The OAUTHC is one of the first-generation teaching hospitals established by the Nigerian government to deliver quality health care to its people, and until very recently the only teaching hospital in Osun State, drawing patients from the whole of Ondo, Ekiti and parts of Oyo and Kwara states, a predominantly Yoruba ethnic population of about 20 million.

Launched in 1977 at the then fledgling University of Ile-Ife (now Obafemi Awolowo University), the hospital complex has grown to encompass two major hospital facilities, one dental hospital and three primary care centers. The major centers include the tertiary referral center in Ile-Ife and the Wesley Guild Hospital at Ilesa, located in a rural setting 30 kilometers from Ile-Ife. The dental center is located within the main campus of the Obafemi Awolowo University, ten minutes from the main hospital.

Cancer Care

Between January 2001 and December 2003, 860 cancer cases (all ages and sexes) were seen at OAUTHC. The most prevalent cancers seen there are breast, prostate and cervical cancers, followed by non-Hodgkin’s, non-Burkitt’s lymphoma, and Burkitt’s lymphoma, respectively. Other cancers include colo-rectal cancer, stomach, sarcomas, liver and skin cancers other than melanomas. In recent months, the hospital has been coordinating the free Glivec treatment for chronic myelocytic leukemia and gastrointestinal stromal tumors, under the Glivec International Patient Assistance Program sponsored by the Max Foundation.

The hospital is involved in collaborative research programs with the INCTR and with the International Agency for Cancer Research in Lyon, France, on the treatment and epidemiology of malignant lymphomas, and is also collaborating with the Meharry Medical College in Nashville, Tennessee, (USA), on the genetic epidemiology of breast cancer in African women.

Dr. Muheez Durosinmi is the sole hemato-oncologist on staff at OAUTHC. Other cancer professionals on staff include pathologists, radiologists, gynecologists, general surgeons, and pediatricians.

Dr. Durosinmi examines a patient in the two-bed Day Ward at OAUTHC, Ile-Ife.

“There is some cancer awareness in Nigeria, although its promotion is not as aggressive as one would want it to be,” says Dr. Durosinmi. “The Nigerian Cancer Society and some other related organizations are assisting with cancer control and prevention programs,” he says, most of which are concentrated in urban centers.

“I wish the government would show more interest in allocating resources to cancer control,” Durosinmi says. “A country as large as Nigeria should have dedicated cancer care centers by now—at least one in each of the six geo-political zones of the country. He notes that cervical cancer could be controlled through routine screening of women, liver cancer through HBV vaccination and compulsory screening of blood for HVB and HCV markers, and lung and several other cancers through avoidance of tobacco use. “It is sad to note that the Nigerian government has recently permitted one of the largest tobacco corporations in the world, British-American Tobacco, to open a new multi-billion tobacco factory in West Africa at Ibadan, Nigeria. This is in spite of the WHO Technical Report 695 of 1983 that states that “25-35% of males between the ages of 18-20 yrs are already addicted to cigarette smoking in the world’s most populous nations of India and China”, he says. “With over 90% of lung cancers being related to cigarette smoking, we fear there will be a marked rise in the incidence of lung and other tobacco-related cancers in our country in the next two decades.”

Burkitt’s Lymphoma

OAUTHC, Ile-Ife is collaborating with INCTR on the molecular characterization and treatment of Burkitt’s lymphoma. The treatment arm will re-validate the role of the widely used cyclophosphamide, oncovin and methotrexate (COM) combination therapy as the first-line treatment in the management of the tumor. In all cases, individual patients will be followed up for at least two years; a data manager/nursing officer will be employed to facilitate patient monitoring (including home visits) for the duration of treatment. Second-line therapy, in the form of etoposide, ifosfamide (+ mesna) and cytarabine will be offered to patients who fail first-line therapy.

Retinoblastoma Study

OAUTHC is also participating in INCTR’s retintoblastoma study. The ophthalmology unit of the hospital is gathering data from the parents of children with retinoblastoma at the time of diagnosis of the tumor in order to identify the the problems they face prior to treatment.

Breast Cancer Study

The breast cancer study is aimed at unraveling the genetic epidemiology of breast cancer in African women using a case control study technique. Tissue specimens from cases and appropriate controls are to be studied. The study participants are entered by breast cancer specialists, oncologists and epidemiologists from Ile-Ife, Nigeria and collaborators from the USA.

Other Collaborative Projects

INCTR is sponsoring a young doctor from OAUTHC to spend a year learning gynecologic oncology at the TATA Memorial Hospital in Mumbai, India. The INCTR is also assisting the hospital with the training of nurses and a social worker who will work with the gynecologist upon his return to Nigeria. This additional training and staffing will complement the limited cervical screening program currently available in the hospital.

“We believe our partnership with INCTR will enhance our understanding of the prevention and management of common cancers in our part of the world, through the introduction of affordable cancer control methods and use of cheaper, cost effective ther.apeutic agents,” says Dr. Durosinmi. “I also believe it will facilitate manpower development and capacity-building in the areas of cancer control and management.

“I am very optimistic about the future for health care in Nigeria,” he says. “The federal government is improving the diagnostic capabilities of many tertiary health facilities across the country and is about to introduce a health insurance scheme that will increase funding for health care. With participatory democratic government, my hope for a better tomorrow with respect to our health care system is very high.”