Joseph Ugbe, a dark-complexioned man in his mid-forties, sat downcast on the pavement at the National Hospital, Abuja. The two white lines on the right side of his neck indicated that the day’s radiotherapy had been administered.
Unlike many patients who scurried home after treatment, having waited all day to be attended to, Ugbe, a distributor in a fast moving consumer goods firm in Port Harcourt, Rivers State, was in no hurry. He had come a long way.
He sat with his gaze fixed on the ground, one hand on his hip. His green shirt, the colour of hope, now wore the look of gloom.
Ugbe was deep in thought when this reporter approached him for a chat. He looked up with a jolt, then broke down and wept hysterically.
“They (radiation oncologists) are threatening to stop my treatment,” Ugbe said amid sobs.
“I spent every dime on my treatment, accommodation and transportation. I have nothing left to my name,” he lamented, wiping tears with the back of his hand.
Ugbe presented with a swelling in the ear at University of Port Harcourt Teaching Hospital (UPTH) in 2015. He was examined and asked to go for a scan.
“Before the result was out, the hospital went on strike,” Ugbe told this reporter.
He went to a private hospital in Port Harcourt whose name he could no longer recall, and later reported at Thermal Hospital in the same city.
“I paid for injections, which I was told would make the tumour disappear,” he recounted. “But I noticed the lump was increasing.”
He was later referred to Federal Medical Centre (FMC), Bayelsa, when he started vomiting blood. “They kept on sending me round and I was spending money. It was trial and error. I was wasting money,” Ugbe said.
From FMC, he was referred to Balm of Gilead in Enugu State, where he was diagnosed of head and neck cancer. A consultant oncologist there advised him to rush to National Hospital, Abuja, for radiotherapy.
“When I got here (Abuja), I started afresh. I did all the tests again and paid N90,000 for radiotherapy, but the machine broke down shortly after that,” Ugbe said.
Rather than spend more money on accommodation, Ugbe was advised to travel back home pending the time the machine would be fixed. Back then, it was uncertain when the machine would be fixed: “I went back to Port Harcourt, but when I started vomiting blood, I was rushed back to the hospital. I was given four courses of chemotherapy, after which I travelled back to Port Harcourt.”
The radiotherapy machine was repaired in 2016. Ugbe was to use the machine for 21 days, but after the third day, the machine broke down again. He travelled back to Port Harcourt, but, again, when he started vomiting blood, he was taken back to Abuja for another dose of chemotherapy.
A new machine was procured in December 2017 and the cost of usage rose to N600,000. Ugbe could not afford it.
He lamented in 2018, “I sold all my property. When I sell, I go back to the hospital and when the money finishes, I stop. All I have on me is N200 and less than N2,000 in my bank account.
“My children have not been to school since 2015, and my landlord has sent my family packing. I have been here (Abuja) since last year.”
With assistance from family and friends, Ugbe completed his radiotherapy. He went for checkup and was told he needed more chemotherapy.
“As it stands now, I am just believing God for a financial miracle to enable me go back to the hospital,” Ugbe said in September 2018.
In December 2018, still unable to commence chemotherapy treatment, his condition deteriorated.
“The pain is excruciating. One of my eyes, ear and part of my mouth is seriously affected. I can’t see and hear with them.”
Sadly, Ugbe breathed his last in January 2019.
“We spent our last, and are currently in debt,” his wife said. “After all the sacrifices, we lost him.”
Ugbe is just one of many cancer patients across Nigeria who, due to insufficient facilities, are forced to move from one city to another in search of treatment, incurring additional costs and burdening their health in the process.
Insufficient cancer machines
With an estimated population of 200 million people, Nigeria boasts of eight cancer centres, out of which four currently have a functional radiotherapy machine. The machines in three centres keep breaking down.
In the past, no budgetary provisions were made for the procurement or repair of radiotherapy machines in the centres. However, the 2018 Federal Government budget provided for the repair of existing radiotherapy machines in the eight centres. The repairs, which were classified as ‘on-going,’ were billed at N30 million.
It is uncertain whether the funds for the repairs had been disbursed as the faulty machines are yet to be repaired.
