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Quayson, SE, EK Wiredu, DN Adjei, and JT Anim. "Breast cancer in Accra, Ghana." Journal of Medical and Biomedical Sciences 3, no. 3 (January 13, 2015): 21–26. http://dx.doi.org/10.4314/jmbs.v3i3.4.
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The aim of this study was to look at the pattern of breast cancer over a period of five years and to compare the findings to similar studies done in the Department and elsewhere within the African sub-region. All breast cancers diagnosed in the Department of Pathology of the Korle Bu Teaching Hospital, Accra, over a 5-year period were compiled. The slides for the cases were retrieved and reviewed. Invasive ductal carcinomas were graded according to the Scarff-Bloom-Richardson’s grading system. The data were entered and analyzed using the EPI-Info microcomputer software (Version 3.5.1, 2008, Center for Disease Control and Prevention (CDC) Atlanta). Breast cancer in Accra is mostly of the ductal type or its variants affecting relatively younger age groups. The mean age of incidence of cancer in Ghana is 48 years, and about 67% have lymph node metastases (at least Stage II or N1) and 74% are of high grade at the time of diagnoses. The percentage of male breast cancers in Ghana is 2.9% (2.0 - 3.75% within the West African sub-region) and is higher than what is reported in Western literature. The results of this study show that there has been no im-provement in the stage at which patients present with breast cancer in the past 30 years.Keywords: Breast cancer, cancer types, cancer grade, lymph node status, Accra
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Twahir, Majid, Rasaaq Adisa Oyesegun, Joel Yarney, Andrew Gachii, Clement Edusa, Chukwumere Nwogu, Gitangu Mangutha, et al. "Access to care and financial burden for patients with breast cancer in Ghana, Kenya, and Nigeria." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): 6562. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.6562.
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6562 Background: Breast cancer is the most frequently diagnosed malignancy and the most common cause of cancer-related death in women in Ghana, Kenya, and Nigeria. We evaluated healthcare resource use and financial burden for patients treated at tertiary cancer centers in these countries. Methods: Records of breast cancer patients treated at the following government/private tertiary centers were included – Ghana: Korle-Bu Teaching Hospital and Sweden Ghana Medical Centre; Kenya: Kenyatta National Hospital and Aga Khan University Hospital; Nigeria: National Hospital Abuja and Lakeshore Cancer Center. Patients presenting within a prespecified 2-year period were followed until death or loss to follow-up. Results: The study included 299 patient records from Ghana, 314 from Kenya, and 249 from Nigeria. The use of common screening modalities (eg, mammogram, breast ultrasound) was < 45% in all 3 countries. Use of core needle biopsy was 76% in Kenya and Nigeria, but only 50% in Ghana. Across the 3 countries, 91-98% of patients completed blood count/chemistry, whereas only 78-88% completed tests for hormone receptor and human epidermal growth factor receptor 2 (HER2). Most patients underwent surgery: mastectomy (64-67%) or breast-conserving Most patients in Ghana and Nigeria (87-93%) paid for their diagnostic tests entirely out of pocket (OOP) compared with 30-32% in Kenya. Similar to diagnostic testing, the proportion of patients paying OOP only for treatments was high: 72-89% in Nigeria, 45-79% in Ghana, and 8-20% in Kenya. Among those receiving HER2-targeted therapy, average number of cycles was 5 for patients paying OOP only vs 14 for patients with some level of insurance coverage. Conclusions: Patients treated in tertiary facilities in sub-Saharan African countries lack access to common imaging modalities and systemic therapies. Most patients in Ghana and Nigeria bore the full cost of their breast cancer care, suggestive of privileged financial status. Access to screening/diagnosis and appropriate care is likely to be substantively lower for the general population.
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Wiafe, H. E., and B. Wiafe Addai. "Advocacy Campaign: Breast Care International Approach." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 237s. http://dx.doi.org/10.1200/jgo.18.95100.
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Background and context: Breast cancer is the leading cause of cancer deaths among Ghanaian women, but it has been identified as 1 of the neglected noncommunicable diseases (NCDs). In 2012, GLOBOCAN reported that ∼2260 people were diagnosed with breast cancer in Ghana with a high age standardized mortality rate of 11.7 per 100,000. Although, it is acknowledged that early detection and prompt action reduces mortality, 80% of newly diagnosed breast cancer patients delay presentation. It is a well-known fact that cancers are now killing more people in Africa than HIV/AIDS, tuberculosis and malaria combined. Due to lack of awareness about cancers and late reporting of the cases, a lot of cancer patients get very little intervention and support and that explains why most cancer deaths occur in Africa, especially women in rural areas. Breast Care International (BCI), a nongovernmental organization in Ghana, established in 2002, is a leading breast cancer advocacy organization in Africa providing an enabling environment to enhance early detection and reduce the late-stage presentation of breast cancer. Aim: To maximize personal and community wellness through community participation, excellence in public health education, empowering people to save lives and to end late-stage presentation of breast cancer in Ghana. Strategy/Tactics: To enhance early detection and reduce late-stage presentation of breast cancer in Ghana by disintegrating the myths and misconception about breast cancer. Program/Policy process: BCI has been conducting outreach awareness programs in Ghana to women groups, educational institutions, churches and social groups, especially those in deprived communities, educating them on breast self-examination (BSE) and then clinically screening the women. The involvement of breast cancer survivors to share their testimonies on various platforms to demystify breast cancer as an incurable disease and the misconceptions of it being from ancestral curses. Community-based nurses trained in basic oncology are to be deployed to the district level to create awareness about breast health and other NCDs at the grass root level with the aim of detecting breast cancer early for a prompt referral to health facilities for further management. Outcomes: BCI’s demand-driven outreach awareness campaigns and screening programs have been empowering women to perform their BSE and as a result most patients report to the hospital with lumps and abnormalities that were detected during their BSE. What was learned: Although, BCI has been intensively involved in breast cancer advocacy programs in Ghana, a concerted effort is required from opinion leaders, political figures, health service providers, organized groups and business organizations to assist to control the incidence of breast cancer in Ghana.
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Boatemaa Benson, Ruth, Bernice Cobbold, Ellen Opoku Boamah, Cynthia Pomaa Akuoko, and Daniel Boateng. "Challenges, Coping Strategies, and Social Support among Breast Cancer Patients in Ghana." Advances in Public Health 2020 (February 25, 2020): 1–11. http://dx.doi.org/10.1155/2020/4817932.
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Background. Despite the high incidence and mortality rate of breast cancer (BC) in Ghana, little attention has been given to the issue of how adult women cope with having BC. The aim of this study was to explore the challenges, coping strategies, and support systems among women diagnosed with BC in Ghana. Methods. A descriptive cross-sectional study was conducted from February to August 2017 at the Komfo Anokye Teaching Hospital (KATH), Ghana. A systematic random sampling technique was used to select 202 women with a confirmed diagnosis of BC. Coping strategies of women with BC were assessed using the Brief-COPE. The associations between sociodemographic characteristics, social network/support, and coping strategies were assessed using linear regression models. Results. The most and least adopted active coping strategies were religious coping and humors, respectively. Self-distraction and substance use were the most and least adopted avoidant coping strategies, respectively. Spouses and children offered the most support to women with BC; having support from 5 or more sources was associated with higher mean active coping (beta [β] 1.14; 95% CI 0.66 to 1.62) and avoidant coping (β 1.46; 95% CI 0.98 to 1.94), as compared with having <2 sources of social support. Conclusion. This study demonstrates that women diagnosed with BC in Ghana adopt varied coping strategies to deal with these challenges. The forms of coping strategies adopted by women diagnosed with BC are influenced by the extent of social support received. Psychosocial counseling and support should be an integral part of BC management. Exploring and including social networks could play an important role in the management of BC in Ghana.
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Agbokey, Francis, Elorm Kudzawu, Mawuli Dzodzomenyo, Kenneth Ayuurebobi Ae-Ngibise, Seth Owusu-Agyei, and Kwaku Poku Asante. "Knowledge and Health Seeking Behaviour of Breast Cancer Patients in Ghana." International Journal of Breast Cancer 2019 (April 1, 2019): 1–9. http://dx.doi.org/10.1155/2019/5239840.
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Background. Breast cancer is a major contributor to cancer-related deaths among women worldwide, despite the numerous measures employed to prevent and manage the disease. This study explored the knowledge and health seeking behaviour of breast cancer patients at the Komfo Anokye Teaching Hospital. Methods. A descriptive cross-sectional study was conducted at Komfo Anokye Teaching Hospital in Kumasi, Ghana, from June 2014 to July 2014. Thirty-five participants were purposively selected. The responses to questions about their experiences with breast cancer were determined using indepth interviews. Transcripts were coded and analysed using NVIVO version 10.0. Results. Participants’ knowledge about signs and symptoms of breast cancer after their diagnosis was high but low for risk factors. Screening for breast cancer through self-breast examination was infrequently performed prior to their diagnosis. The patients’ first point of care was generally health facilities. Some patients reported late due to misinterpretation of signs and symptoms, cultural influences and fear of losing their breast to surgery, physician delay, health providers’ laxity, and disinterest in breast cancer. Men, for example, husbands, decide on where and when breast cancer patients go for treatment. Conclusion. There is poor knowledge of the risk factors for developing breast cancer. Patients resorted to the hospital as first options for cure but were generally delayed in doing so. There is the need to create awareness about breast cancer among the general population.
