Fear killing more Nigerians than cancer — Dr Omolola Salako

2026-02-24 - 09:46

By Chioma Obinna Cancer is no longer a distant or rare diagnosis in Nigeria. It is a growing public health emergency quietly reshaping families, straining the health system, and exposing deep gaps in prevention, early detection, and access to treatment. Nigeria faces a critical shortage of oncologists, radiotherapy centres, and comprehensive insurance coverage, leaving many families to shoulder catastrophic out-of-pocket costs. Good Health Weekly spoke to Dr. Omolola Salako who has been treating patients over the past two decades,examines the realities behind the statistics, the myths that continue to endanger lives, and the urgent reforms needed to confront Nigeria’s cancer challenge. She speaks candidly about the cancer crisis in Nigeria, the myths that are costing lives, and why prevention remains one of the country’s greatest missed opportunities. Excerpts: Cancer in Nigeria That reality alone is sobering. Over the past two decades, I have committed my life to building ecosystems of hope. I founded Sebeccly Cancer Care in 2006, launched Oncopadi Digital Health in 2017, and opened Pearl Oncology Specialist Hospital in 2021. Through these platforms, we have provided preventive care services to more than 30,000 people and cared for over 5,000 cancer patients and their families. My journey into oncology was shaped by personal loss. I lost my sister to cancer, and that experience transformed my pain into purpose. What my work has exposed is deeply troubling. First, there is the grip of fear. I see patients paralysed by cancer so deep they make life-altering decisions based on spirituality and myths rather than evidence based medicine. Patients are often paralysed by fear so overwhelming that they make life-altering decisions based on myths and spirituality rather than evidence-based medicine. Second, cancer is never an individual diagnosis; it is a family crisis. The family’s level of understanding and support often determines survival, yet they are usually overwhelmed and under-informed. Third, we are failing at prevention. Too many Nigerians are dying from cancers that could have been prevented through vaccination or routine screening. We are fighting late-stage diagnoses that should not be happening in 2026. The family burden Cancer isn’t an individual diagnosis; it’s a family crisis. The family’s support—or their lack of health literacy—dictates the patient’s survival. They are as much a part of the medical team as I am, yet they are often overwhelmed and under-informed. The Prevention Failure: We are failing to prevent the preventable. Too many Nigerians are dying from cancers that could have been stopped with a simple vaccine or a routine screen. We are fighting a war against late-stage diagnoses that shouldn’t be happening in 2026.We are not preventing the preventable cancers well enough and fast enough. What are common fears of Nigerians newly diagnosed with cancer? Where do the fears come from? In their eyes, I often witness the ‘Fear of the Unknown’ locked in a crushing battle with ‘Why me?’. There are days defined by the tears of frustration and overwhelm, and others transformed by tears of joy as we realize we are winning or that the tumor is reducing in size. Yet, I am constantly moved by those who, though shaken, refuse to dwell in fear. They manage the complexity of their emotions with a quiet grace, choosing to accept the diagnosis and navigate their journey from a place of resolve rather than give up or be angry or be in denial. But fear is constant. In some instances, that fear is often fed by the “evil arrow” narrative—the belief that cancer is a spiritual attack from “village people” or enemies. We have to be honest: cancer is the toughest battle a human can face, and fear is a natural physiological response. But here is the shocking truth I see on a weekly basis: Fear is currently killing more Nigerians than the disease itself. Because many patients are operating from a place of raw emotion rather than information, that fear drives them to make catastrophic decisions. They abandon evidence-based medical treatment for “alternatives” that offer false hope. In other instances, they visit multiple cancer centres and hospitals without staring treatment. They abandon proven treatments for unverified alternatives that promise false hope. Some visit multiple hospitals without starting therapy. These delays can be deadly. This is exactly why I wrote The Gifts of Survivorship: You Are Bigger than Cancer. I needed a way to help patients de-escalate that panic. In the book, I distill 10 principles that help people reclaim their power and embrace their purpose. I tell my patients every day: A cancer diagnosis is just a few chapters of your life; it is not the entire book. You are bigger than this diagnosis, and you do not have to let fear write your ending. In some cases, it is fuelled by the belief that cancer is a spiritual attack from enemies. We must be honest. Cancer is one of the toughest battles a human being can face. Fear is a natural response. However, what I witness weekly is alarming. Currently, which are the most common cancers in Nigeria, and who is most vulnerable? The numbers are a wake-up call for every Nigerian. In 2022 alone, over 127,000 Nigerians were diagnosed with cancer. The “Big Five” that dominate our clinics are Breast, Prostate, Cervical, Colorectal cancer, and Non-Hodgkin’s Lymphoma. What is truly shocking, however, is the gender disparity: Women are disproportionately impacted. Nigerian women account for over 60 percent of all cancer cases and suffer a significantly higher death rate. While cancer does not discriminate by your bank account, your religion, or your tribe, our vulnerabilities are often shaped by our environment and our choices. For example a silent Environmental Threat: Those living in areas like the Niger Delta, where “black soot” blankets the air, are breathing in carcinogens daily. We are seeing a direct link between this environmental pollution and diseases including rising cancer risks. Secondly, obesity is a leading risk factor that we must address. Thirdly, while the disease strikes both rich and poor, the poor are most vulnerable to the outcome. Without a robust National Health Insurance Scheme, the majority of our patients will need to pay out of pocket. In reality, many patients abandon treatment because cancer treatment, though life saving and available, is expensive. Environmental exposure is another serious factor. In regions like the Niger Delta, where black soot and industrial pollution contaminate the air, residents are exposed daily to carcinogens. We are observing correlations between environmental degradation and rising cancer risks. Obesity and sedentary lifestyles are also contributing significantly. Breast, cervical, prostate