Examining Cancer Patients' Perceptions of the Impact of COVID-19 on Teleoncology: Findings From 15 Nigerian Outpatient Cancer Clinics.

PURPOSE: To examine cancer patients' perspectives on the impact of COVID-19 on teleoncology in Nigeria. METHODS: Data from a multicenter survey conducted at 15 outpatient clinics to 1,097 patients with cancer from April and July 2020 were analyzed. The study outcome was telemedicine, defined as patients who reported their routine follow-up visits were converted to virtual visits because of COVID-19 (coded yes/no). Covariates included patient age, ethnicity, marital status, income, cancer treatment, service disruption, and cancer diagnosis/type. Stata/SE.v.17 (StataCorp, College Station, TX) was used to perform chi-square and logistic regression analyses. P values ≤ .05 were considered statistically significant. RESULTS: The majority of the 1,097 patients with cancer were female (65.7%) and age 55 years and older (35.0%). Because of COVID-19, 12.6% of patients' routine follow-ups were converted to virtual visits. More patients who canceled/postponed surgery (17.7% v 7.5%; P ≤ .001), radiotherapy (16.9% v 5.3%; P ≤ .001), and chemotherapy (22.8% v 8.5%; P ≤ .001), injection chemotherapy (20.6% v 8.7%; P ≤ .001) and those who reported being seen less by their doctor/nurse (60.3% v 11.4%; P ≤ .001) reported more follow-up conversions to virtual visits. In multivariate analyses, patients seen less by their doctors/nurses were 14.3 times more likely to have their routine follow-ups converted to virtual visits than those who did not (odds ratio, 14.33; 95% CI, 8.36 to 24.58). CONCLUSION: COVID-19 caused many patients with cancer in Nigeria to convert visits to a virtual format. These conversions were more common in patients whose surgery, radiotherapy, chemotherapy, and injection chemotherapy treatments were canceled or postponed. Our findings suggest how COVID-19 affects cancer treatment services and the importance of collecting teleoncological care data in Nigeria.

Health-related quality of life associated with different cervical cancer therapies received by patients in two Nigerian tertiary hospitals.

Background: There are important consequences from cervical cancer (CC) disease and its treatment among survivors, especially the impact on quality of life (QoL). Objective: To evaluate the health-related QoL associated with different CC therapies received by patients in two Nigerian tertiary hospitals. Methods: This study employed a prospective longitudinal design. It was conducted at Usmanu Danfodiyo University Teaching Hospital, Sokoto and Ahmadu Bello University Teaching Hospital Zaria, North-Western Nigeria. Data of all the 157 eligible CC patients were collected at baseline and after therapy. Data analysis was done with appropriate descriptive and inferential statistics using SPSS V. 20 for windows. P<0.05 was considered statistically significant. Results: Chemotherapy (CT) was the major therapy option received by 78(49.7%) of the patients. Patients who received chemoradiation therapy (CRT) and adjuvant chemotherapy (CTS) had the highest increase in mean overall health-related QoL of 0.138 (t=8.456, p<0.001) and 0.138 (t=6.489, p<0.001) higher than their respective baseline scores. Patients who received CT had the least increase in mean overall health-related QoL of 0.095 (t=4.574, p<0.001) from baseline. Conclusion: Chemoradiation therapy and adjuvant chemotherapy were associated with highest increase in mean overall health-related QoL. Chemotherapy was associated with the least increase in mean overall health-related QoL.

Development and reliability testing of a cervical cancer patients knowledge and practice of self-care management of treatment-related adverse events questionnaire.

INTRODUCTION: Cervical cancer (CC) treatment-related adverse events (AEs) were found to be among the major reasons for treatments delays and medication non-adherence. Knowledge and practice of self-care management of these AEs are therefore needed to complement the pharmacotherapeutic interventions. Instruments for assessing CC patients' knowledge and practice of self-care management of treatment-related Adverse Events (AEs) are lacking. Hence, the rational for this study. METHODS: A prospective, cross-sectional study was conducted on CC patients receiving chemotherapy, radiotherapy or both, with or without surgery in Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, a tertiary hospital in North-Western Nigeria. A panel of 14 experts judged the content validity of the items initially selected. Purposive sampling technique was used, 31 CC patients were recruited and interviewed for the questionnaire pre-testing. Descriptive statistics and psychometric analysis were conducted using SPSS Version 20.0 for Windows. A Cronbach's alpha coefficient ≥0.70 was considered acceptable. RESULTS: A 12-domain questionnaire instrument was developed. Eight (57.1%) of the expert panelists rated the questions' items as "Very good for the study" and none of them rated any of the content "not relevant for the study". The reliability studies showed that the overall knowledge and practice questions response rates were 71.0% and 77.4% and Cronbach's alpha (α) values were 0.956 and 0.913, respectively. CONCLUSION: A reliable, 12-domain cervical cancer patients' knowledge and practice of self-care management of treatment-related adverse events questionnaire was developed. Further research on the psychometric qualities of the instrument is needed.

