 You're welcome back. I did say that today is we're going to be talking about something which is really important something that is killing some people, especially not especially killing the women and that is cervical cancer and so much is not said about it or rather so much of our population does not even know about it and how to go about it and we're very lucky that there is there seem to be a vaccine for that and Nigeria is on the verge of having that vaccine come to us. So we're glad now that we're going to be joined by Dr. Wango Bin Anthony who is a medical practitioner that will help us throw more light on what cervical cancer is and also Itoro Usoro, the change leader in Guruvoo Collective. Let me start by welcoming Governor Obinna to the program. I said Governor. Dr. Obinna, welcome to the program. Thank you so much. Okay, and Itoro, welcome to the program as well. Thank you for having me. Okay, we'll keep it short and simple because our time is fast spent. Let's begin with Dr. Give us an insight into what cervical cancer really is and the dangers that it poses to women for. Okay, so cervical cancer is the cancer of the cervix. And we will mention cervix. Cervix is part of the woman's uterus. We call it uterus or womb. So the lower segment of uterus has a lower part of it called the cervix. And this cervix is a lower part of uterus from where the baby passes through during delivery. So this part of the cervix, this part of the uterus called cervix is prone to cancer called cervical cancer. The upper part of the uterus, the womb has its own cancer, the endometrial cancer. But specifically today, we are talking about the cervical cancer, which is the cancer of this particular part of the uterus or womb called the cervical cancer. And this cancer is caused, 99% of this cancer is caused by human papillomavirus, HPV virus, causes 99% of this cancer. And this human papillomavirus can be prevented. That's why we look at cervical cancer as a greater good disease, because it can be prevented. It's in Nigeria, low income countries, South Sahara, Africa, who have high records for cervical cancer. Because in the western countries, in developed countries, the vaccine is there, they are doing screening with these that call the body of cervical cancer to the nearest minimum. So cervical cancer, it's something that we must know about, just like you said in your introduction, most Nigerians don't know anything about cervical cancer. And that is why our foundation, HPV Women Campaign has been on the forefront to educate Nigerians on the need to know that there is cervical cancer. And that this cancer can be prevented. It's not like other cancers that you may not have control over. It can be prevented through vaccination, primary prevention, and it can also be prevented through screening, through secondary prevention, and then health education. So that's why we are here to talk about this cancer for people to be aware. You will be surprised that the recent survey done by our chairperson, Mr. Toro, at Abu-Jaziz, we discovered that out of 100 women, about less than 10, lose about cervical cancer. Less than 10, lose about cervical cancer. And this is a cancer that in the clinic, average cases of 2 to 3 cases, I see every day in clinic, 2 to 3 cases within a week, 2 to 3 cases. And those cases at that point, they have blue cancer, because any stages of this cancer, they are symptomatic. And because the cervix is hidden, you will not know what is going on there unless you're screening. So, but you begin to know that something is going on there when the cancer becomes symptomatic. And when it becomes symptomatic, you may present with bleeding from the vagina, or you may present with a mass from the cervix. And at this stage, it's already advanced and it's difficult to treat at this stage. The prognosis is poor at this stage. So that's why we are here talking about this, that if it's dictated early through screening, most of deaths can be prevented. And if young years are vaccinated, as early as between 9 to 15 years, it's still extended up to 6 years, most of this cancer can be prevented. Because this urban patruma virus that causes 99% of this cancer is seduary transmitted, is through seduary contact. So if we can get vaccine to prevent one from being infected by this human patruma virus, we can prevent more than 99% of the cervical cancer. Other ones from genetics, smoking, those are minima compared to the burden of human patruma virus, the burden of it as regards to the cause of cervical cancer. Thank you. I'll come back to you to tell us the nisigreti about the treatment and everything we need to know. But let me go to Itoro first of all now. Itoro, tell us your experience. We've just been told that you did advocacy, you did outreach, you did sensitization and you found out a lot of things. Give us an insight to how Nigerians react to this and how much awareness that they have on cervical cancer. Thank you sir. For two years now, I've actually been on awareness campaigns, education, mostly in low and middle income areas of the nation. And it's a surprise you to note that so many women, I can say 90% of the patients have at limit, they've not heard about it. They haven't heard about it before. And the 10% that have heard about this issue, less than 10% of that 10% have been screened. So they just know about this, but they do not go forward. Just like a project director, they'll probably not rightly say this is actually preventing through awareness because a face step is for the people to know that this issue is actually there. And secondly, they should be screened for persons who have passed the vaccination stage. And I'm happy that the federal government currently have ruled out