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Kyei, K. A. "Assessment of Anxiety and Depression Among Breast Cancer Patients in Ghana." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 99s. http://dx.doi.org/10.1200/jgo.18.37000.
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Background: Cancer of the breast happens to be one of the most important diseases worldwide and in Ghana, accounts for the highest referral at the study site. The treatment of breast cancer has evolved over the years offering patients high rates of survival. What is missing in the literature are studies that focus on determining levels of depression and anxiety and how this assessment will impact treatment outcome for breast cancer patients undergoing radiotherapy. Hence, recognizing a better understanding in this study will promote positive social change in three different ways. First, it will serve the cancer population especially patients undergoing breast cancer treatment to manage depression and anxiety. Second, it will enhance efforts for coping and finally increase the overall quality of life of these patients undergoing treatment. Aim: This study aims to find various interventions for depression and anxiety among breast cancer patients in Ghana. Methods: The author used a mixed method design to gather both quantitative and qualitative data. The qualitative data were an interview with selected working participants whiles the quantitative data were a nonprobabilistic approach using a structured questionnaire. This mixed method was a triangulation that described how the interviews supported and confirmed the responses from the patient participants. There was an evaluation of the relationships with a combination of two modified scales, Patient Health Questionnaire (PHQ) and Depression Anxiety Stress Scale (DASS). The sample consisted of 100 patients between the ages of 20-89, and six professionals with a minimum of five years' work experience. Results: Findings of this study indicated the need intervene through counseling and education on behalf of patients in Ghana as they undergo breast cancer treatment. Age and monthly income of patients were statistically significant in predicting the anxiety and depression among the patients. The R (0.397) value was less than 0.5, which depicted that the alternate hypothesis could be accepted. The independent variables significantly predicted the anxiety and depression. Conclusion: The study illustrates a need to understand how breast cancer patients in Ghana go through treatment with the high impact of anxiety and depression with treatment which affects total well-being and life after treatment. Although interventions and management should be available to breast cancer patients with anxiety and depression undergoing treatment of their coping with the burden of the disease, a striking improvement in the survival of patients could be achieved when proper systems are put in place by the Ministry of Health and the government.
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Sekyere, M. Owusu. "Incidence and Risk Factors of Arm Lymphedema Following Breast Cancer Treatment." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 213s. http://dx.doi.org/10.1200/jgo.18.85800.
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Background: All breast cancer patients are at risk for developing lymphedema (LE) as a complication of breast cancer surgery and radiation. The reported incidence ranges from 5%-60%. In Ghana, 50% of women with breast cancer who come to the hospital present with late-stage breast cancer. Komfo Anokye Teaching Hospital (KATH) has no available data to support LE incidence. Aim: To determine the incidence and risk factors of lymphedema after breast cancer treatment at the oncology unit of KATH, Kumasi, Ghana between 01 January 2005 to 31 December 2008. Methods: Breast cancer and lymphedema related variables were collected from the medical records of breast cancer patients. Data were analyzed using descriptive statistics and χ2 tests. Results: Among 313 patients treated for breast cancer between 2005 and 2008, 31 (9.9%) developed lymphedema after treatment. A χ2 test showed that axillary lymph node dissection was statistically a significant risk factor of lymphedema (χ2 test value = 7.055, P = 0.008). Radiation and late stage of breast cancer diagnosis may have contributed in development of lymphedema despite having P value > 0.05. Age, BMI and hypertension were also not associated with lymphedema. Conclusion: This study provides evidence that the incidence of lymphedema was 9.9% with axillary lymph node dissection as a statistically significant risk factor of lymphedema. Implication for practice: With majority of breast cancer patients presenting with late stage disease and also undergoing axillary lymph node dissection, lymphedema will continue to be a problem in Ghana. Knowing the incidence and risk factors of lymphedema not only helps in the early detection and effective management of lymphedema but also provides base-line data for further research on lymphedema in Ghana.
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Nartey, Yvonne, Philip C. Hill, Kwabena Amo-Antwi, Kofi M. Nyarko, Joel Yarney, and Brian Cox. "Cervical Cancer in the Greater Accra and Ashanti Regions of Ghana." Journal of Global Oncology 3, no. 6 (December 2017): 782–90. http://dx.doi.org/10.1200/jgo.2016.005744.
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Purpose Cervical cancer is a common cancer among women worldwide. An estimated 528,000 new cases and 266,000 deaths occurred in 2012. More than 85% of invasive cervical cancer cases occur in low- and middle-income countries. Cervical cancer ranks as the most common cancer among women in Ghana. We conducted a retrospective study to assess the descriptive epidemiology of cervical cancer in Ghana. We describe cervical cancer incidence and mortality rates for the regions served by two large hospitals in Ghana. Patients and Methods Information for women diagnosed with invasive cervical cancer between 2010 and 2013 was collected from the Komfo Anokye and Korle Bu Teaching Hospitals through review of medical, computer, and pathology records at the oncology units and the obstetrics and gynecology departments. Telephone interviews were also conducted with patients and relatives. Data were analyzed using summary statistics. Results A total of 1,725 women with cervical cancer were included in the study. Their ages ranged from 11 to 100 years (mean, 56.9 years). The histology of the primary tumor was the basis of diagnosis in 77.5% of women and a clinical diagnosis was made in 22.5% of women. For the 1,336 women for whom tumor grade was available, 34.3% were moderately differentiated tumors. Late stage at presentation was common. The incidence and mortality rates of cervical cancer increased with age up until the 75 to 79–year age group and began to decrease at older ages. The Greater Accra region had higher overall incidence and mortality rates than the Ashanti region. Conclusion Our study suggests that improvements in the application of preventive strategies could considerably reduce the burden of cervical cancer in Ghana and other low- and middle-income countries. The study provides important information to inform policy on cancer prevention and control in Ghana.
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Twahir, Majid, Razaq Oyesegun, Joel Yarney, Andrew Gachii, Clement Edusa, Chukwumere Nwogu, Gitangu Mangutha, et al. "Real-world challenges for patients with breast cancer in sub-Saharan Africa: a retrospective observational study of access to care in Ghana, Kenya and Nigeria." BMJ Open 11, no. 3 (March 2021): e041900. http://dx.doi.org/10.1136/bmjopen-2020-041900.
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ObjectiveTo evaluate medical resource utilisation and timeliness of access to specific aspects of a standard care pathway for breast cancer at tertiary centres in sub-Saharan Africa.DesignData were retrospectively abstracted from records of patients with breast cancer treated within a prespecified 2-year period between 2014 and 2017. The study protocol was approved by local institutional review boards.SettingSix tertiary care institutions in Ghana, Kenya and Nigeria were included.ParticipantsHealth records of 862 patients with breast cancer were analysed: 299 in Ghana; 314 in Kenya; and 249 in Nigeria.InterventionsAs directed by the treating physician.Outcome measuresParameters selected for evaluation included healthcare resource and use, medical procedure turnaround times and out-of-pocket (OOP) payment patterns.ResultsUse of mammography or breast ultrasonography was <45% in all three countries. Across the three countries, 78%–88% of patients completed tests for hormone receptors and human epidermal growth factor receptor 2 (HER2). Most patients underwent mastectomy (64%–67%) or breast-conserving surgery (15%–26%). Turnaround times for key procedures, such as pathology, surgery and systemic therapy, ranged from 1 to 5 months. In Ghana and Nigeria, most patients (87%–93%) paid for diagnostic tests entirely OOP versus 30%–32% in Kenya. Similarly, proportions of patients paying OOP only for treatments were high: 45%–79% in Ghana, 8%–20% in Kenya and 72%–89% in Nigeria. Among patients receiving HER2-targeted therapy, the average number of cycles was five for those paying OOP only versus 14 for those with some insurance coverage.ConclusionsPatients with breast cancer treated in tertiary facilities in sub-Saharan Africa lack access to timely diagnosis and modern systemic therapies. Most patients in Ghana and Nigeria bore the full cost of their healthcare and were more likely to be employed and have secondary or postsecondary education. Access to screening/diagnosis and appropriate care is likely to be substantively lower for the general population.
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Binka, Charity, David Teye Doku, and Kofi Awusabo-Asare. "Experiences of cervical cancer patients in rural Ghana: An exploratory study." PLOS ONE 12, no. 10 (October 11, 2017): e0185829. http://dx.doi.org/10.1371/journal.pone.0185829.
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Hills, Susannah E., and Mark E. Prince. "Quality of Life of Head and Neck Cancer Patients in Ghana." Otolaryngology–Head and Neck Surgery 147, no. 2_suppl (August 2012): P174—P175. http://dx.doi.org/10.1177/0194599812451426a157.
