Cancer rising in our communities: What you need to know – prevention, warning signs and cancer staging

What Every Family Must Know About Prevention, Warning Signs and Cancer Staging

By Olawuyi Victor OYETAYO

CEO Genesis Medical Diagnostics Centre Prince Olawuyi

Biomedical Scientist, Community Health Advocate and CEO, Genesis Medical Diagnostics Centre

Cancer is not automatically a death sentence. Many cancers can be prevented, and many can be successfully treated—particularly when detected early and managed appropriately.

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Cancer is no longer a distant disease affecting only people in wealthy countries or families somewhere else. Across Nigerian communities, more families are encountering breast cancer, prostate cancer, cervical cancer, colorectal cancer, liver cancer, blood cancers and other malignancies.

However, we must be scientifically careful when discussing the apparent increase. Better awareness and diagnosis may explain part of the rise in reported cases, while population growth, longer life expectancy, infections, tobacco exposure, alcohol consumption, obesity, physical inactivity, environmental hazards and changing lifestyles may also contribute. In many Nigerian communities, incomplete cancer registration means the true burden may be higher than available figures suggest.

The most troubling problem is not merely that cancer occurs. It is that many patients arrive at appropriate healthcare facilities only after the disease has become advanced. Fear, poverty, misinformation, spiritual interpretations, unregulated treatment, weak referral systems and limited access to pathology and imaging all contribute to dangerous delays.

What exactly is cancer?

The human body is made of trillions of cells. Normally, these cells grow, divide and die in a controlled manner. Cancer develops when genetic changes cause some cells to grow uncontrollably, resist normal cell death and sometimes invade surrounding tissues.

A collection of abnormal cells may form a tumour. However, not every tumour is cancerous.

A benign tumour is non-cancerous. It may grow or cause pressure, but it does not invade distant organs.
A malignant tumour is cancerous. It can invade nearby tissues and may spread to other parts of the body.
Some cancers, including leukaemia, begin in blood-forming tissues and may not produce a solid lump.

When cancer cells travel from their original location to distant organs through the blood or lymphatic system, this is called metastasis.

Cancer is not contagious. However, some infections associated with cancer—including human papillomavirus, hepatitis B, hepatitis C and Helicobacter pylori—can be transmitted or acquired.

The cancers of greatest concern in our communities

The exact pattern varies by sex, age and location, but breast, prostate and cervical cancers are among the leading cancers in Nigeria. Liver and colorectal cancers also represent important public-health concerns. International estimates should be interpreted in light of limitations in national cancer registration.

1. Breast cancer

Breast cancer is a major cause of illness and death among women. It can also affect men, although male breast cancer is uncommon.

Warning signs include:

A new breast or armpit lump
Thickening or swelling of part of the breast
Unexplained change in breast size or shape
Dimpling or redness of the breast skin
Nipple inversion, discharge or bleeding
Persistent breast or nipple changes

Not every breast lump is cancer, and breast pain alone is not usually diagnostic of cancer. Nevertheless, every persistent or suspicious change requires professional assessment. Women should know the normal appearance and feel of their breasts and report changes promptly. Clinical examination, appropriate imaging and, where indicated, tissue sampling may be required.

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2. Prostate cancer

The prostate is a gland located below the bladder in men. Prostate cancer becomes more common with increasing age, particularly after 50, and men of African ancestry have an elevated risk.

Warning signs include:

Difficulty starting or stopping urination
Weak urinary flow
Frequent urination, especially at night
Blood in the urine or semen
Persistent pain in the back, hips or pelvis
Unexplained weight loss in advanced disease

These symptoms can also result from benign prostate enlargement, infection or other conditions. A prostate-specific antigen test—commonly called PSA—does not independently confirm cancer. An abnormal result requires clinical interpretation and may lead to examination, imaging and biopsy. Men should discuss their individual risk and the potential benefits and limitations of PSA testing with a qualified clinician.

3. Cervical cancer

Cervical cancer affects the lower part of the womb and is predominantly caused by persistent infection with high-risk types of human papillomavirus. It is one of the most preventable cancers through HPV vaccination, cervical screening and timely treatment of precancerous changes. Precancer usually causes no symptoms, which makes screening essential.

Warning signs include:

Bleeding after sexual intercourse
Bleeding between menstrual periods
Bleeding after menopause
Persistent, unusual or foul-smelling vaginal discharge
Pelvic, back or leg pain
Pain during sexual intercourse

HPV vaccination is prioritised for girls aged 9–14 years, while women should undergo cervical screening according to national clinical guidelines. Vaccination does not eliminate the need for future screening.

4. Colorectal cancer

Colorectal cancer begins in the colon or rectum. Although it occurs more frequently after age 50, cases among younger adults must not be dismissed.

Warning signs include:

Blood in the stool or rectal bleeding
A persistent change in bowel habit
Persistent diarrhoea or constipation
Unexplained abdominal pain or swelling
Unexplained iron-deficiency anaemia
Unintentional weight loss
Persistent fatigue

Haemorrhoids can cause rectal bleeding, but no one should assume that blood in the stool is ‘only piles’ without appropriate medical evaluation.

5. Liver cancer

Chronic hepatitis B and C infections are major causes of liver cancer. Heavy alcohol consumption, cirrhosis, obesity and other chronic liver diseases can also increase risk. Exposure to aflatoxin—produced when maize, groundnuts and other foods are poorly stored and become mouldy—is particularly relevant in some African settings.

