The mobile phone as a tool in improving cancer care in Nigeria.

OBJECTIVE: The use of mobile phone as a tool for improving cancer care in a low resource setting. METHODS: A total of 1176 oncology patients participated in the study. Majority had breast cancer. 58.4% of the patients had no formal education; 10.7 and 9.5% of patients had college or graduate education respectively. Two out of every three patients lived greater than 200 km from hospital or clinic. One half of patients rented a phone to call. RESULTS: At 24 months, 97.6% (1132 patients) had sustained their follow-up appointments as against 19.2% (42 patients) who did not receive the phone intervention. 72.8% (14 102 calls) were to discuss illness/treatment. 14% of the calls were rated as emergency by the oncologist. 86.2% of patients found the use of mobile phone convenient/excellent/cheap. 97.6% found the use of the phone worthwhile and preferred the phone to traveling long distance to hospital/clinic. Also the patients felt that they had not been forgotten by their doctors and were been taken care of outside the hospital/clinic. CONCLUSIONS: Low resource countries faced with the burden of cancer care, poor patient follow-up and poor psychosocial support can cash in on this to overcome the persistent problem of poor communication in their healthcare delivery. The potential is enormous to enhance the use of mobile phones in novel ways: developing helpline numbers that can be called for cancer information from prevention to treatment to palliative care. The ability to reach out by mobile phone to a reliable source for medical information about cancer is something that the international community, having experience with helplines, should undertake with colleagues in Africa, who are experimenting with the mobile phone potential.

Psychosocial effects of mastectomy on married African women in Northwestern Nigeria.

OBJECTIVES: Few studies have examined the psychosocial impact of breast cancer and its treatment on African women who come from a poverty-stricken, uneducated background in a developing country. The purpose of this study was to describe the specific psychosocial effects of breast cancer on married African women in order to help physicians educate and counsel future women and their families in Northwestern Nigeria. METHODS: Two semi-structured, self-report questionnaires were given to 81 consenting married African women treated with unilateral total mastectomy secondary to operable breast cancer at the Ahmadu Bello University Teaching Hospital. Questionnaires were answered at the time of the diagnosis and treatment consultation and at 6 months postmastectomy and included questions about demographics, frequency of conjugal relations and how the woman's sense of femininity was affected. Marital status was also tracked up to 3 years. RESULTS: Six months after surgery, the survey responses revealed that 67.9% of women felt inadequate as a woman because of the mastectomy and that 79.0% experienced a decrease in frequency of conjugal relations. Three years after primary breast cancer treatment, 61.7% of the participants were still married while 38.3% reported being divorced/separated from their husbands. CONCLUSIONS: These results indicated that married African women face significant physical, emotional and social changes and difficulties following primary breast cancer treatment. Culturally sensitive therapeutic groups and interventions should be established to help Nigerian women with breast cancer and their spouses and families understand and cope with the disease and its long-term health and quality-of-life implications.