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Ragosta, Summer, Ivelyn Harris, Ntim Gyakari, Emmanuel Otoo, and Alex Asase. "Participatory Ethnomedicinal Cancer Research with Fante-Akan Herbalists in Rural Ghana." Ethnobiology Letters 6, no. 1 (July 21, 2015): 66–79. http://dx.doi.org/10.14237/ebl.6.1.2015.253.
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An ethnomedicinal study was initiated with herbalists in coastal Central Region Ghana to explore how cancer is defined, diagnosed, and treated within a traditional Fante-Akan context. The participatory, service-oriented investigation included international collaboration with herbalists and traditional plant experts. On-site meetings informed community leaders and members of project intent and methods, guided protocol, and gauged critical support. To provide immediate educational and economic opportunities, hands-on activities with villagers transferred academic and applied skills. Ethnographic interviews and voucher specimen collections were conducted with seven herbalists. Plant samples were dried and housed locally in a community herbarium cabinet constructed in Kormantse. Ten cancer ethnopharmacopoeia plants were identified, most of which are species considered native to tropical Africa. Fante Akan herbalists listed various types of cancers they treat with herbal remedies, along with ethnomedicinal descriptions of disease etiology, diagnoses, and treatments. The most common cancer type mentioned was “breast cancer.” Topical application was the most often cited method of administering remedies. Researchers established key contacts in the Kormantse, Salt Pond, and Elmina communities, and identified local and international research collaborators for a proposed interdisciplinary project focused on longitudinal case studies with herbalists, patients, and medical physicians.
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Addai, Abena, and Beatrice Wiafe Addai. "THE REALITY OF HOLISTIC TREATMENT FOR ADVANCED BREAST CANCER PATIENTS IN GHANA." Breast 48 (November 2019): S68. http://dx.doi.org/10.1016/s0960-9776(19)30733-7.
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Abruquah, Akua A., Robert P. Biney, Ernest B. Osei-Bonsu, Kofi M. Boamah, and Eric Woode. "Cancer pain assessment and management in ambulatory patients at a tertiary hospital in Ghana." International Journal Of Community Medicine And Public Health 4, no. 6 (May 22, 2017): 1793. http://dx.doi.org/10.18203/2394-6040.ijcmph20172135.
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Background: Adequate cancer pain assessment using valid and reliable pain assessment tools is essential for effective cancer pain management. This study evaluated the common types, effectiveness as well as adherence to prescribed analgesics in oncology outpatients in a tertiary oncology centre in Ghana.Methods: This descriptive cross-sectional study involved 204 oncology outpatients with different confirmed cancer diagnosis attending clinic at the Oncology Directorate of a Tertiary Hospital in Ghana. The research instruments used were the medical folders of patients, a hospital-based electronic drug database system; hospital administration management systems (HAMS) and the Brief Pain Inventory Long-Form (BPI-LF).Results: More than half (63.7%) of the participants reported moderate pain, 37.8% received opioid analgesics: 31.4% strong opioids and 6.4% weak opioids. Less than one-fourth (21.6%) had complete pain relief and 18.1% felt they needed a stronger pain medication. A little more than one-fourth (28.4%) of participants took their pain medications 1-2 times per day. Almost half (45.6%) of participants did not experience side effects from taking pain medications and 27.9% needed more information about their pain medications.Conclusions: Enhancing effective cancer symptom management approaches in healthcare practitioners and incorporating existing knowledge and guidelines on cancer pain management into routine clinical practice should be done to enhance efficient pain relief.
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Hobenu, Kafui A., and Florence Naab. "A qualitative study of the physical consequences experienced by women with cervical cancer in Accra, Ghana." African Journal of Midwifery and Women's Health 14, no. 2 (April 2, 2020): 2–12. http://dx.doi.org/10.12968/ajmw.2019.0006.
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Background/aims Cervical cancer is a highly prevalent type of cancer that causes severe physical consequences, including pain and sleep disturbance. However, in Ghana, little is known about the experiences of women with cervical cancer. This study explored the physical experiences of women with cervical cancer in Accra, Ghana to help healthcare professionals understand the experiences of their patients and improve the care given. Methods This study employed an exploratory descriptive qualitative approach, using purposive sampling technique to select study participants. In-depth interviews lasting between 45 and 90 minutes were conducted face-to-face with 15 women with cervical cancer receiving treatment at a teaching hospital in Ghana to gather information on their physical experiences resulting from the cancer. The interviews were recorded with the participants' consent. Data were transcribed verbatim and subjected to content analysis concurrently with data collection. Results Content analysis revealed the following sub-themes within disease-related physical consequences of cervical cancer: pain, impaired sleep patterns, weight loss and gynaecological problems. Conclusions The findings of this study suggest that women with cervical cancer experience physical consequences that negatively impact their wellbeing. Healthcare providers should employ a multidisciplinary approach in the management of women with cervical cancer.
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Calys-Tagoe, Benedict NL, Joel Yarney, Ernest Kenu, Nana Adwoa K. Owusu Amanhyia, Ernest Enchill, and Isaac Obeng. "Profile of cancer patients’ seen at Korle Bu teaching hospital in Ghana (A cancer registry review)." BMC Research Notes 7, no. 1 (2014): 577. http://dx.doi.org/10.1186/1756-0500-7-577.
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Shrauner, W. R., A. Gyedu, and T. P. Kingham. "Characteristics of Patients with Primary Liver Cancer at Komfo Anokye Teaching Hospital, Ghana." Journal of Surgical Research 186, no. 2 (February 2014): 501. http://dx.doi.org/10.1016/j.jss.2013.11.150.
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Meena, S. S., R. Chambuso, and C. Edusa. "Training and Skills-Gaining Fellowship for Cancer Radiotherapy Planning and Treatment With 3D-CRT in Ghana." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 92s. http://dx.doi.org/10.1200/jgo.18.22500.
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Background: The global incidence of cancer is rising, especially in low and middle income countries. Radiotherapy is important in cancer treatment of curative and palliative care, either alone or in combination with other treatment modalities. However radiotherapy techniques have evolved from two dimensional (2D) to three-dimensional conformal radiotherapy (3D-CRT) and intensity modulated radiotherapy (IMRT). In addition, this new image-based treatment planning reduces the volume of surrounding normal tissues to be irradiated unnecessarily and being exposed to high dose of radiation. Thus improves treatment outcome while reducing treatment related toxicities. Aim: To train and gain skills in radiotherapy planning and treatment with modern radiation 3D-CRT technology in Ghana. Methods: Hospital based cross sectional study will be conducted at the Sweden Ghana Medical Centre in Ghana and the Ocean Road Cancer Institute (ORCI), in Tanzania. We will recruit patients with a convenient sample size, from different cancer diagnosis and stages after obtaining their signed consents. The outcome from 2D and 3D planning and treatment techniques will be compared. We will use pretreatment CT scan images to assess tumor size prior to treatment and posttreatment CT scan images to assess treatment response. Furthermore, the WHO toxicity grading criteria will be used to assess early treatment related side effects between 2D and 3D treatment techniques. Results: I have not yet been on the fellowship program, I will go to Ghana on 1st May 2018 and am expecting to finish my fellowship at the end of May 2018. I will have a final report concerning my fellowship project by August 2018, hence I will present the results of my visit to the World Cancer Congress in October 2018. I will also share my skills and knowledge obtained during my fellowship program in Ghana to my home institution and other cancer care hospitals in Tanzania through regular conference meetings, Continuous Medical Education (CME) sessions and during my daily clinical practice while supervising postgraduate students pursuing masters of medicine in clinical oncology. After data analysis, I expect my results will show better treatment outcome with minimal early treatment side effects in 3D than 2D radiotherapy planning and treatment techniques. Conclusion: This training will significantly improve patient's treatment outcomes, care and quality of life due to minimum tissue damage after 3D conformal radiotherapy with intensity modulated radiation.
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Sarfo, V. Gyasi, and B. Wiafe Addai. "The Role of Survivors in Breast Cancer Advocacy and Treatment in Ghana." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 246s. http://dx.doi.org/10.1200/jgo.18.98700.
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Background and context: Breast cancer is rapidly becoming a growing public health problem in sub-Saharan Africa. Despite the lack of a national cancer registry, it is estimated that 2260 women were newly diagnosed with breast cancer. 1021 out of the 2260 women died of the disease (GLOBACON, 2012). The mean age for Ghanaian women according to the Ghana Breast Health Study is 43 years while white American women are usually diagnosed ∼60 years. To address the alarming rate by which women present late for diagnosis, several advocacy groups have implemented education and awareness programs in the country. However, despite aggressive campaigns to improve early detection, there are still a record number of late presentations indicating that there is still a need for a more aggressive approach. The Peace and Love Survivors Association (PALSA), was inaugurated in 2012 at the Peace and Love Hospital. Aim: To help Breast Care International (BCI) on their outreach programs to educate women about breast cancer and eradicate the stigma, myths and misconceptions surrounding the disease. Strategy/Tactics: Speak out and share our stories to encourage and empower newly diagnosed women, support and navigate them through their treatment, build a community of survivors. Program/Policy process: Some members have dedicated themselves to always go out with BCI and share their stories to show breast cancer is survivable when detected and treated early. Postmastectomy survivors among us show their artificial breasts in public for women to know they have 1 breast which is helping a lot. We started the HOPE Program in 2013 to navigate the newly diagnosed patients. We do home visits and phone calls to assist and check on patients as they go through treatment. We first of all share our story to the patient so that she will know she is not alone. We tell them the number of years we have survived and that makes them more relaxed. Outcomes: We have been able to navigate quite a number of patients through their treatment journey to also become members of our association and that has increased our membership to >800 women and men. Three of us have been used by the Peace and Love Hospitals and gone through training to help counsel newly diagnosed patients. I can say patients feel more relaxed and comfortable with us. They even sometimes call us to discuss their problems with us and we help them to sort it out with the hospital especially when it is financial. What was learned: Women are important to our husbands, children, family and society as a whole and we should not die needlessly. Early detection and prompt action equals prevention and together we can make an impact. Our stories are powerful and we can help save a lot of women in very diverse ways. We are now helping BCI to raise funds to treat early-stage breast cancer patients who are indeed poor. Our goal is to help women understand the disease and report early to the hospital for treatment.