and liver cancers account for a large share of cases. Why are these cancers so prevalent? Approximately 40 percent of cancers are preventable, yet we are not preventing them effectively or urgently enough. Nigeria is hyper-endemic for Hepatitis B and C, which are major drivers of liver cancer. These infections silently transform healthy liver cells into cancerous ones over decades. Cervical cancer is almost entirely caused by persistent Human Papillomavirus infection. It is heartbreaking because this is a cancer that should eventually become rare. Young girls from the age of nine should receive the HPV vaccine, and women should undergo regular screening. For breast and prostate cancers, lifestyle changes are playing a role. Diets high in processed sugars, increasing obesity, and low physical activity contribute to inflammatory and metabolic pathways that drive cancer development. About 40 per cent of cancers are preventable yet the sheer prevalence of these cancers when we have the tools to prevent many of them. The reasons are a complex mixture of genetics, shifting lifestyles, infections and environmental factors. But here is the shocking reality that every Nigerian must understand: A significant portion of our cancer burden is actually caused by preventable infections. We are seeing an explosion of liver cancer because Nigeria is a “hyper-endemic” zone for Hepatitis B and C. These are chronic viral infections that quietly change normal liver cells to abnormal cancerous cells over decades. The Cervical Crisis Almost every case of cervical cancer is caused by thechronic infection with Human Papillomavirus (HPV). It is heart-wrenching because this is a cancer that simply shouldn’t exist now or in the future. All women of reproductive age should have their annual medical checkup including their cancer screening. Getting the HPV vaccine is so crucial especially for young girls from the age of 9. The Lifestyle Shift For breast and prostate cancers, we are seeing the impact of “Westernized” lifestyles, diets high in processed sugars, rising obesity, and lower physical activity directly and indirectly amplify inflammation and metabolic pathways for cancer development and progression. Are cancer cases truly rising, or are we simply diagnosing more due to better awareness? It is both. On the positive side, more Nigerians are becoming proactive about their health. Employers and insurers are encouraging annual screenings, and that means cancers are being detected earlier. That may make the numbers appear higher, but early detection saves lives. At the same time, risk factors such as pollution, sedentary living, and dietary changes are genuinely increasing cancer incidence. Which lifestyle habits do Nigerians underestimate most when it comes to cancer risk? Diet is often underestimated. Excessive consumption of red meat is a concern. Our love for suya, asun, and kilishi is cultural, but moderation matters. Within the intestines lives a complex ecosystem called the gut microbiome. When large quantities of red meat are consumed, certain gut bacteria convert carnitine into a compound known as TMAO, which has been linked to colon cancer. Food is not just culture; it is chemistry, and what we eat directly affects our biological processes. We are witnessing a fundamental shift in the Nigerian lifestyle that is fueling an organic rise in cancer cases. For example, consuming red meat in large quantities is unhealthy. Many Nigerians love their orisirisi, Asun, Suya, Kilishi etc but eating it in high quantities can disturb your intestines. Inside your intestines lives a massive world of bacteria called the gut Microbiome. It’s a bustling city filled with both Good Bacteria (the protectors) and Bad Bacteria (the troublemakers). When you eat large amounts of Red Meat, certain bad bacteria in your gut feast on the carnitine. Carnitine is naturally produced in your liver and kidneys, but it is also found in high concentrations in animal products most notably in red meat. While carnitine is essential for energy, the way our gut bacteria handle a high red meat intake is where the cancer risk comes in. They turn the carnitine in that meat into #TMAO, a chemical linked to colon cancer. How much do environmental factors contribute to cancer risk in Nigeria? Environmental factors It contributes to about 40 percent of cancers. If we fix these issues; we can reduce people’s exposure to harmful chemicals and pollutants. We know how to stop 40 percent of cancers from ever developing because decades of research has identified and provided evidence on how air pollution with chemicals or water containing heavy metals and industrial spillage of toxic chemicals are detrimental to people’s health. The media, medical community and government must unite to make our environments safe and clean. To learn more on how to prevent cancer, please source for credible information and you can learn more by searching for #AtoZPreventCancer. Our goal is simple- to simplify the science and help you make better health decisions. If we intensify our public health education, help more people to be aware and apply the knowledge, then oncologists can focus on the cancers we don’t yet know how to prevent. Cancer treatment is often described as catastrophic for families. Why is care so expensive? Cancer care involves diagnosis, surgery, chemotherapy, radiotherapy, targeted therapies, and sometimes immunotherapy. Many of these treatments and drugs are imported, and the infrastructure required is costly. Without comprehensive insurance coverage, families bear the burden directly. Some sell assets or crowdsource funds. Others discontinue treatment midway because they can no longer afford it. Cancer is not only a medical emergency; it is a financial crisis for many households. Is the NHIS effective covering cancer care? Do we have enough facilities and specialists? Coverage remains limited, and we do not have enough oncologists or radiotherapy centres to meet national demand. When fewer than 100 clinical oncologists serve over 200 million people, access becomes a systemic challenge. We need expanded insurance coverage, increased investment in infrastructure, and strategic policy reform to improve access. Many Nigerians still believe cancer equals death. What’s your message to those living in fear or denial? Cancer may be part of your story, but it does not have to define it. Early detection saves lives. Prevention saves lives. Evidence-based treatment saves lives. Do not allow fear to dictate your decisions. You are bigger than cancer. This book is your step-by-step guide to gaining calm and clarity, thriving beyond cancer and creating a life of meaning, peace, and joy. Please read my new book The GIFTS of Survivorship: You Are Bigger Than Cancer. You can learn more here https://www.dromololasalako.com/#