National Hospital, Abuja
The radiotherapy machine at National Hospital, Abuja, broke down in February 2017 and was replaced with a new multileave linear accelerator (LINAC) machine in December 2017. During the installation of the new cancer machine, the Minister of Health, Isaac Adewole, said the machine could treat about 100 cancer patients daily. Chinedu Aruah, a clinical radiation oncologist at the hospital, however, told this reporter that the machine could only do 30 to 40 patients a day.
“We are able to attend to that number of patients because the workers sacrifice to spend more time,” Aruah said. “We go by 10pm to 11pm.”
However, this reporter observed that the machine was doing only about 20 patients daily. Some patients spent a lot of time in the machine and sometimes the radiotherapy had to be redone due to errors. The hospital charged N90,000 for radiotherapy in 2015, but when it commenced treatment with the new machine in December 2017, patients were charged N600,000.
However, close to the Christmas period, the hospital announced a “promo price” of N300,000, so that more patients could afford the treatment. The promo ended on January 31, 2018.
“It is expensive to secure this machine and train the workers. So, it is not something that government will just invest in without trying to get back a little bit of the money,” Aruah said.
He explained that the high charge for use of the machine in Abuja was to set some money aside for repairs, in case the machine broke down in the near future.
“If this machine were to develop a fault, you would have to invite experts from overseas to repair it because most often we don’t have local engineers who are going to repair it,” he said.
In addition to the cost of using the machine, patients had to pay for accommodation for an uncertain period of time.
Lagos University Teaching Hospital
The atmosphere in the Radiation and Oncology Department at Lagos University Teaching Hospital (LUTH), when this reporter visited in January 2018, was serene.
It was learnt that the 11-year-old linear accelerator machine, the only radiotherapy machine at this centre, broke down in June 2017.
“When the (radiotherapy) machine was working, the crowd here was overwhelming. People came from different parts of the country because LUTH had the only machine that was working,” Zainab Kadiri, a 30-year-old patient who had come for check-up, recalled. “We get here (hospital) as early as 5am to stand a chance of being attended to each day.”
Kadiri said she lost three of her friends when the machine packed up.
“One of them was 25 years old. Her kidney and other organs failed,” she said in an emotion-laden voice. “She was swollen before she died.”
Some of the patients at this section of the hospital had come for chemotherapy, while others were there to inquire if and when the machine would be fixed.
“The machine is old and overworked. The best thing is to get a new machine,” said Muhammad Habeebu, head of the Oncology Department at LUTH. “While the machine was functional, there was hardly any month we didn’t have to repair it.”
Remi Ajekigbe, a professor of Radiotherapy and Oncology and consultant radiotherapist and oncologist, who was the head of department for 11 years before he retired late 2017, expressed a similar view.
“The machine needs a complete change. Fixing it is of no use because it will break down again,” Ajekigbe said.
“Radiotherapy is supposed to kill the cancer cells on the surface of the body. If the cancer cells from the primary side are dead, they may not spread or spread early to cause death,” he said.
While the machine lies unfixed, the death toll from cancer-related causes continues to rise.
“Patients are dying,” said Muhammad in January 2018. “We cannot do without the machine. Radiotherapy is very imperative.”
When the machine was up and running, LUTH charged between N100,000 and N150,000 per patient for radiotherapy. The machine would usually attend to about 70 patients daily, but the number dropped to 40 shortly before it packed up.
“The challenge in LUTH is not affordability, it is availability of the machine,” said Muhammad. “When the machine was available, most people could afford it.”
On February 9, 2019, President Muhammadu Buhari inaugurated an advanced cancer treatment center in LUTH. The cancer treatment centre is a public-private partnership (PPP) arrangement between the Nigeria Sovereign Investment Authority and LUTH. But, the centre is not yet in use.
“Maybe in the next two months patients can be treated here,” Habeebu told this reporter during a visit to the centre in March 2019.
“After the installation, there will be calibration and workers trained,” he said.
Usmanu Danfodiyo University Teaching Hospital
The story is not any different at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. The linear accelerator radiotherapy machine, which was procured in 2010, was also not functional when this reporter first visited in January 2018.
“The machine stopped working on July 16, 2016. It started working in October 2017 but developed some fault in December 2017,” said Usman Malami, head of Radiotherapy, UDUTH.
