patients and families find deeper meaning and experience a sense of personal growth during cancer treatment, while living with cancer, and as a cancer survivor.

A Place for Spirituality in Your Cancer Care?

Even though there are more cancer survivors today than ever before, a cancer diagnosis is scary for most people because they are suddenly faced with their mortality. They also don’t know what to expect from the cancer and treatment, although they know it will be challenging.

Often cancer patients report that they feel alone because they believe that no one can truly know what they are going through. Priests practice what is called compassionate presence, where they make themselves available to help people with cancer feel more connected to another human being, and perhaps to God, during this part of life’s journey. Many newly diagnosed cancer patients pray for a cure. However, if a cure is not in sight, cancer patients may look for emotional healing and often hope this healing can come from their spiritual relationship. They want to find meaning in their lives and their existence, and they are looking for a sense of support.

End of life decisions have a huge spiritual component. Some studies show that doctors’ support of spiritual well-being in very ill patients helps improve their quality of life. Health care providers who treat patients coping with cancer are looking at new ways to help them with religious and spiritual concerns. Doctors may ask patients which spiritual issues are important to them during treatment as well as near the end of life. When patients with advanced cancer receive spiritual support from the medical team, they may be more likely to choose hospice care and less aggressive treatment at the end of life.

When Spirituality Is Not Comforting

For some, a cancer diagnosis has the opposite effect on their sense of spirituality. It makes them doubt their beliefs or religious values, challenges their faith, and can cause spiritual distress. Some people become angry with God for allowing them to get cancer or wonder if they are being punished.

Spiritual distress can make it harder for patients to cope with cancer and its treatment. If you feel this way, it could have a negative effect on your attitude and progress. However, even people who are angry at God or are non-believers might benefit from talking to a spiritual counselor, experts say. Expressing feelings of shaken belief to someone who may be able to help restore faith, or even just understand your anger and doubts, can be therapeutic.

How to Find Spiritual Help if You Have Cancer

Each patient has unique spiritual needs based on cultural and religious traditions and upbringing. So you may be unsure about how to bring up the subject with your health care team. Keep in mind, though, that doctors and nurses are used to discussing this topic. Your cancer care professionals know that these beliefs can impact heavily on patients’ attitudes toward cancer and the challenges ahead, as well as decisions about treatment. Most teaching hospitals and cancer centers have churches around to help you cope with the challenges you are facing.

You shouldn’t be afraid to ask to see a priest or pastor. Even if he or she is not of your faith, they have helped hundreds of people take a similar journey, and will not try to convert you to a particular religious belief. They are there to offer solace, not conversion.

The priest/pastor/imam will spend time talking with you, will pray with and for you, and will offer a compassionate presence when you need it. And if you want to see a person in a certain religious tradition, such as a priest or an imam, the doctor can find someone for you.

Spiritual practices that may help you cope with your cancer and its treatments include:

  • Praying alone or with someone else
  • Having someone else pray for you
  • Meditation
  • Meditative breathing
  • Reading scripture or other holy works
  • Saying one passage from your religious tradition over and over again like a mantra
  • Using the language of your religion, such as English, Arabic, or Latin, in your prayers
  • Listening to classical or spiritual music
  • Yoga
  • Talking about spiritual matters with another
  • During times of pain and discomfort, during treatments, or when you feel alone, these and other practices can help take you mentally to another place where you feel whole, connected, and at peace.

Good Nutrition

Good nutrition is always important while you are receiving cancer treatment. Adequate daily intake of calories, protein, vitamins and minerals is needed to promote healing and aid in minimizing side effects.

The consequences of malnutrition among patients with cancer can lead to weight loss, muscle weakness, apathy, immune deficiency, frequent infections and higher mortality.

What is a calorie? A calorie is a unit of energy. A nutritional requirement / consumption is often expressed in calories/day e.g 1g of fat contains 9Kcal.


When we eat and drink more calories than we use up, our bodies stores the excess as body fat.

Here are some recommendations to promote good nutrition:

  • Drink plenty of fluids: 6-8 glasses each day, if possible, (1.5-2 quarts).
  • If your appetite is limited, You might prefer to eat 5 or 6 smaller meals rather than the 2 or 3 larger meals usually eaten each day.
  • If cooking smells are unpleasant, try cool or chilled foods which have fewer aromas. Remember to eat slowly and chew your foods well.
  •  A pleasant atmosphere or meals enjoyed with friends or family often helps stimulate the appetite


Recommendations for nutrition may be individualized based on your current health status and history including those with diabetes. Your dietitian can provide additional recommendations or assistance in helping you meet your nutrition and/or diet therapy goals.


Healthy Eating Strategies

Everyone should make an effort to make healthy food choices to promote good health.

Watching the amount of fat you eat is important: Diets that are high in fat are often high in calories and can lead to weight gain. Ounce for ounce, fats contain more calories than carbohydrates or proteins, but it’s important to keep in mind that just because something is low in fat doesn’t mean it’s low in calories.

A good rule of thumb when you’re reading food labels: For every 100 calories, if the product has 3 grams of fat or less, it’s a low-fat product. This means 30% or less of the calories come from fat.

Foods like margarine, mayonnaise, and some salad dressings that get most of their calories from fat must have half or less than half the fat of the regular version of the food to be called “light.” These foods don’t have to meet the 30% cutoff for number of calories from fat to be considered low-fat.

 Guidelines include:

  • avoiding oversized portions
  • choosing low-fat dairy products e.g Low-fat (1%) or fat-free (skim) yogurt, cottage cheese, or milkchoosing foods low in sodium
  • eating plenty of fruits, vegetables and whole grains
  • drinking water instead of sugary drinks

Calorie goals involves your weight aim (either weight loss or weight gain). If weight gain, calorie surplus is ideal, if weight loss – calorie deficit e.g eating less than the body needs and exercising.

An average person needs to eat about 2000 – 2500Kcal / day to maintain a healthy body weight.

You should aim to make daily food and beverage choices within your calorie goals to maintain or achieve a healthy weight.