My esteemed teacher, mentor, and role model, Prof. G. A. Rahman, has consistently shared compelling breast cancer articles with me for over 5 years. Today, on October 13, 2023, I received an exceptionally intriguing and exciting one. The article, published by Shin et al. from the Republic of Korea last month (Cancers 2023, 15(19), 4720; https://doi.org/10.3390/cancers15194720 ), is about the long-term survival of patients with Breast cancer. No, not early breast cancer but Metastatic Breast Cancer. The study discovered 110 cases of metastatic disease surviving for more than 10 years, encompassing all molecular subtypes, accounting for 13.3% of the cohort studied.
I thought it’s worth sharing because this article passed almost all the questions of “what is in it for practice and patients in Nigeria.”
Now, why should we, in Nigeria and perhaps Africa, be interested in this article? Firstly, it reports on metastatic disease diagnosed either de novo or after progression or recurrence, a profile similar to 70-80% of breast cancer patients in Nigeria/Africa. The median age of the patients was 48.5 years, with more than 50% under the age of 50, mirroring the distribution of breast cancer patients in Nigeria/Africa.( DOI 10.31557/apjcc.2021.6.4.477-492)
What makes this even more compelling to share is the treatment the patients received. The majority underwent regular surgery, chemotherapy, radiotherapy, and hormonal therapy, with those HER2 positive receiving targeted therapy — all of which are available in Nigeria, albeit with some accessibility challenges. Notably, the authors stated that “the majority of patients in this cohort had no access to novel therapies such as CDK4/6 inhibitors, pertuzumab, trastuzumab etc.” Astonishingly, 20% were not treated with the intention to cure. They survived on palliative treatment for more than 10 years —Wow! a remarkable revelation.
In my perspective, I have always believed that we can have long-term survivors in Nigeria, and we are diligently working to create a substantial pool of survivors. I have personally witnessed and treated cases of metastatic disease, surviving for more than 5 years in Nigeria. However, we lack extensive data due to inadequate record-keeping. In conclusion, borrowing a line from the author’s own conclusion, “Patients with MBC may have exceptionally favorable prognoses regardless of the molecular subtype,” to this, I boldly add, even in Nigeria. Our immediate task is to determine what works for Nigerian patients within the available resources.
Agodirin Olayide
Olayide, I quite agreed with you especially your last submission “to determine what work for Nigeria”
My only worry is the fact that we are competing with socio-religion believe: many patients will still reject what you offer “in Jesus name”. Poverty, which is double-edged sword with ignorance, is also a major factor to deal with.
I, however, will encourage us all not to relent.