University of Iowa Hospitals & Clinics Iowa City, IA
M. O. Evbuomwan1, C. Njoku2, O. G. Oluyede2, T. Afekhai3, G. A. Ogbonna4, and B. C. Adegboyega2,5; 1Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, IA, 2Department of Radiotherapy, Lagos University Teaching Hospital, Lagos, Lagos, Nigeria, 3Canceraware, Lagos, Lagos, Nigeria, 4Departments of Medicine and Health Sciences, Abia State University, Uturu, Abia, Nigeria, 5NSIA-LUTH Cancer Center,, Lagos, Lagos, Nigeria
Purpose/Objective(s): In Nigeria, access to radiation therapy for cancer patients is limited by a lack of funding and infrastructure challenges; and psychosocial factors like depression, anxiety, marital status, social status, religious belief could affect the quality of life of cancer patients. This study aims to assess the psychosocial factors that could affect cancer patients undergoing radiation therapy in Lagos, Nigeria. Materials/
Methods: The Lagos University Teaching Hospital (LUTH) Institutional Review Board (IRB) reviewed this study and granted an IRB exemption. A cross-sectional study was conducted on 151 cancer patients undergoing radiotherapy at the NSIA-LUTH Cancer Center, Lagos, Nigeria. A validated questionnaire was used to assess patient’s sociodemographic, depression, and anxiety. Descriptive analysis, Fisher Exact and Kruskal-Walli’s test were performed to examine the association between psychosocial factors and social demographics of patients undergoing radiation therapy. Results: The median age was 52 years (range, 8 -78 years) with a median annual income of N100,000 (=241 USD) (IQR N180,000). Most patients were female (64.2%), married (84%), with postsecondary education (67.8%), unemployed (64.9%), and Yoruba (46.4%) ethnic background. Most of the patient were diagnosed with breast cancer (39.1%). When asked “What do you believe caused your cancer,” 74.8% noted they don’t know, 11.8% noted family history and genetics, whereas 13.4% noted other cause. Majority of the patients reported they did not have metastasis (60.8%), whereas 29.7% reported metastasis and 3.4% were unsure if their cancer has metastasized. Most of the patient have had both chemotherapy and surgery (51.8%) prior to their current radiation therapy. Majority of the patients neither had depression (87.8%) nor anxiety (97.2%). The association between patient’s cancer type and psychosocial factors were not significant for both depression (p = 0.062) and anxiety (p = 0.744). The Kruskal-Walli’s test shows patients’ anxiety status differed based on their belief of what cause cancer (p = 0.04). Conclusion: This study examined and described the psychosocial factors affecting cancer patients undergoing radiation treatment in Lagos, Nigeria. More studies are needed to elucidate other psychosocial facets and explore the appropriate interventions required to prevent psychosocial factors affecting cancer patients undergoing radiotherapy in low-income countries. These efforts could help identify multidisciplinary oncologic challenges in resource-poor settings.