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Yvonne, O. "Breast Disorders and Africultural Coping Strategies: An Exploratory Study Among Breast Cancer Patients in Ghana." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 6s. http://dx.doi.org/10.1200/jgo.18.20100.
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Background: The psychological cannon highlights on a new paradigm shift from the traditional models such as the bio-psychosocial model to disease and treatment to the inculcation of spirituality (Bio-psychosocial-S) in holistic treatment plan. Breast cancer is the second leading malignancy in Ghana and appears to be on the ascendency in recent times. Emerging studies have documented increasing diagnosis in premenopausal women which conflicts with previous findings. However, an attempt to handle the disease has been crippled with logistic and structural challenges. Breast cancer patients have adopted various strategies over the years in attempt to handle the structural challenges inherent in the diagnosis, treatment and post treatment plan. Using qualitative research methodology, twelve participants were conveniently sampled and interviewed. This preliminary study explored views and perceptions of breast cancer patients on breast cancer and how they have coped with the condition. Results: were analyzed using Interpretative Phenomenological Analysis (IPA) to explore how participants make meaning of their experiences. Findings showed that socio-cultural factors play an integral role in participants' interpretations of the disease and this also informed the culture-specific coping ties which were used respectively. Implications for psychological models, treatment, and research are discussed.
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Addai, A., and B. W. Addai. "Breast Cancer Survivorship in Ghana: Peace and Love Survivors´ Association (PALSA)." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 179s. http://dx.doi.org/10.1200/jgo.18.37100.
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Background and context: About 10 years ago in Ghana, you couldn´t find a woman to say I had breast cancer, went through the treatment and I am still alive and a survivor now. Today Breast Care International (BCI) has breast cancer (bc) survivors who not only share their stories but show their postmastectomy scars. Aim: To create a community of bc survivors reintegrating into society emotionally, physically, psychologically healed/content and by so doing demystify bc in Ghana. PALSA has over 800 survivors. Strategy/Tactics: 2 years after completion of active treatment, our patients are absorbed into PALSA where they continue to receive counseling and postcancer reviews. Some PALSA members were trained in 2013 by Carries´ Touch from California, USA on how to share their stories, counsel and navigate newly diagnosed bc patients. Program/Policy process: Survivorship is complex. Our survivors need to be filled and content to genuinely impact their audience when they share their stories and navigate bc patients. a) Survivors in our HOPE (Helping Others through Personal Experience) program counsel and walk the treatment journey with newly diagnosed patients. b) Showcasing survivorship with > 300 survivors parade during BCI Ghana walks for the cure. c) Survivors join all BCI outreach programs to share their stories, with postmastectomy survivors boldly showing their external prosthesis and framed photos of their scars. d) 2017 Dress Campaign - 5 bc survivors with pink tailor made clothes shared their stories through art. This year 20 survivors will participate thanks to donation in kind from GTP. e) September 30th 2017, survivors´ children and their mothers danced at the African Regent Hotel and the arrival hall of Kotoka International Airport to usher in the pink month. f) For the first time Kotoka International Airport was decorated in pink for the month of October to celebrate breast cancer awareness. Outcomes: Before the HOPE project PLH had 70% defaulting treatment especially mastectomy, compared with 10% default rate now. More women are ready and eager to be screened because they see and hear women survive bc and mastectomy for years. Flash mobs and the dress campaign are new and fun ways to take breast cancer awareness to the youth. What was learned: Building a strong survivorship program is an important part of life after bc. Not only do we maximize impact in advocacy and awareness creation with survivors, our survivors care/support each other and find a place to heal and integrate in society (either reintegrating or find something new like being used at PLH in HOPE, decorating airports for the pink month). Our survivors are ready and eager to share their stories and help change bc in Ghana in their own unique ways. We just need to create all the different ways they can do this and save as many lives as possible.
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Abruquah, Akua A., Robert P. Biney, Ernest B. Osei-Bonsu, Kofi M. Boamah, and Eric Woode. "Adequacy of pain management in oncology patients at a tertiary hospital in Ghana." International Journal of Basic & Clinical Pharmacology 6, no. 2 (January 28, 2017): 251. http://dx.doi.org/10.18203/2319-2003.ijbcp20170316.
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Background: Although cancer pain is well documented, efficient management is largely inadequate in most patients especially in developing countries. This study evaluated the adequacy of pain management as well as potential social factors that may be associated with inadequate pain management.Methods: 204 ambulatory oncology patients (82% female; mean age 53.5) attending clinic at the Oncology Directorate, of a tertiary hospital in Ghana from January to December, 2015 were recruited and their pain severity and functional interference assessed with the Brief Pain Inventory (BPI). The adequacy of pain management was computed as the pain management index (PMI) using the BPI.Results: Although 62% of respondents were prescribed high potency opioids, 56.9% of them exhibited significant pain while 34.9% required a stronger analgesic to manage their pain. Majority of patients (56%) were over-managed for their pain (had PMI score >0). Only 26.4% had optimal cancer pain management. Pain interfered mostly with patients’ sleep (46.2%) and general activity (42.5%). Patients with high pain intensity were more likely to have it affect their daily activity (P<0.0001). Men were more likely to have inadequate pain management than females.Conclusions: This study has shown that whereas pain management may be adequate, there is the tendency for opioid tolerance and abuse as over 50% of patients receive more analgesics than required. The tenets of the WHO 3-step analgesic ladder should be strictly adhered to achieve optimum cancer pain relief.
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Asoogo, C., F. Aitpilla, F. M. Hoyte-Williams, F. Awittor, B. Awuah, J. Akpaloo, E. Morhe, and E. Dassah. "Building Community-Based Awareness and Navigating Breast Cancer and Palliative Care Programme in Kumasi, Ghana." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 151s. http://dx.doi.org/10.1200/jgo.18.40500.
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Introduction: Breast cancer is the leading cancer in Ghana and most patients report with advanced disease. Patients face many challenges in trying to access health care and support; these are particularly relevant in the case of metastatic diseases. A structured program would provide a means of rapid referral for definitive diagnosis, treatment and palliative care, where necessary. Aim: To establish community-based structured patient network, navigation and breast health awareness programs that will reduce delays in accessing care, improve the quality of end-of-life care among patients with metastatic breast cancer. Strategy: We established a community-based patient network program comprising 15 community-based patient navigators in the Kumasi metropolis and a social media networking and navigation platform made up of a team of experts and community navigators, breast cancer survivors and patients with advanced breast cancer to share experiences and express/address concerns. We assessed the breast cancer database of Komfo Anokye Teaching Hospital to establish the number, location and density of patients. Community navigator's established direct in-person contacts with the patients to offer support explain and enroll them into the social media network and navigation platform. The project team carried out various awareness campaigns including talks to organized groups, house-to-house and media campaigns. Program/Policy process: We engaged with the Ghana Health Service, local government authorities as well as traditional and community leadership in the design and implementation of the program, to encourage community ownership from the onset. These key stakeholders were also pivotal in organizing durbars, talks to organized groups and community meetings to reach out to the people. Recruitment of volunteers within the communities will ensure that patient navigation has the best chance to continue within these communities beyond the grant period. The project coordinator and her team were available for consultation and also paid periodic visits to the communities. Outcomes: A structured program to enhance referral and access to care; a community-based patient navigation system to recruit and provide support to patients with advanced breast cancer; a social media platform to provide guide and immediate support to patients with metastatic breast cancer; and improved awareness of breast cancer and its prevention in the communities. Conclusions: The program improved the health care system in the communities and also expands outreach to persons living with metastatic breast cancer to provide support and improve treatment outcomes and quality of life. It also encourages patients to visit hospitals for treatment through ease of access to medical care and informed treatment choices and palliative care.
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Donkor, P. "A prospective study of patients with advanced oral cancer in Ghana: a preliminary report." British Journal of Oral and Maxillofacial Surgery 36, no. 3 (June 1998): 237. http://dx.doi.org/10.1016/s0266-4356(98)90594-0.
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Ghanney, E. C., D. Mensah, E. Addo, and D. Meier. "Palliative care education and training workshop for caregivers of patients with cancer in Ghana." Annals of Global Health 81, no. 1 (March 12, 2015): 28. http://dx.doi.org/10.1016/j.aogh.2015.02.575.
