Health Diary: Surviving Breast Cancer in Nigeria; A Survivor’s Story

Promise Adebayo

Health Diary is a monthly Healthconnect24/7 series that explores the different health challenges and stories of people in Nigeria. To share your Health Diary story with us, please fill this form.

To kick off this monthly series, in honor of World Cancer Day themed #ClosetheCancerGap, we spoke to Elizabeth Princewill-Sanni, a Nigerian who got diagnosed at 38 despite no family history of cancer. She shared how her diagnosis and treatment process went in Nigeria, how important her faith and circle were to her this period, shedding light on the great and not so great things she experienced.  

How did you find out that you had cancer?

In 2018, I had my daughter and she breastfed for just 7 months, 2 years after this, I found a lump in my breasts. I saw a doctor and a biopsy* test called FNAC (fine needle aspiration and cytology) was done. The test came back clear, and I went on with my life. Another 2 years later (2022), I noticed that the lump got bigger, and I was experiencing bloody discharge from that nipple, as a medical person, I knew the signs, but I constantly brushed it off.

While trying to get the right family planning method for me, I had to discuss my medical history with my gynecologist and she suggested that I do another breast ultrasound, see a surgeon with the scan result and then revisit the family planning. I knew something was off when the sonographer** was looking puzzled while doing the scan. At that point, I made up my mind to take out the lump regardless of the outcome of the scan.

After consulting with the surgeon, I opted for the lump removal instead of another biopsy. Since it is standard practice to send off excised tissue for what we call histopathology*** to know if there are any abnormalities, mine was sent and the result showed that it was a cancerous growth.

This marked the beginning of my journey, from consulting with my gynecologist to receiving a breast cancer diagnosis.

*Biopsy - An examination of tissue removed from a living body to discover the presence, cause, or extent of a disease.
**Sonographer - A sonographer is an allied healthcare professional who specializes in the use of ultrasonic imaging devices to produce diagnostic images, scans, videos or three-dimensional volumes of anatomy and diagnostic data.
***Histopathology - The study of changes in tissues caused by disease

Wow! How old were you when you got this diagnosis?

I was 38 at the time I got the diagnosis.

So, what were the options available to you when you found out, considering the Nigeria health care system?  

To answer this, I think it is important to state that the cancer was caught quite early (stage 1), so it was still localized which means treatment was easier and more targeted as opposed to malignancy*. After the diagnosis, I had to see an oncologist** and my first treatment was to get a mastectomy*** and this was largely because of my age and estrogen level. After this, I started chemotherapy and radiation.

I had an entire village behind me, around me and with me throughout this journey. There was support from the company I worked with at the time, a health insurance company. I also had support from my family and colleagues who held me up in prayers.

*Malignancy - A disease resulting from uncontrolled growth and division of abnormal cells.
**Oncologist - A medical practitioner qualified to diagnose and treat tumors.
***mastectomy - A mastectomy is an operation to remove a breast. It's used to treat breast cancer in women and breast cancer in men.

What role did your faith or spirituality play while navigating this journey?

My faith played a huge role in navigating this journey. At first, I was mad at God for a while because I was quite committed to him, I was nice to people around me and I helped people in need. Anyway, when I realized that I still needed God’s strength to navigate the journey, I went back on my knees and asked for his grace.

I actually did not tell my mum about my surgery (the mastectomy) until 2 weeks after the surgery because being a mother myself, I knew her fear of losing me was going to shake her faith in God. I had just my husband, my pastor’s wife and another member of the church in my circle at the start of the journey.

Looking back, I am in constant awe of how God made me go to the hospital for a family planning after 10 years of marriage, because I always used the calendar method to track my ovulation and it worked well. I choose to see God’s hand in ordering my steps because I could have continued to push off the signs and it would have gotten worse. If it had gotten worse, due to the policies of the health insurer, I would have had to cover all my medical bills myself.

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You mentioned that you worked at a health insurance company, following this diagnosis, did you have to renegotiate working at your company, and did you experience any stigmatization?

So, this is funny because when I got the diagnosis, it weighed me down and at some point, I was depressed. I said earlier that I was mad at God, it was the people around me that made me realize that the mind is capable of anything, and your body only needed convincing. This made me encourage myself and not accept defeat. I took 2 weeks off work to recuperate after the surgery, but I talked to my boss to allow me to do whatever I could, no matter how little, just to stay relevant. When my chemotherapy started, I took a week off work and returned the next week when I was strong enough. Only my team lead and top executives knew, for days I was not physically in the office, it was easy to say I was working from home.

Even with other people who knew my health condition, I did not experience any form of stigmatization rather they were amazed at how I was managing it all. In all honesty, it was their support and encouragement that did the trick.

I can imagine that there were a lot of milestones and memories during and after your treatment, what was a major memory or milestone during this process?

This journey had me crying and smiling at the same time. It is a scary place to be, you know, when everything suddenly comes to a halt, all your plans crushed and you must start thinking of how to survive the next treatment, the next day, being there for your kids.

It is impossible to exhaustively say how much I learnt during this journey. I learnt to forgive more, hold less grudges, and be more kind because no one knew what was going on with me on the outside. I was always cheerful, and you wouldn’t know I was going through this until I say it. It fits right into the saying that you should “be nice to people, everyone you meet is fighting a battle”.

True! Following your treatment, are there still aftereffects of the surgery or chemotherapy that you still deal with?

Oh! Definitely, first there’s something called chemo brain “you are unable to accurately remember things”. This happens during and after treatment. It was quite bad during my treatment but I’m making progress every day, the numbing pain is also getting better by the day. Of course, your body isn’t the same anymore but more importantly, I’m here to see my kids grow, be there for my husband and family and achieve other goals I have set for myself.

What resources do you think are needed to improve cancer care and support in Nigeria?

I believe there are more and more initiatives like the cancer awareness month and all that is now being more embraced, people are encouraged to be more aware about changes in their body and there are more cancer treatment centers. I believe we are in the right direction with cancer care, and I hope we will get there.

What message would you like to share with readers about cancer awareness and people currently battling cancer?

As a Nigerian, our cultures or beliefs can make us choose fear of what others will say over our own wellbeing. We need to understand that there’s a place for spirituality and there’s also a space for medical treatments. God created the people who help with detecting and treating ailments.

I am a born-again Christian, I love God, but I am also a nurse and I understand that our bodies fail us sometimes. I was 38 with no family history of cancer when I was diagnosed but I understood that I needed God’s strength to go through my treatment rather than “pray the diagnoses away”. Let’s not get too holy and forget to be logical.

Above all, know your risks, learn about your family’s cancer history, pay attention to your body so you can tell when there’s something off, watch what you eat and ultimately do everything within your means to maintain a healthy lifestyle.

I would also like to say no two journeys will ever be the same. Two people can have the same diagnoses and process things differently. Realities can be different in terms of jobs, family, support, finances etc.

How is lifelike now for you?

I lived in Lagos Nigeria when I was diagnosed, I had my mastectomy in Nigeria and started my Chemotherapy here too. There are a lot of negative stories about our healthcare system in Nigeria, but I benefitted from it positively.

I recently relocated to Canada now with my family and I work in the oncology unit of the hospital. Working here reminds me about how fickle life is and I am very satisfied knowing I can now help patients who I was nice like and can relate to everything they are going through. I hope that one day, I can come back to Nigeria and help more cancer patients and also spread awareness. To everyone reading this, life happens to us all, but you don’t know how string you can be until being strong is the only option you have, I am rooting for you always.

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