Warning signs include:

Pain or swelling in the upper-right abdomen
Yellowing of the eyes or skin
Unexplained weight loss
Loss of appetite
Persistent weakness
Abdominal swelling

Hepatitis B vaccination, safe blood transfusion, sterile medical practices, testing and treating eligible patients with viral hepatitis, limiting alcohol and preventing food contamination can reduce risk.

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General warning signs that should never be ignored

Cancer symptoms differ according to the organ involved. Nevertheless, seek medical assessment for:

A new or enlarging lump
Unexplained bleeding
A sore that does not heal
Persistent cough or hoarseness
Difficulty swallowing
Persistent change in bowel or bladder habits
Unexplained weight loss
Severe or persistent fatigue
Persistent pain without a clear explanation
A mole or skin lesion that changes in size, colour or shape

These symptoms do not automatically mean cancer. They mean that proper assessment is necessary.

Understanding cancer staging

People frequently hear expressions such as ‘Stage II’ or ‘Stage IV’ without understanding what they mean. Cancer stage describes how much cancer is present and how far it has spread. It helps clinicians select treatment, estimate prognosis and communicate consistently.

For many solid cancers, staging considers the TNM system:

T—Tumour: the size of the original tumour and the extent to which it has invaded nearby tissues.
N—Nodes: whether cancer has spread to nearby lymph nodes.
M—Metastasis: whether it has spread to distant organs.

Stage	General meaning
Stage 0	Abnormal cells remain where they developed and have not invaded nearby tissue. This is commonly called carcinoma in situ.
Stage I	Cancer is present but is usually small and confined to its original organ or site.
Stage II	The cancer is larger or has extended further locally. Depending on the cancer, nearby lymph nodes may be involved.
Stage III	The cancer has spread more extensively into nearby tissues or regional lymph nodes but has not necessarily reached distant organs.
Stage IV	The cancer has spread to a distant part of the body. This is called metastatic cancer.

These are general descriptions. The precise definition of each stage differs between breast, prostate, cervical, colorectal and other cancers. Some cancers—including leukaemia and many brain tumours—use different classification systems.

A higher stage generally indicates more extensive disease, but stage is not the whole story. Prognosis and treatment also depend on:

The exact cancer type and subtype
The grade or aggressiveness of the cells
Molecular and hormonal characteristics
The patient’s general health
Response to treatment
Availability and quality of care

Stage IV does not mean that nothing can be done. Treatment may control disease, reduce symptoms, prolong life and preserve dignity. Palliative care is not surrender; it can be provided alongside cancer treatment.

How cancer is confirmed

Cancer must not be diagnosed solely by symptoms, prayer-house pronouncements, ultrasound findings or a tumour-marker result.

Assessment may involve:

Medical history and physical examination
Laboratory investigations
Ultrasound, mammography, X-ray, CT, MRI or other imaging
Endoscopy, depending on the suspected site
Cytology or biopsy
Histopathological examination
Immunohistochemistry or molecular testing where required

In most solid tumours, histopathological examination of tissue is the definitive method of confirming the diagnosis and determining its type and grade. Imaging then helps determine the extent of disease. Tumour markers such as PSA, CA-125, CEA, AFP and CA 15-3 can be useful in selected circumstances, but they are not universal stand-alone cancer tests.

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Reducing our cancer risk

The World Health Organization estimates that approximately 38% of cancers can currently be prevented through existing evidence-based strategies.

Avoid tobacco in every form and avoid second-hand smoke.
Limit or avoid alcohol.
Maintain a healthy body weight.
Exercise regularly.
Eat vegetables, fruits, legumes and other fibre-rich foods.
Reduce excessive consumption of processed meat.
Vaccinate eligible children against HPV.
Ensure hepatitis B vaccination.
Test for hepatitis B and C when appropriate and obtain proper treatment.
Store maize, groundnuts and other foods properly; discard visibly mouldy food.
Use protective equipment against harmful occupational chemicals and radiation.
Participate in appropriate cervical, breast and colorectal screening.
Discuss prostate-cancer risk with a clinician.
Seek medical attention promptly when symptoms persist.

Screening is intended for people without symptoms. Anyone who already has suspicious symptoms requires diagnostic assessment rather than merely attending a routine screening exercise.

What our communities must do

Cancer control cannot be left to individual patients alone. Government, health institutions, community organisations, religious bodies, traditional leaders and the media all have responsibilities.

Sustained community education in local languages
Wider access to HPV and hepatitis B vaccination
Affordable, quality-assured screening and diagnostic services
Stronger pathology, imaging and cancer-registry capacity
Clear referral pathways between primary care and specialist centres
Financial protection for patients requiring surgery, chemotherapy or radiotherapy
Regulation of false cancer remedies and misleading health claims
Psychological, social and palliative support for patients and families

We must also confront stigma. Cancer is not necessarily a punishment, spiritual attack or consequence of immoral behaviour. Although faith and spiritual support may help patients cope, they should complement—not replace—medical diagnosis and treatment.

The message every family should remember

Do not hide a suspicious lump. Do not repeatedly treat unexplained bleeding without establishing its cause. Do not allow fear of diagnosis to produce a more dangerous delay. Do not assume that every cancer is incurable.

Early diagnosis can mean less extensive treatment, lower cost, reduced suffering and a better chance of survival. Many cancers have a high probability of successful treatment when detected early and treated appropriately.

Cancer detected early may be treated successfully. Cancer prevented saves a family from suffering. Cancer symptoms ignored may become a tragedy that knowledge and timely action could have prevented.

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