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Bonsu, Adwoa Bemah, Busisiwe Purity Ncama, and Kwadwo Osei Bonsu. "Breast cancer knowledge, beliefs, attitudes and screening efforts by micro-community of advanced breast cancer patients in Ghana." International Journal of Africa Nursing Sciences 11 (2019): 100155. http://dx.doi.org/10.1016/j.ijans.2019.100155.
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Opoku, S. "Assessing the Quality of Life of Breast Cancer Patients Undergoing Treatment at the National Radiotherapy Center, Accra, Ghana." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 116s. http://dx.doi.org/10.1200/jgo.18.57200.
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Background: Quality of life is an important clinical outcome in assessing health care. It is a concept that includes many subjective elements: physical, emotional and social function, attitudes to illness, patient's daily lives-including family interactions. Quality of life is increasingly used as an outcome measure in oncology research studies appearing in a variety of forms in several literatures. Aim: The study was aimed at assessing the quality of life of breast cancer patient undergoing treatment at the Radiotherapy Center, Accra, Ghana. Methods: This cross-sectional descriptive study involved 30 patients over a 3-month period. Functional Assessment of Cancer Therapy (FACT-B) Specific Scale for Breast Cancer Survey Instrument was used to collect the data which was analyzed with SPSS. Results: The peak age range of the patients was between (56-65) years. Out of these, 60% (n=18/30) received triple treatment modalities, namely, surgery, chemotherapy and radiotherapy. Surgery and chemotherapy alone accounted for 16.7% (n=5/30). Further 10% (3/30) had surgery with adjuvant radiotherapy. Three patients 10% had only surgery and one patient (3.3%) received both chemotherapy and radiotherapy. The scores for the quality of life domains were general emotional well-being (18.8+8.4), general physical well-being (16.5+6.1), general social well-being (14.3+7.0) and general functional well-being (10.9+5.7). The quality of life of three patients (10%) was found to be poor, while 70% (n=21/30) had stable quality of life and 20% (n=6/30) with good quality of life. Conclusion: Considering the quality of life domains or subscale scores and the overall quality of life scores, it is concluded that no significant difference exists ( P > 0.05) in the quality of life status of the patients irrespective the treatment modality received.
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Jiagge, Evelyn, Joseph Kwaku Oppong, Jessica Bensenhaver, Francis Aitpillah, Kofi Gyan, Ishmael Kyei, Ernest Osei-Bonsu, et al. "Breast Cancer and African Ancestry: Lessons Learned at the 10-Year Anniversary of the Ghana-Michigan Research Partnership and International Breast Registry." Journal of Global Oncology 2, no. 5 (October 2016): 302–10. http://dx.doi.org/10.1200/jgo.2015.002881.
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Women with African ancestry in western, sub-Saharan Africa and in the United States represent a population subset facing an increased risk of being diagnosed with biologically aggressive phenotypes of breast cancer that are negative for the estrogen receptor, the progesterone receptor, and the HER2/neu marker. These tumors are commonly referred to as triple-negative breast cancer. Disparities in breast cancer incidence and outcome related to racial or ethnic identity motivated the establishment of the International Breast Registry, on the basis of partnerships between the Komfo Anokye Teaching Hospital in Kumasi, Ghana, the University of Michigan Comprehensive Cancer Center in Ann Arbor, Michigan, and the Henry Ford Health System in Detroit, Michigan. This research collaborative has featured educational training programs as well as scientific investigations related to the comparative biology of breast cancer in Ghanaian African, African American, and white/European American patients. Currently, the International Breast Registry has expanded to include African American patients throughout the United States by partnering with the Sisters Network (a national African American breast cancer survivors’ organization) and additional sites in Ghana (representing West Africa) as well as Ethiopia (representing East Africa). Its activities are now coordinated through the Henry Ford Health System International Center for the Study of Breast Cancer Subtypes. Herein, we review the history and results of this international program at its 10-year anniversary.
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Frempong, Emmanuel, Francis Yeboah, Samuel Nguah, and Osei Afriyie. "Response to chemotherapy and association with three tumour markers in breast cancer patients in Ghana." International Journal of Cancer Therapy and Oncology 2, no. 3 (June 7, 2014): 02034. http://dx.doi.org/10.14319/ijcto.0203.4.
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Kugbey, Nuworza, Anna Meyer-Weitz, and Kwaku Oppong Asante. "Mental adjustment to cancer and quality of life among women living with breast cancer in Ghana." International Journal of Psychiatry in Medicine 54, no. 3 (October 9, 2018): 217–30. http://dx.doi.org/10.1177/0091217418805087.
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Objective This study examined whether cancer-specific coping strategies have any significant influence on the quality of life of 205 women living with breast cancer in Ghana. Methods Using a cross-sectional survey design, participants were administered questionnaires which measured their cancer-specific coping strategies and health-related quality of life. Results Correlation analysis showed that helplessness-hopelessness negatively correlated with physical wellbeing, emotional wellbeing, functional wellbeing, and breast cancer additional concerns. Anxious preoccupation negatively correlated with all the domains of quality of life, whereas fighting spirit was positively correlated with emotional and functional wellbeing. Cognitive avoidance was positively correlated with functional wellbeing, while fatalism was positively related with all the domains of quality of life. Regression analysis revealed that anxious preoccupation predicted significant decreases in all the domains of quality of life, while helplessness-hopelessness predicted significant decreases in emotional and functional wellbeing domains. However, cognitive avoidance predicted significant increase in the functional domain of quality of life. Conclusion These findings underscore the need for psychosocial support for breast cancer patients to adopt effective coping strategies to deal with their challenges in managing their illness.
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Thomas, Abigail S., Kelley M. Kidwell, Joseph K. Oppong, Ernest K. Adjei, Ernest Osei-Bonsu, Angela Boahene, Evelyn Jiagge, Kofi Gyan, and Sofia D. Merajver. "Breast Cancer in Ghana: Demonstrating the Need for Population-Based Cancer Registries in Low- and Middle-Income Countries." Journal of Global Oncology 3, no. 6 (December 2017): 765–72. http://dx.doi.org/10.1200/jgo.2016.006098.
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Purpose Breast cancer, the most common cancer worldwide, is the leading cause of cancer mortality in Ghanaian women. Previous studies find Ghanaian women are diagnosed at a younger age and at more advanced stages (III and IV), and have tumors with characteristics similar to African American women. We sought to remedy gaps in knowledge about breast cancer survival in Ghana and its relation to demographic and biologic factors of the tumors at diagnosis to assist in cancer control and registration planning. Methods Individuals with a breast cancer diagnosis who sought care at Komfo Anokye Teaching Hospital from 2009 to 2014 were identified via medical records. Follow-up telephone interviews were held to assess survival. Kaplan-Meier plots and Cox proportional hazards models assessed survival associated with clinical and demographic characteristics. Results A total of 223 patients completed follow-up and were analyzed. The median survival was 3.8 years. Approximately 50% of patients were diagnosed with grade 3 tumors, which significantly increased the risk of recurrence or death (hazard ratio [HR] for grade 2 versus 1, 2.98; 95% CI, 1.26 to 7.02; HR grade 3 v 1, 2.56; 95% CI, 1.08 to 6.07; P = .04). No other variables were significantly associated with survival. Conclusion Higher tumor grade was significantly associated with shorter survival, indicating impact of aggressive biology at diagnosis on higher risk of cancer spread and recurrence. Contrary to prevailing notions, telephone numbers were not reliable for follow-up. Collecting additional contact information will likely contribute to improvements in patient care and tracking. A region-wide population-based active registry is important to implement cancer control programs and improve survival in sub-Saharan Africa.
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Asoogo, C., M. Hoyte-Williams, B. Dwobeng, D. Sam, and E. Amankwa-Frimpong. "Experiences of Patients Diagnosed and Living With Metastatic Breast Cancer in Kumasi, Ghana: A Lesion to Learn From Low-Middle Income Country." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 8s. http://dx.doi.org/10.1200/jgo.18.40600.
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Background: Breast cancer is a leading cause of death among women in Ghana. About 50% of cases seen at the oncology directorate are breast cancer-related, and 85% of these cases present in advanced stage with very poor prognosis and high mortality. Objectives: To explore and describe the experiences of patients diagnosed and living with metastatic breast cancer. Methods: A cross sectional descriptive study design was used to involved breast cancer patients at Komfo Anokye Teaching Hospital who comes from various social and ethnic groups as well as geographically distinct areas from the vast territory of the Ashanti region and the Northern part of Ghana. Convenient sampling was used to select 120 participants for the study using semistructured questionnaire. Data of their social and demographic background and experiences living with metastatic breast cancer were obtained after seeking informed consent. Results: The study revealed that 12% of participants diagnosed and living with metastatic breast cancer experience loneliness and devastated, 22% experience fear and anxiety, while 35% experience stigma from both family and the society. Moreover, feeling of anger and hopelessness also account for 15%, 11% experience financial changes, while 5% of participants experience both physical and emotional pain with their diagnosis and treatment. Recommendations were made for policy makers, health care professionals, and other researchers. These include the need for intensified metastatic breast cancer awareness campaigns, educating health care providers on the need for professional counseling on metastatic breast cancer and the need to organized support groups, so that patients could contact each other. Emphasis should be placed on training of nurses to deal with issues relating to metastatic breast cancer. Conclusion: Generally, fear and anxiety, stigma, feeling of loneliness, devastated, anger and hopelessness, emotional and physical pain and financial changes are the variables that explain the experiences of women diagnosed and living with metastatic breast cancer. Some support groups has shown an improvement, therefore efforts to raise public awareness of metastatic breast cancer should be continued. The current study became imperative to fill this identified gap and improve health interventions and health outcomes for metastatic breast cancer patients in future.