When the machine broke down, the patients were referred to the two functional cancer centres at that time: National Hospital, Abuja, and University College Hospital, Ibadan. Most of them, however, refused to go.
“A large number of our patients are still waiting for the machine to be fixed because they cannot afford the additional cost of travelling to faraway states for treatment,” Malami said.
Margaret Aje, a 63-year-old retired nurse from the Kaduna State Ministry of Health, was one of those waiting patiently for the machine to be repaired.
Aje discovered a lump in her breast in 2016 and reported at a private hospital in Kaduna State, where the result showed a malignant tumour. She journeyed to Sokoto State, and was diagnosed of Stage 2 breast cancer at UDUTH.
“I was asked if I wanted the breast removed. I said it should, to prevent the cancer from spreading to another part of my body,” she recounted. “I didn’t take chemotherapy before the surgery because the cancer didn’t spread.”
Aje had a mastectomy in April 2016 and was booked for radiotherapy in November 2016.
“After the surgery, I started receiving chemotherapy and concluded in October 2016. The wound healed and I was to resume radiotherapy in November,” she told this reporter.
“Since 2016, till now (February 3, 2018), I’m yet to do the radiotherapy,” she said.
Like many other patients, she was given the option of either of the two cancer centres with functional machines at the time.
“I cannot afford to pay for accommodation for a long period of time. I hear there are so many people on the line to use the machine,” said Aje, who relies on her little pension, siblings, and son for financial support.
While waiting for the machine to be fixed, the second breast was affected and Aje underwent another mastectomy.
She commenced radiotherapy afterwards but, sadly, she lost the battle to cancer.
“She was a strong woman,” said Manasseh Aje, her son.
“We just assume that is what God feels is best for us,” Manasseh told this reporter in March 2019.
Musa Tudu, a policeman from Kebbi State who was diagnosed of cancer of the tongue in 2016, was also waiting. According to him, he was rushed to police hospital in Birnin-Kebbi when he noticed blood gushing from his nose and mouth in June 2013.
He was referred to FMC, Birnin-Kebbi, where he was treated for two years and, in 2015, he felt better and decided to discontinue treatment because of lack of funds
But after eight months, blood started coming out of his mouth and nose again.
In 2016, Tudu was referred to UDUTH. He started chemotherapy and had to hang around the hospital premises for months because he did not have money to rent an apartment.
After five courses of chemotherapy, he was referred to the National Hospital, Abuja, but could not afford the extra cost.
“I was supposed to start radiotherapy on February 29, 2018, but I don’t have money,” Tudu said. “I’m still hoping to get the money. All my salary has gone into the treatment.”
The radiotherapy machine at UDUTH served about 40 patients daily when the machines at other centres were functional and 70 patients when it was the only one running. The cost per patient hovered between N80,000 and N120,000.
After a year and four months, the radiotherapy machine at UDUTH was fixed and the cost rose to N200,000.
University of Nigeria Teaching Hospital (UNTH), Enugu
When this reporter visited the University of Nigeria Teaching Hospital (UNTH), Enugu, in January 2018, the machine was functional.
The radiotherapy machine, which had broken down in June 2014, was fixed in November 2017 through a PPP arrangement.
“We were waiting for the new machine that the (health) minister promised us. I attended the meeting (the minister) called to give some proactive steps,” Kenneth Nwankwo, head of Oncology Department at UNTH, said.
“He wasn’t in the next meeting but he sent information that, ‘Look o, you people (oncologists) should try and find anyone, whatever way you do, enter PPP, do whatever.’ So, this PPP came and we started working,” Nwankwo said.
But in the space of two months, the machine was repaired three times, prompting the financier to review the cost of usage upwards, from N150,000 per patient to between N200,000 and N300,000 depending on the number of weeks the patient was being treated.
“He (financier) found out that the money was not covering the expenses, so he had to step up the price,” he said. “Even the minister said we have to raise the amount to ensure that we maintain the machine.”
The additional cost notwithstanding, the Oncology Department was filled to capacity with patients, most of whom had come from far and wide to use the machine. Some of the patients rented apartments close to the hospital, while a few who couldn’t afford such apartments slept around the hospital premises.