a vaccination program because with the vaccination now, young girls will be vaccinated. And of course, the positive agent, which is the HPV, will be reduced and eliminated. And at the end of the day, the burden of these menace should be reduced in our nation. But why is the vaccination a thing now? Why they're saying Nigeria to introduce HPV vaccines to protect girls against cervical cancer? Why has it not been introduced before? Or if it has been introduced, why is it taking so much time to reach everybody? Okay, we have so many other vaccines in our national immunization program. Personally, when I lost my mom, because I actually lost my mom to this particular issue, which is what prompted and gave me the passion to run with this to see how I can prevent the pain and the heartbreaks and the vacuums in families. Okay, so when I researched and I saw that this was not actually part of our immunization program. Personally, in June 1st, through the change of platform, I was able to write a petition to federal government. And the petition is actually getting traction on so many signatures, actually on it. So I want to believe this has also been what has prompted the government because they've seen that so many persons are reacting and responding in this regard. But prior to this time, it was just discussions, you know, we had persons talk about this, we had the federal minister of health, they talked about this, they debated on it. But I'm excited that at this point, we are going to be having the vaccines. And this has really been my heart desire and I'm excited that that is happening. Okay, Doctor, let me come back to you. How dangerous, maybe it's a relevant question because we should know it's dangerous. But how dangerous is this cervical cancer so that the person hearing for the first time will know that something needs to be done promptly when the symptoms present themselves. Tell us how dangerous this cervical cancer is and what to look out for so that people can go for screening fast enough. Okay, just like every other cancer, the moment you hear cancer, I'm sure your guess will be as good as mine, that anything cancerous or cancer is a dangerous illness. But what makes cervical cancer peculiar is that in early stage, it's asymptomatic. Because that part of the organ I told you the cervix is hidden. It's right there in the upper part of the upper vagina, you can see the cervix, which is part of the uterus, the lower segment of uterus. So the location where it is, it's hidden. So if something is going on there, you will know. So it's asymptomatic when this cancer begins to proliferate and grow. It's asymptomatic. So you will not know what's going on there until when it becomes a full-blown cancer. When it becomes a full-blown cancer, that is when it becomes symptomatic. And that's why that is when you can identify something is going on in me. And they can present with bleeding of vagina, meaning you can see blood bleeding from the private parts from the vagina. Then you can also present with false smelling vagina discharge. False smelling vagina discharge. Then the cervix can be eroded with a max exfoliating mass. Most times the mass can even cover 2-3 of the vagina in advanced cases. And just like any other cancer doesn't limit itself at the site of lesion. There is metastasis to other organs. It can metastase to the liver. It can metastase to the brain. It can metastase to other parts of the body, lungs. So it's quite dangerous. So it's important that we know about this. Another important thing to... Sorry, I was just going to ask. If it is breast cancer, for instance, there are things that you can do in front of the mirror and find out if you have it without even waiting for symptoms to show and everything else. Is it also possible for cervical cancer to do a self-examination and find out whether it is there or not? It's not possible because the cervix, even for your finger to reach the cervix, where you put your finger through your vagina to reach the cervix, you can touch it but you won't know what it's doing on there, unless you can feel a mass. And when you're feeling a mass, mind you, it's already in advanced stage. So it's not possible. And that's the importance of screening. The only tool to identify what is going on there is screening. And that is why women of reproductive age, American Cancer Society recommend that women 25 to 65 years should do cervical cancer screening. It's only through screening you can identify what is going on there. What screening does, if you're nervous, you must get screened. And what screening does is to detect the pre-cancerous lesions. Those lesions that will expose you to cancer in the next 10 years, in the next 20 years because cervical cancer is not a day cancer. It doesn't come overnight. It takes years. And it's important to note, too, that this virus, human papillomavirus, that causes cervical cancer, we have one that is high and low, there are one that is high and low-grade types. It's high-risk type that can progress to cervical cancer. When you're affected by a low-risk type, it doesn't progress to cervical cancer. It can cause benign lesions. It's also important to note that this virus that causes cervical cancer, it doesn't cause cancer in individuals. Within two years, most of the human papillomavirus, even when you contract it, can spontaneously resolve. It's only the high-risk type that persists, the persistent infection that can transform into cancer. And this persistent infection, which are the high-risk type, type 16, type 18. These are, and others, these are major ones that can progress to cervical cancer. And so the tool for identifying what is going on there is screening. When you're screened, we have