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Kyei, K. A., and P. Engel-Hills. "A pain survey to support role development for Radiation Therapists in Ghana." Journal of Radiotherapy in Practice 12, no. 2 (May 24, 2012): 105–13. http://dx.doi.org/10.1017/s1460396912000040.
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AbstractA research study was conducted at the radiation oncology department of a large teaching hospital in Ghana, to determine whether the use of a pain questionnaire would facilitate a contribution by the radiation therapists (RTs) to the management of pain in the patients undergoing external beam radiotherapy. The rationale for the study was to test the pain questionnaire as a tool for routine use by RTs and to increase the knowledge and skill of the RTs with regard to pain assessment in order that they could have an effective role in the multidisciplinary approach to pain management.The pain questionnaire for administration by RTs was adapted as a tool for assessing pain. The tool and the process were tested in a prospective study of 90 participants who willingly consented to participate. The data was analysed as a means of evaluating the questionnaire and learning about pain in this group of cancer patients. The results of this analysis were integrated with the findings from textual data published in a previous paper.Findings revealed that RTs could administer a limited pain questionnaire and use this for clinical assessment of patients with pain, refer patients who need urgent medical attention to the doctors, monitor the patients receiving radiotherapy and adjuvant chemotherapy as well as provide meaningful suggestions to the multidisciplinary team on the management of pain.Through this reflective process it is recommended that because RTs have daily contact with patients during external beam radiotherapy treatment and because the majority of cancer patients in the study population experience pain, the RTs should enhance their knowledge of pain and participate in routine pain assessment. Through engagement in this role development the quality of care to the patient population in Ghana will be improved.
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Kugbey, Nuworza, Anna Meyer-Weitz, Kwaku Oppong Asante, Joel Yarney, and Verna Vanderpuye. "Lived Experiences of Women Receiving Medical Treatments for Breast Cancer in Ghana: A Qualitative Study." SAGE Open 11, no. 3 (July 2021): 215824402110450. http://dx.doi.org/10.1177/21582440211045077.
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Breast cancer diagnosis and its treatment present women with significant challenges which require adjustment in several domains to ensure good health outcomes. Any psychosocial interventions to address the challenges need to be informed by empirical evidence. However, there is dearth of empirical literature in this regard in the Ghanaian context. To address some of these gaps, we explored the lived experiences of women living with breast in Ghana to inform healthcare practice and breast cancer research. In-depth individual interviews were conducted among 11 breast cancer patients receiving medical treatment for breast cancer. The interpretative phenomenological approach was used in the data analysis. Findings from the study showed that participants’ lived experiences cluster around three major themes; burdens of breast cancer treatments, alternative/herbal medicine use, and breast cancer stigma. These findings underscore the need for a multidisciplinary treatment approach to achieve optimum health outcomes among these groups of women.
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Kugbey, Nuworza, Kwaku Oppong Asante, and Anna Meyer-Weitz. "Illness perception and coping among women living with breast cancer in Ghana: an exploratory qualitative study." BMJ Open 10, no. 7 (July 2020): e033019. http://dx.doi.org/10.1136/bmjopen-2019-033019.
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ObjectiveIllness perception has been shown to have significant influence on the well-being and coping strategies of persons living with chronic medical conditions. Understanding of how women living with breast cancer cognitively and emotionally represent their illness and coping strategies used is likely to help in designing focused psychosocial interventions aimed at improving their health and well-being. This study explored the illness perceptions and coping strategies among women receiving care for breast cancer.DesignA qualitative phenomenological study (using semi-structured in-depth interviews).SettingOncology department of a tertiary hospital in Ghana.ParticipantsEleven women receiving breast cancer treatment were purposively sampled and in-depth individual interviews were conducted with questions based on illness perception and coping literature.ResultsIn terms of illness perceptions, it emerged that most of the participants lacked adequate factual knowledge about breast cancer and perceived causes but believed in the curability of their illness through medical treatments and the help of God. Spirituality, social support and diversion coping were the key resources for coping among the participants.ConclusionBreast cancer patients lacked adequate factual knowledge of breast cancer and their perception about the causes of breast cancer is rooted in biopsycho-spiritual model of illness. The reliance on spirituality and social support as the main coping strategies suggests the need for psychosocial interventions tailored to the spiritual and psychosocial needs of the patients.
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Gyedu, Adam, Cameron E. Gaskill, Godfred Boakye, Abdul Rashid Abdulai, Benjamin O. Anderson, and Barclay Stewart. "Differences in Perception of Breast Cancer Among Muslim and Christian Women in Ghana." Journal of Global Oncology, no. 4 (December 2018): 1–9. http://dx.doi.org/10.1200/jgo.2017.009910.
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Purpose The burden of breast cancer continues to increase in low- and middle-income countries (LMICs), where women present with more advanced disease and have worse outcomes compared with women from high-income countries. In the absence of breast cancer screening in LMICs, patients must rely on self-detection for early breast cancer detection, followed by a prompt clinical diagnostic work-up. Little is known about the influence of religious beliefs on women’s perceptions and practices of breast health. Methods A cross-sectional survey was administered to female members of Islamic and Christian organizations in Ghana. Participants were asked about their personal experience with breast concerns, knowledge of breast cancer, performance of breast self-examination, and experience with clinical breast exam. Results The survey was administered to 432 Muslim and 339 Christian women. Fewer Muslim women knew someone with breast cancer (31% v 66%; P < .001) or had previously identified a concerning mass in their breast (16% v 65%; P < .001). Both groups believed that new breast masses should be evaluated at clinic (adjusted odds ratio [AOR], 1.08; 95% CI, 0.58 to 2.01), but Muslim women were less likely to know that breast cancer can be effectively treated (AOR, 0.34; 95% CI, 0.23 to 0.50). Muslim women were less likely to have performed breast self-examination (AOR, 0.51; 95% CI, 0.29 to 0.88) or to have undergone clinical breast exam (AOR, 0.48; 95% CI, 0.27 to 0.84). Conclusion Muslim women were found to be less likely to participate in breast health activities compared with Christian women, which highlights the need to consider how religious customs within subpopulations might impact a woman’s engagement in breast health activities. As breast awareness initiatives are scaled up in Ghana and other LMICs, it is essential to consider the unique perception and participation deficits of specific groups.
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Kusi, Grace, Adwoa Bemah Boamah Mensah, Kofi Boamah Mensah, Veronica Millicent Dzomeku, Felix Apiribu, and Precious Adade Duodu. "Caregiving motivations and experiences among family caregivers of patients living with advanced breast cancer in Ghana." PLOS ONE 15, no. 3 (March 12, 2020): e0229683. http://dx.doi.org/10.1371/journal.pone.0229683.
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Yamoah, Kosj, Kwamena Beecham, Sarah Hegarty, Terry Hyslop, Timothy Norman Showalter, and Joel Yarney. "Early results of prostate cancer radiation therapy at Korle Bu Teaching Hospital: An analysis with emphasis on research strategies to improve treatment delivery and outcomes among patients in Ghana." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e15163-e15163. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e15163.
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e15163 Background: Although there is interest in racial disparities in prostate cancer outcomes among persons of African descent living in the United States there is scant data available regarding disease presentation and treatment response among black men living in Africa. In this study we evaluate disease presentation and early clinical outcomes among Ghanaian men with prostate cancer treated with external beam radiotherapy (EBRT). Methods: A total of 379 men with prostate cancer were referred to the National Center for Radiotherapy and Nuclear Medicine, Ghana, from January 2003 to December 2009. Data were collected regarding patient- and tumor-related factors such as age, prostate specific antigen (PSA), Gleason score, clinical stage, and use of hormonal therapy. For patients who received EBRT, freedom from biochemical failure (FFbF) was evaluated using Kaplan-Meier analysis. Results: The median age at diagnosis was 65 years. Of 379 patients referred for treatment 69.6% of all patients had initial PSA >20ng/ml, and the median iPSA was 39.0 ng/ml. A total of 128 men representing 33.8% of overall cohort were diagnosed with metastatic disease at time of referral. We identified 166 men treated with EBRT or brachytherapy +/- androgen depravation therapy (ADT), and an additional 139 men treated with ADT alone (including orchiectomy in 38 patients). The median EBRT dose was 70 Gy, in 2 Gy per fraction. Among all EBRT patients with at least 2 years of follow-up after treatment (n=52; median follow-up time: 38.9 months), 5-year actuarial FFbF was 65.1%: 67.0% for patients with PSA < 30.0 ng/mL and 63.2% for PSA ≥ 30.0 ng/mL [log-rank, p=0.586]. Conclusions: This is the largest series reporting on outcomes for prostate cancer treatment in West Africa. That one-third of patients presented with metastatic disease suggests potential need for earlier detection of prostate cancer to permit curative-intent local therapy. Data from this study will aid in the strategic development of a prostate cancer research roadmap in Ghana, with a focus on improving therapeutic approach as well as fostering a prudent allocation of scarce resources.