Patient's Perspective on the Impact of COVID-19 on Cancer Treatment in Nigeria.

PURPOSE: Because of the global COVID-19 pandemic, health care organizations introduced guidelines for modifications to health and cancer medical care delivery to mitigate transmission and ensure quality health outcomes. To examine the extent and impact of these modifications on oncology service disruptions in Nigeria, we surveyed oncology patients across selected public and private cancer treatment centers. MATERIALS AND METHODS: Participating in the study were 15 tertiary cancer treatment centers across 12 Nigerian states. We recruited adult patients with cancer (18+ years) on active treatment to complete a self-administered survey on cancer care during COVID-19. We conducted descriptive and multivariate data analysis using Stata 16.1. RESULTS: Respondents were (n = 1,072), female (65.7%), ages 18-49 years (50.3%), and married (80.7%). The top two cancers were breast and prostate. Overall, 17.3% of respondents reported disruptions to cancer care, and more than half (51.0%) reported difficulties accessing care. Changes in chemotherapy regimens or route of administration were reported in 8.4% of respondents. Odds for any disruption were highest for older patients, western states, patients with prostate cancer, and patients with two or more flu symptoms. Odds for radiotherapy cancellation were highest for older patients, those with prostate cancer, and those with medium service perception. CONCLUSION: This study investigated COVID-19-influenced cancer treatment disruptions in Nigeria. Patients with cancer experienced significant disruptions to cancer care. Vulnerable patients are most likely to be negatively affected. Policies and strategies aimed at minimizing service disruptions while maintaining cancer patients' safety should be a priority for all health care institutions in the COVID-19 era.

Delayed hypersensitivity to oxaliplatin in a nigerian patient with colorectal cancer-A case report.

INTRODUCTION: Oxaliplatin is a third generation anti-neoplastic platinum compound (organo-platinum complex) used in the treatment of several solid tumours either as a single agent or in combination with other chemotherapy drugs. Hypersensitivity reactions to oxaliplatin are uncommon, with most reports indicating an incidence of 1-5%. The severity of reactions may vary from grade 1 side effect in line of skin flushing and/or rashes to very severe, life-threatening systemic anaphylaxis (grade 3/4). Following mild to moderate hypersensitivity reactions, steroids and/or antihistamines could be administered, after which the patient can be re-exposed to the drug. In severe hypersensitivity reactions however, oxaliplatin must be discontinued while alternative chemotherapeutic regimen or even other forms of therapy should be considered. CASE REPORT: A 56 year old woman with colorectal cancer who was commenced on adjuvant oxaliplatin therapy developed Hypersensitivity reaction about 2 hours of the first oxaliplatin administration, for which the drug was discontinued and the symptoms improved. She had similar reactions in 2 subsequent attempts at administering same drug, after which the drug was changed. A placebo infusion was administered twice with no untoward reactions.Management and outcome: With each reaction, the drug was immediately discontinued and she was promptly given intranasal oxygen and corticosteroids. She was premedicated with anti-histamines and corticosteroids prior to subsequent cycles. Oxaliplatin was consequently discontinued and she experienced no further hypersensitivity reaction to the subsequent drug regimen. DISCUSSION: Hypersensitivity reactions to oxaliplatin, though a rare occurrence, are more likely idiosyncratic; with more cases being reported in recent times.

Pattern of Cancers Treated with Radiotherapy in Uduth Sokoto: A New Center Experience.

BACKGROUND: Cancer is a leading public health problem worldwide. In many developing countries, cancer tends to present in predominantly advanced stages, to a certain extent due to lack of comprehensive screening and poor access to efficient management. This study was carried out to describe the pattern of cancers managed in the Department of Radiotherapy and Oncology in Usmanu Danfodiyo University Teaching Hospital Sokoto, North-western Nigeria. MATERIALS AND METHODS: This was a cross-sectional descriptive study involving patients with malignancies that attended the new Oncology Department of the Usman Danfodiyo University Teaching Hospital Sokoto, North-West Nigeria for the period of one year (June 2013 - May 2014). The data was analyzed using SPSS (versions 20). RESULT: A total of 210 patients with complete records met the criteria for the study. Majority 162 (77.1%) were females with a mean age of 45.68±12.4 years. The male patients were 48 (22.9%) with mean age 46.27±16.5. The spectrum of malignant lesions observed were cancer of the cervix 77 (36.67%), breast cancer 74 (35.24%), nasopharyngeal cancer 20 (9.52%), cancer of the larynx 18 (8.57%) and rectal cancer 14 (6.67%). Late presentation was most common with 6 (3%), 101 (49.8%) and 58 (28.6%) patients presenting at stage I, III and IV, respectively. CONCLUSION: The study demonstrates that Cancer of the cervix is the leading malignancy in the study population.