Knowledge and Experience of Cancer Patients Receiving Chemotherapy in a Teaching Hospital in Nigeria

摘要

Background : Cancer, a non communicable disease is an important disease associated with severe suffering before eventual death of the patient. The incidence is rising world wide and over 60% of new cases have been estimated to occur in less developed part of the world. In Nigeria 70% patients present in late stage 3 and 4, at which palliative Radiotherapy and chemotherapy are the main stay of treatment. This study was conducted to find out the level of knowledge of our patents about chemotherapy and to assess self reported experience of chemotherapy. Method: Over a period of 10 months in 2011, 100 Consecutive cancer patient while receiving chemotherapy in the Radiotherapy clinic of the University College Hospital (UCH), Ibadan, were interviewed, using a set of questionnaires. These questionnaires consisted of sections A, addressing demographic variables, section B: knowledge of chemotherapy and section C addressing issues concerning their experiences on side effects of chemotherapy. The data was analyzed using SPSS software version 16. Results: One hundred patients were interviewed in the study period. The highest frequency of patients are in the age group 50-59 years, with male/female ratio of approximately 1:3. Most of the patients had Kanofsky Performance Status (KPS) of 70-90%. The common malignancies among them were breast, cervix, and nasopharyngeal cancer. Thirty six of the patients had Anthracycline based chemotherapy while 64 had non -Anthracycline. 88% of the patients complied with treatment and completed prescribed 6 courses. A good number of participants (98%) had prior information about chemotherapy and possible side effects. 95% of these patients expressed satisfaction with the chemotherapy treatment received and coped with the side effects because they were well prepared, though the process was tedious. Conclusion : The high level of knowledge and satisfaction among the patients may be attributed to the influence of the psycho-oncology clinic where these patients are counseled before commencement of treatment in the department. It is an avenue where most of their concerns are addressed. Introduction Cancer a non-communicable disease is an important disease associated with severe suffering before eventual death of the patient. The incidence is rising worldwide and it has been estimated that over 60% of new cases will occur in the less developed part of the world. Unfortunately the developing worlds have access to less than 10% of recourses committed worldwide to cancer control1. (WHO 1986).Most cancer patient in Nigeria present late and over 70% are in stages 3 &4, Campbell et al2 in their review of 5000 cancer cases in Ibadan, reported that majority presented at first visit in advanced stages while Ketiku et al3 reported 66% late presentation in stages III and IV.The late presentation has been attributed to lack of knowledge of cancer awareness, poverty, inadequate treatment facilities and inadequate cancer specialists to attend to the huge population of patients. For instance we have less than 30 radiation oncologists in Nigeria to a population of over 140 million people, and this scarcity cut across various specialties. There is no well-structured cancer control program and the unchecked activities of the traditional medicine and alternate medicine practitioners in Nigeria have further contributed to the late presentation. It has been estimated some years ago by Solanke et al4that there would be about 500,000 new cases of cancer yearly in Nigeria.With late presentation in Nigeria palliative Radiotherapy and Chemotherapy are the main stay of treatment5. Most commonly the term chemotherapy is used to refer to cancer killing drug. The drugs can be used as single agent or in combination, targeted to eliminating rapidly dividing cancer cell in the body. Chemotherapy can also be used in combination with other treatment modalities like surgery or radiotherapy as adjuvant or neo-adjuvanttherapy.Chemotherapy is used in