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Atobrah, Deborah, and Akosua Adomako Ampofo. "Expressions of Masculinity and Femininity in Husbands’ Care of Wives with Cancer in Accra." African Studies Review 59, no. 1 (April 2016): 175–97. http://dx.doi.org/10.1017/asr.2016.2.
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Abstract:This article explores the care that husbands in Accra, Ghana, provide for wives who have been diagnosed with cancer. Making use of an inductive, qualitative approach, the study analyzes observations of and in-depth ethnographic interviews conducted with five married female cancer patients and their husbands over a ten-month period. The results suggest a strong association among husbands’ care, wives’ responses to husbands’ care, and cultural ideals of femininity and masculinity. The findings suggest that husbands’ selective and often limited gender-based investments in unpaid care work make their sick wives exceedingly vulnerable in a context in which care for the terminally ill takes place predominately in familial settings.
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Adam, Awolu, and Felix Koranteng. "Availability, accessibility, and impact of social support on breast cancer treatment among breast cancer patients in Kumasi, Ghana: A qualitative study." PLOS ONE 15, no. 4 (April 16, 2020): e0231691. http://dx.doi.org/10.1371/journal.pone.0231691.
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Adusei-Poku, P., S. Y. Opoku, and D. Oppong. "Assessing the quality of life of breast cancer patients undergoing treatment at the National Radiotherapy Center, Accra, Ghana." European Journal of Cancer 72 (February 2017): S163. http://dx.doi.org/10.1016/s0959-8049(17)30607-x.
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Ayee, Richmond, Maame Ekua Oforiwaa Ofori, Emmanuel Ayitey Tagoe, Sylvester Languon, Kafui Searyoh, Louis Armooh, Estella Bilson-Amoah, et al. "Genotypic Characterization of Epstein Barr Virus in Blood of Patients with Suspected Nasopharyngeal Carcinoma in Ghana." Viruses 12, no. 7 (July 16, 2020): 766. http://dx.doi.org/10.3390/v12070766.
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Nasopharyngeal cancer (NPC) is associated with Epstein Barr virus (EBV) infection. However different viral strains have been implicated in NPC worldwide. This study aimed to detect and characterize EBV in patients diagnosed with NPC in Ghana. A total of 55 patients diagnosed with NPC by CT scan and endoscopy were age-matched with 53 controls without a known oncological disease. Venous blood was collected from the study participants and DNA extracted from the blood samples. Detection of EBV and genotyping were done by amplifying Epstein Barr nuclear antigen 1 (EBNA-1) and Epstein Barr nuclear antigen 2 (EBNA-2), respectively, using specific primers. Viral load in patients and controls was determined using real-time polymerase chain reaction. EBV positivity in controls (92%) was significantly greater than that of NPC patients (67%) (χ2 = 19.17, p < 0.0001), and viral infection was independent of gender (χ2 = 1.770, p = 0.1834). The predominant EBV genotypes in patients and controls were genotype 2 (52%) and genotype 1 (62%), respectively. Median EBV load was significantly higher in NPC patients than the control group (p < 0.01). In summary, prevalence of EBV genotype 2 infection was higher in NPC patients than the control group. Assessment of EBV load may be used as a biomarker for the diagnosis of NPC.
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Renner, Lorna, Shivani Shah, Nickhill Bhakta, Avram Denburg, Sue Horton, and Sumit Gupta. "Evidence From Ghana Indicates That Childhood Cancer Treatment in Sub-Saharan Africa Is Very Cost Effective: A Report From the Childhood Cancer 2030 Network." Journal of Global Oncology, no. 4 (December 2018): 1–9. http://dx.doi.org/10.1200/jgo.17.00243.
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Purpose No published study to date has examined total cost and cost-effectiveness of maintaining a pediatric oncology treatment center in an African setting, thus limiting childhood cancer advocacy and policy efforts. Methods Within the Korle Bu Teaching Hospital in Accra, Ghana, costing data were gathered for all inputs related to operating a pediatric cancer unit. Cost and volume data for relevant clinical services (eg, laboratory, pathology, medications) were obtained retrospectively or prospectively. Salaries were determined and multiplied by proportion of time dedicated toward pediatric patients with cancer. Costs associated with inpatient bed use, outpatient clinic use, administrative fees, and overhead were estimated. Costs were summed for a total annual operating cost. Cost-effectiveness was calculated based on annual patients with newly diagnosed disease, survival rates, and life expectancy. Results The Korle Bu Teaching Hospital pediatric cancer unit treats on average 170 new diagnoses annually. Total operating cost was $1.7 million/y. Personnel salaries and operating room costs were the most expensive inputs, contributing 45% and 21% of total costs. Together, medications, imaging, radiation, and pathology services accounted for 7%. The cost per disability-adjusted life-year averted was $1,034, less than the Ghanaian per capita income, and thus considered very cost effective as per WHO-CHOICE methodology. Conclusion To our knowledge, this study is the first to examine institution-level costs and cost-effectiveness of a childhood cancer program in an African setting, demonstrating that operating such a program in this setting is very cost effective. These results will inform national childhood cancer strategies in Africa and other low- and middle-income country settings.
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Arko-Boham, Benjamin, Bright Afriyie Owusu, Nii Ayite Aryee, Richard Michael Blay, Ewurama Dedea Ampadu Owusu, Emmanuel Ayitey Tagoe, Abdul Rashid Adams, Richard Kwasi Gyasi, Nii Armah Adu-Aryee, and Seidu Mahmood. "Prospecting for Breast Cancer Blood Biomarkers: Death-Associated Protein Kinase 1 (DAPK1) as a Potential Candidate." Disease Markers 2020 (May 25, 2020): 1–7. http://dx.doi.org/10.1155/2020/6848703.
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Background. Breast cancer is the commonest malignancy in women worldwide. It is estimated to affect approximately 1.5 million women annually and responsible for the greatest number of cancer-related mortalities among women. In 2018, breast cancer mortalities stood at 627,000 women representing approximately 15% of all cancer deaths among women. In Ghana, breast cancer is the second leading cause of cancer deaths, with an incidence of 2,900 cases annually; one of eight women with the disease die. This gives impetus to the fight for improved early detection, treatment, and/management. In this light, we investigated the potential of death-associated protein kinase 1 (DAPK1) as a biomarker for breast cancer. As a tumour suppressor, its expression is activated by several carcinogens to influence cellular pathways that result in apoptosis, autophagy, immune response, and proliferation. Aim. To investigate DAPK1 as a blood biomarker for breast cancer. Methods. Blood samples of participants diagnosed with breast cancer and healthy controls were collected and processed to obtain serum. Information on age, treatment, diagnosis, and pathology numbers was retrieved from folders. Pathology numbers were used to retrieve breast tissue blocks of patients at the Department of Pathology of the KBTH. Tissue blocks were sectioned and immunohistochemically stained with anti-DAPK1 and counterstained with hematoxylin to determine the DAPK1 expression levels. DAKP1 levels in blood sera were quantified using a commercial anti-DAPK1 ELISA kit. Case and control group means were compared using one-way ANOVA and Chi-square test. Statistical significance was set at p≤0.05. Results and Discussion. DAPK1 levels were higher in sera and breast tissues of breast cancer patients than controls. The augmented DAPK1 expression can be interpreted as a stress response survival mechanism to remediate ongoing deleterious events in the cells orchestrated by carcinogenesis. In the presence of abundant DAPK1, the proliferative power of cells (both cancerous and noncancerous) is increased. This may explain why high DAPK1 expression strongly associates with aggressive breast cancer phenotypes like the ER-negative breast cancers, especially the triple-negative breast cancers (TNBC) which are the most aggressive, fast-growing, and highly metastatic. Conclusion. DAPK1 is highly expressed in sera and breast tissues of breast cancer patients than nonbreast cancer participants. The elevated expression of DAKP1 in circulation rather than in breast tissues makes it a candidate for use as a blood biomarker and potential use as therapeutic target in drug development.
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Edzie, Emmanuel Kobina Mesi, Klenam Dzefi-Tettey, Philip Narteh Gorleku, Adu Tutu Amankwa, Eric Aidoo, Kwasi Agyen-Mensah, Ewurama Andam Idun, et al. "Evaluation of the Clinical and Imaging Findings of Breast Examinations in a Tertiary Facility in Ghana." International Journal of Breast Cancer 2021 (July 19, 2021): 1–9. http://dx.doi.org/10.1155/2021/5541230.