Procured 11 years ago, the machine in UNTH could treat up to 70 patients a day, but by January, 2018, the hospital struggled to treat 50 due to lack of manpower.
“We have neither house officers nor resident doctors,” the head oncologist at the hospital said. “If we have more staff, we can run shifts.”
The radiotherapy machine in the hospital broke down shortly after this reporter visited in January 2018. It was up and running after some months.
“Ideally, what we are supposed to do is link up to a centre, but some patients would refuse. They [patients] will say let them wait,” he said. “The problem is when the waiting becomes too long, it becomes a headache. There are a lot of critical issues. You have to do a lot of calculations to know what you can do and what can damage the patient; it’s a serious thing.”
Cost of cancer in Nigeria
Being a cancer patient in Nigeria comes with a lot of burdens. Even when detected early, the facilities to tackle cancer are not available. This makes the journey a tortuous one for patients.
The case of Ugbe (cited earlier) exemplifies this sad reality. But Ugbe was not alone in this ordeal.
Thirty-year-old Zainab Kadiri (mentioned earlier), was diagnosed of stage 3 breast cancer in December 2015. She completed her eight courses of chemotherapy at LUTH, and underwent a mastectomy on February 9, 2017.
Kadiri was supposed to use the radiotherapy machine for 14 days but after the 10th day, the machine, which was the only functional one in the country at that time, broke down.
“When the machine broke down, I started reacting to the radiotherapy treatment I had taken,” she told this reporter in January 2018. “For two months now, I’ve been treating a severe skin burn but the sore has refused to heal.”
She was advised to wait for the sore to heal before she could proceed for radiotherapy.
“It has not been easy,” said Kadiri, who quit her teaching job in 2016 and had to rely on her mother in the village, friends and church members for assistance, “I’m trying to get better now.”
However, Kadiri never got better. Like Ugbe, she lost the battle to cancer.
Patricia Ebenuwa, 38, was relaxing after breakfast in May 2017, when her hand wandered to her breast and she felt a lump.
In June 2017, Ebenuwa was diagnosed with triple negative breast cancer — the rarest and riskiest of all cancer types, at LUTH.
At the hospital, she was disturbed when she learnt about the side effects of chemotherapy.
“I was scared, but I was told that soursop syrup is 10,000 times more effective than chemotherapy,” she said. “I did some research online and found the information to be true.”
Ebenuwa started drinking soursop syrup but rather than shrink, the lump continued to enlarge.
“Within three months, the lump grew so big that my sister had to rush me down to the hospital because I was very weak,” she said.
She completed her chemotherapy in January 2018 and had a mastectomy in March.
“I don’t know how to get assistance to complete my treatment,” Ebenuwa told this reporter in June 2018. “All the money for my clothing business has gone into my treatment and my family has incurred so much debt.”
In October 2018, Ebenuwa raised some funds and continued her treatment.
“My doctor is introducing a new type of chemotherapy for me,” she said with so much excitement.
She could not afford radiotherapy treatment at the National Hospital, Abuja. So, she opted for University College Hospital (UCH), Ibadan, which was way cheaper.
“We were treated once a week so everyone could have a feel of the machine because we were many,” she said.
While undergoing radiotherapy, the lump reappeared. But this time, in her neck and armpit.
When this reporter visited Ebenuwa at LUTH in November 2018, she was a shadow of her former self.
“I felt very weak and couldn’t do anything on my own. So, I was asked to go for X-ray,” she said, gasping for breath. “The result showed a massive fluid covering my lungs.”
Shortly after the visit, resident doctors at the hospital went on strike and Ebenuwa continued her treatment in a private hospital. Unfortunately, she died on December 8, 2018.
Ifeoma James, a 59-year-old retired teacher, visited a private hospital in Nnewi, Anambra State, immediately she noticed a lump in her armpit.
The doctor told her it was nothing to worry about. He billed her N3,000, gave her some drugs and told her the growth would disappear in no time.
Before then, James examined her breast regularly and since the lump was not in her breast, she believed the doctor.
“I always checked my breasts, but the lump deceived me. It went to hide in my armpit,” she said with a look of despair.
Rather than disappear as she was told, the stone-like tumour kept increasing in size.
“I was waiting for the growth to go but it became hard like a stone. It was painful. I couldn’t sleep,” James said trying to suppress the pain.
