In 2010, Ethel Olomu was enrolled as a scholarship student at the Lagos Business School when she first discovered a lump in her breast. She had never heard about breast cancer before then. After her mother, a retired nurse, helped examine her breast, Olomu went to a doctor in south-south Nigeria, who told her she had nothing to worry about. “He said it was benign, and he could remove it,” Olomu says, “So I had a lumpectomy as an outpatient. In fact, we were conversing when he removed that lump.”
Unfortunately for her, it wasn’t a benign lump. Weeks later, she woke up in the middle of the night to see that her breast had enlarged to the size of “almost 10 people’s heads.” She had to drop out of business school and close her small business. After eight months of misdiagnosis, ineffective medications, and turning to traditional medicine and prayers, her sample work was sent to India, where she was diagnosed with Stage 4 breast cancer.
“They said, ‘This is the last stage of cancer, she has three weeks to live. Take her to hospice and show her all the love you can.’” Olomu tells OkayAfrica that a friend refused to accept she was dying, “She found a cancer clinic in Abuja where a visiting doctor from Atlanta comes to treat people. We went there, and he sent us back based on the diagnosis. But we insisted that I stay. Finally, he admitted me only on the condition of hospice and started giving me blood transfusions to ease my passing.”
Fortunately for Olomu, the blood transfusions built up her immunity, which enabled her to undergo chemotherapy and a mastectomy. During all this, she experienced what she refers to as grade one stigmas. “At a time when people thought it weird that women had to touch their breasts to check for breast cancer, and many didn’t even know what it was, I became ostracized. Some people saw me as taboo; some said I offended the gods. If I had 100 friends, 98 of them left, saying they didn’t want my sin to rub off on them. Others avoided me because they believed breast cancer could be transmitted.”
To ensure that other women who are diagnosed with breast cancer don’t encounter the stigmas based on myths about the disease, Olomu started doing community outreaches in 2014 to inform people about breast cancer. By 2020, she officially launched an NGO, Engraced Life Foundation, to encourage early detection, host screenings and cancer awareness walks, and raise funds for breast cancer treatments.
Myths, Misdiagnosis, and the Cost of Care
Breast cancer is a noncontagious disease that commonly affects women and a few men globally, with a high mortality rate in Africa. According to the World Health Organization (WHO), one in two women with breast cancer in Sub-Saharan Africa dies from it within five years of the diagnosis. In comparison with countries of the Global North, where the breast cancer survival rate is 90%, only 40% of breast cancer patients survive in Sub-Saharan Africa. Among the leading causes of death from breast cancer is late detection.
Dr Lucy Idiese, radiation and clinical oncologist at the University of Benin Teaching Hospital, Nigeria, says that early-stage diagnosis is uncommon because many people don’t willingly go for screening, and others use alternative means of treatment when they get diagnosed.
“Some patients go to prayer houses, use supplements, and [try] other things. By the time a person who has Stage 1 comes back to the hospital for treatment, after realizing that the alternative means don't work, they're usually at Stage 4. By that time, there's little to nothing to be done,” Dr Idiese says.
Meanwhile, another major factor in late diagnosis is the myths that stop people from seeking proper healthcare. In a 2022 WHO report, Dr Miriam Mutebi, a Kenyan oncologist, said that breast and cervical cancer are often linked to “sexual promiscuity” in Sub-Saharan Africa. According to Dr Idiese, some people believe that breast cancer is contagious by being in proximity to those who have it; some believe it is only older women who can get breast cancer. “There are people who tell you that it's only old people who can get breast cancer. But young people are getting it. I had a 15-year-old patient who had breast cancer,” she says.
Early-onset breast cancer was a strange concept for Aisha (last name withheld for anonymity), a Sudanese-American who got diagnosed with cancer at 31. Before that, she believed that only women in their 40s and above got breast cancer. Despite her healthy lifestyle and age, she was diagnosed with Stage 2 breast cancer and has gone through multiple treatments, including chemotherapy and mastectomy.
The realities of the difference in access to healthcare, particularly for cancer patients, became stark to Aisha when two of her relatives based in Sudan were also diagnosed with cancer around the same time. While she was getting treatment in New York, the health of her relatives rapidly declined.
“My family is from Sudan, and I had two family members who were going through the process of cancer, similar to me. Something that has been hard to grapple with is that I had my doctors, a caseworker who helped me navigate, an oncological surgeon, health insurance, and a grant my hospital helped me get, yet most folks that I know living in Sudan don’t have insurance,” Aisha tells OkayAfrica. “Also, health insurance is very complicated, depending on what country you're in. Something that people don't think about, especially people not talking enough about the war in Sudan, Congo, and all these other places, is how much these things interrupt the most basic way people can live their lives and to be able to receive care.”
Financial and Cultural Hurdles in Cancer Care
In different parts of Africa, there is little to no access to health insurance, which can offset the cost of treatment. So, many breast cancer patients have to pay out of pocket — from diagnosis to the treatment stage — which is often beyond their limited financial capacity.
Ifeoluwa Aribatise, co-founder of healthtech company Heala, says cancer care is very expensive, and there aren't enough doctors, clinics, or drugs to adequately help the number of patients that require them in Nigeria. In addition to that, deep-rooted cultural beliefs and misinformation often delay or worsen outcomes of treatment.
“There’s a cultural thing where we, as a people, don’t understand how fickle health is, then we turn to spirituality in place of medicine when we get sick.” Aribatise says, “When my sister was diagnosed with breast cancer, there were some people who, in their own wisdom and care, said honey and black pepper would work. Some said we should use holy water and herbs. I told them there's a reason God gave doctors wisdom and put all these natural resources on earth. Science is [meant] to transform these things for our own good.”
Aribatise unfortunately lost her sister to breast cancer after a recurrence years after the initial treatment. She believes that breast cancer awareness is very important, so that treatment and care are easily available to patients without fear of stigma or abandonment.
“Every day is cancer day. Every day is the time to get checked. Every day is a good day to get insured, talk to a doctor, and know and understand your body,” says Aribatise.