several methods of screening. In Nigeria, within the reach of the economy, most of the screening is done with either visual inspection with acidic acid, visual inspection with a Lugola iodine, then pap smear, and then you can proceed to do coposcoping, and then biopsy and histology. So in doing screening, if from the screening, using pap smear or visual inspection with iodine, if there is, if we dictate any precancerous religion, then treatment can be offered in what we call screen-and-treat approach. You can use, there are several methods of upgrading methods, like iotherapy, you can use to destroy the religion. Then if you screen, and you're negative to human-patruma virus, it's expected that you should screen every three years using this visual inspection acidic acid, pap smear, visual inspection with iodine. But if you're using human-patruma DNA testing, you're expected to screen every five years. The truth is that if you've been screening every three years, there is no way the cancer can come over, right? Okay. There is no way it can come over. Doctor, doctor, very simply now, all the things you're mentioning, it sounds like big grammar, and if it's big grammar, it means that it's going to be very expensive. That is the mentality of an average Nigerian. Is it affordable, the screening you're talking about? You know, I'm talking affordable, not from the point of a rich man, but affordable to the common man. The screening is affordable, but with the nature of Nigerian economy, even if we put up the screening to be 3,000, some people may not still be able to afford it. And that is why we, our NGO, Help The Woman campaign, has gone beyond taxing to do free cervical cancer screening. Three months ago, we organized free cervical cancer screening and we screened up to 100 women in collaboration with our partner hospital, Family Life Center, and VVF hospital, VVTAM, applying on stage. And we screened over 100 women, and most of them, I have the data which I may not share here, the one we discovered from them. So we have taken it as a point of duty to do free cervical cancer screening. For women, we may not afford it, because average screening, if at the current cost, average screening might cost, if you have to go through the entire issue, cost between 10,000 to 20,000, it's quite expensive for some people. But that's why we are working, we're also trying to partner with agencies, international agencies, government, so that this cervical screening we are doing, we can be able to have some funds to offer it to a large group of people, women. Our target is to screen at least one million women in Nigeria every year, at least one million every year. And by every screen, we target to screen 1,000 women, but they can be charged for them. Alright, a million women a year will amount to 200 years before, or at least 100 years before you can screen the whole of Nigerian women. So I do hope you get that partnership that will make every Nigerian to be screened, and every Nigerian woman to get the vaccination, the people who are still at that range. So let me come to Itoro quickly now, Itoro. What is the level of response like? I'm just putting two questions together. What's the level of response like from the people that you have been taking this awareness campaign to, and how close are we to getting this vaccine because we don't have a particular date that we know right now that this vaccine is going to come? Okay, for the people we actually reach out to, they are usually scared at first, but of course because of the strategies and approaches that we put in place, they start to reach out to them. At the end of the day, they are excited, they are happy, and they embrace what we are sharing to them. So we have several, you know, big thoughts, games, engaging them, you know, freebies, and ensuring that they are excited about what we're doing. So basically for what we've done for the past two years, I must say it's exciting. We see the excitement in the faces of the people, and we are happy about this issue. Some of them are usually scared because that's the first time, you know, anytime you mention cancer, people are like, oh, a dead sentence, but of course we usually tell them what this is about, and they embrace and they are excited about it. Then for the vaccination, I want to thank the federal government for actually, you know, embracing this, though I think this is on a temporary basis, my petition actually acts the federal government to actually make it, you know, a permanent thing because when you go to primary health care facilities, mostly in remote areas, they really do not have anything to actually offer these particular services. So I'm still, you know, pleading and asking federal government and other agencies to actually make these available, affordable and accessible because this... Sorry. Okay, well, we lost the audio of Itoro there, but we were talking about the fact that this cancer vaccine is going to come up here in Nigeria. So we thank the government for that, and we thank your organization for doing what they are doing. We do hope that you get the right partnership to continue this good work and make sure the vaccines are available to all. Thank you, gentlemen, for coming on the show. Thank you. Well, that's the much we can take. I wish we had more time, but we are going to do a follow-up if we need to. But the code for the day today is health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. That is according to World Health Organization. So be sure that if you can say you're healthy, you will have health in mind and body. That's the much we can take this morning on the show. On behalf of the entire crew, my name is Nyam Gul at Gadji. Let's do it again tomorrow.