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Breast diseases have been one of the major battles the world has been fighting. In winning this fight, the role of medical imaging cannot be overlooked. Breast imaging reveals hidden lesions which aid physicians to give the appropriate diagnosis and definitive treatment, hence this study, to determine the clinical and imaging findings of breast examinations to document the radiologic features in our setting. This cross-sectional retrospective study reviewed the sociodemographics, imaging reports (mammography and ultrasonography with BI-RADS scores and their features), and the clinical data of 425 patients from September 2017 to September 2020 in the Cape Coast Teaching Hospital. 72 solid lesions with their histology reports were also reviewed. Data obtained were organized, coded, and analyzed using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, USA) version 20.0. The results obtained were presented in appropriate tables and charts. A chi-squared test was employed for associations and statistical significance was specified at p ≤ 0.05 . 63.29% of the patients were married, but only 18.59% had a positive family history of breast cancer. BI-RADS scores 1(57.46%) and 2(27.99%) were the most recurrent findings. The most common BI-RADS 2, 3, 4, and 5 imaging features were benign-looking axillary lymph nodes (66.33%), well-defined solid masses (61.54%), ill-defined solid masses (42.86%), and ill-defined solid masses with suspicious-looking axillary lymph nodes (100.00%), respectively. The most frequent indications were routine screening (49.18%), mastalgia (26.59%), and painless breast masses (19.77%). There was significant association between duration of symptoms and breast cancer ( p value = 0.007 ). In conclusion, routine breast screening and mastalgia were the topmost indications for breast imaging. BI-RADS 1 and 2 were the commonest BI-RADS scores, and benign-looking axillary lymph nodes and simple cysts were the most frequent imaging features for BI-RADS 2 and ill-defined solid masses and suspicious-looking axillary lymph nodes for BI-RADS 4 and 5.
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Badu-Peprah, Augustina, and Yaw Adu-Sarkodie. "Accuracy of clinical diagnosis, mammography and ultrasonography in preoperative assessment of breast cancer." Ghana Medical Journal 52, no. 3 (December 26, 2018): 133–39. http://dx.doi.org/10.4314/gmj.v52i3.5.
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Background: Cancer of the breast is the most common malignancy affecting women in many parts of the world. Its early detection has, therefore, become necessary to reduce morbidity and mortality from the disease. In sub-Saharan Africa, radiological imaging, histology and management programs are associated with challenges.Objectives: This study seeks to assess the validity of clinical diagnosis, mammography and breast ultrasonography in the preoperative assessment of suspected breast cancer patients for accurate detection of the disease to enable appropriate management.Methods: A prospective cross-sectional study was carried out in the Radiology Department of Komfo Anokye Teaching Hospital, Kumasi, Ghana, between November 2007 and July 2008 with a sample size of 103. All patients with a clinical suspicion of breast cancer who gave informed consent were recruited, underwent bilateral mammography and whole breast ultrasonography and then biopsy for all BIRADS categories 4 or 5 lesions. The histopathology results were retrieved to complete the study.Result: In this study the definition of malignancy was made using histology as the gold standard. A total of 103 patients were recruited for this study with mean age of 55(+15) years, out of which 52 (50.5%) had malignant lesions. The overall sensitivity of clinical diagnosis was 50.5%. While the overall sensitivity and specificity for mammogram and ultrasound were 73.0%, 80.0% and 100%, 80.4% respectively. Conclusion: In conclusion, this study has demonstrated that clinical diagnosis, ultrasound and mammography can potentially predict breast cancer disease with considerable sensitivity and specificity. Funding: Not declaredKeywords: breast cancer, mammography, ultrasonography, histology, clinical diagnosis
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Asamoah, Francis Adumata, Joel Yarney, Aba Scott, Verna Vanderpuye, Zhigang Yuan, Daniel C. Fernandez, Michael E. Montejo, et al. "Comparison of Definitive Cervical Cancer Management With Chemotherapy and Radiation Between Two Centers With Variable Resources and Opportunities for Improved Treatment." JCO Global Oncology, no. 6 (October 2020): 1510–18. http://dx.doi.org/10.1200/go.20.00303.
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PURPOSE Cervical cancer remains a major health challenge in low- to middle-income countries. We present the experiences of two centers practicing in variable resource environments to determine predictors of improved radiochemotherapy treatment. METHODS AND MATERIALS This comparative review describes cervical cancer presentation and treatment with concurrent chemoradiotherapy with high-dose-rate brachytherapy between 2014 and 2017 at the National Radiotherapy Oncology and Nuclear Medicine Center (NRONMC) in Korle-Bu Teaching Hospital, Accra, Ghana, and Moffitt Cancer Center (MCC), Tampa, FL. RESULTS Median follow-up for this study was 16.9 months. NRONMC patients presented with predominantly stage III disease (42% v 16%; P = .002). MCC patients received para-aortic node irradiation (16%) and interstitial brachytherapy implants (19%). Median treatment duration was longer for NRONMC patients compared with MCC patients (59 v 52 days; P < .0001), and treatment duration ≥ 55 days predicted worse survival on multivariable analysis (MVA; P = .02). Stage ≥ III disease predicted poorer local control on MVA. There was a difference in local control among patients with stage III disease (58% v 91%; P = .03) but not in survival between MCC and NRONMC. No significant difference in local control was observed for stage IB, IIA, and IIB disease. CONCLUSION Although there were significant differences in disease presentation between the two centers, treatment outcomes were similar for patients with early-stage disease. Longer treatment duration and stage ≥ III disease predicted poor outcomes.
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Fredua-Agyeman, Mansa, Blessing Onwukwe, and Nii Armah Adu-Aryee. "Antibiotic prescribing and the risk of antibiotic–associated diarrhoea in Korle Bu Teaching Hospital, Ghana: a pilot study." Journal of Infection in Developing Countries 14, no. 08 (August 31, 2020): 861–68. http://dx.doi.org/10.3855/jidc.11259.
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Introduction: This study sought to identify the association of antibiotic prescribing and the risk of antibiotic-associated diarrhoea (AAD) in Korle Bu Teaching Hospital (KBTH) in Ghana.
Methodology: Patients from the Male Urology Ward and Treatment Room of the Surgical Department of KBTH were followed up over three months to determine if they had experienced any unusual diarrhoeal illness after antibiotic therapy. 81 eligible patients (adults) were included in the study but a total of 70 patients (mean age of 56.71 years) were successfully followed up during the study period.
Results: The top conditions presented by patients were urological infection (66.7%), cancer (15.3%) and leg ulcer (18.1%). Ciprofloxacin (50%) and ceftriaxone (28.5%) were the most prescribed antibiotics. Eleven patients (more than 1 in 7) developed diarrhoea that could be associated with their use of antibiotics. The occurrence of AAD was significantly associated with type of antibiotic used by patient. 73% of patients who developed symptoms of AAD had received Clindamycin. Risk of AAD was not significantly associated with age and comorbidities.
Conclusions: The rate of AAD in the Male Urology Ward and the Treatment Room of the Surgical Department of KBTH during the period of this study was 15.7%. Clindamycin was identified as the most implicated antibiotic.
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Acquah, George. "The use of gold markers and electronic portal imaging for radiotherapy verification in prostate cancer patients: Sweden Ghana Medical Centre experience." International Journal of Cancer Therapy and Oncology 2, no. 1 (February 11, 2014): 020112. http://dx.doi.org/10.14319/ijcto.0201.12.
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Asamoah, Francis A., Joel Yarney, Shivanshu Awasthi, Verna Vanderpuye, Puja S. Venkat, Angelina K. Fink, Arash O. Naghavi, et al. "Contemporary Radiation Treatment of Prostate Cancer in Africa: A Ghanaian Experience." Journal of Global Oncology, no. 4 (December 2018): 1–13. http://dx.doi.org/10.1200/jgo.17.00234.
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Purpose Data on prostate cancer (PCa) treatment in Africa remains under-reported. We present a review of the management of PCa at the cancer center of the largest tertiary referral facility in Ghana, with emphasis on curative treatment. Methods We retrospectively reviewed data on 1,074 patients seen at the National Center for Radiotherapy and Nuclear Medicine from 2003 to 2016. Patient and disease characteristics at presentation are presented using descriptive statistics. The χ2 and Fisher’s exact tests and Mann-Whitney U test were used to analyze differences between categorical and continuous variables, respectively. Methods of survival analysis were used to evaluate the relative risk of biochemical disease-free survival (bDFS). Results Seventy percent of the study population presented with localized disease. High-risk disease presentation accounted for 64.4% of these patients. Only 57.6% of patients with localized disease received curative radiotherapy. The 5-year overall survival for the curative cohort was 96% (interquartile range, 93% to 98%). The 5-year bDFS rates for low-, intermediate-, and high-risk groups were 95%, 70%, and 48%, respectively. Both Gleason score and pretreatment prostate-specific antigen were significant predictors for bDFS in multivariable analysis. Conclusion We show that the majority of patients with PCa have locally advanced disease at the time of presentation for radiotherapy. bDFS was significantly better for low- and intermediate-risk than for high-risk disease. These data emphasize the dire need to re-evaluate screening and patient education of PCa in regions of the world with high incidence and mortality as well as the need for improved access to care and treatment delivery.