After a long wait, she was advised to visit Nnamdi Azikiwe University Teaching Hospital.
“They (doctors) said the lump was cancerous. It was advanced then,” James told this reporter.
James was referred to UNTH, Enugu. There, she underwent a mastectomy because the cancer had reached an advanced stage. Then, she commenced radiotherapy.
Initially, she made the two-hour journey from Nnewi to Enugu on a daily basis. When it became too stressful, however, she had to rent a room two kilometres from the hospital.
“I have a room inside the town, just like most people here (at UNTH). We all rented rooms a few kilometres from the hospital,” she said. “I am still processing my pension. So, my siblings pay my hospital bills.”
Danboyi Dapweh is facing a similar challenge. Diagnosed of cancer of the tongue in 2014 at Christian Hospital in Vom, Plateau State, 83-year-old Dapweh, a retired reverend of the Church of Christ in Nations (COCIN), was referred to Plateau Specialist Hospital. From there, he was referred to Jos University Teaching Hospital (JUTH) in March 2016, where he underwent surgery. He could barely talk when this reporter met him.
“JUTH sent us to Zaria, where they gave him injections for six months,” his wife said. “We were referred to UDUTH for radiotherapy. We paid to use the machine but after four days, it broke down.”
From there, Dapweh was referred to National Hospital, Abuja.
“We got there on January 15, 2018, but we started treatment in March,” Mrs. Dapweh said. “We sleep in the church.”
Such is also the fate of a minister in Dunamis Church, who was diagnosed of cancer of the eye in 2015 at Eye Specialist Hospital in Benue State.
“The surgery was done at National Health Centre, Kaduna, in 2016 and I was referred here (Abuja) in 2018 for radiotherapy to kill the remaining abnormal cells,” said the minister, who did not want to be named because, according to her, knowing she was seeking medical attention in a hospital could scandalise her flock.
“I don’t want my church members to know I’m sick. How will they believe what I tell them and take my advice if they know I’m in the hospital?” she queried.
Other cancer patients this reporter met at UNTH had similar sad stories to tell.
Doris Amadi, a civil servant in Benin, Edo State, was diagnosed of cancer of the stomach at University of Benin Teaching Hospital (UBTH) and had her womb removed.
“I was bleeding, so they referred me here to burn it out because the blood was too much,” said Amadi. “I had to put up with someone in the hospital until I finally rented a room.”
Vincent Oketa, another patient, presented with abdominal pains in March 2017 at Federal Teaching Hospital, Abakiliki, and was diagnosed of cancer of the abdomen in October of that year. “They did biopsy operation and referred me here. I lodged in a hotel for the period of the treatment. I don’t know when they will book me to commence radiotherapy,” Oketa said.
Why cancer patients die
Nigeria has one of the worst cancer death ratios in the world, four in five cases, according to a WHO report. Out of over 100,000 people diagnosed with cancer annually in the country, about 80,000 are said to die from the disease, amounting to 240 Nigerians every day or 10 Nigerians every hour. Oncologists attribute the high incidence to late presentation.
“Our cancers are presented in their late stages. Seventy-five to 80 per cent of the cases are in stages three and four when the patients are almost passing on,” said Ajekigbe.
He said some of the patients present late because of their superstitious beliefs. As such, they believe it ought to be tackled spiritually.
“I don’t know, maybe witchcraft or the wicked woman. So, the doctor is not the first port of call, it’s the witch doctor or even the church or Imam,” Ajekigbe said. “Unfortunately, the church is not helping matters. Here, all our pastors are miracle workers. They will deceive people to make money, but when the pastor is sick, he comes to the hospital.”
Nwankwo said the survival rate was low because of lack of awareness: “That’s why we do a lot of advocacy so that people would come earlier when the cost of treatment will be less. When they come in advanced stages, the cost of treatment is poor and even the outcome is poorer.”
Insufficient facilities and personnel to adequately tackle cancer is another factor.
“We don’t have the facilities in place. All the required equipment, personnel are not there. So, in this part of the world people die; the mortality rate is higher than in developed countries,” said Ajekigbe.
Cancer is one of the greatest global health challenges with new cases and deaths from the disease on a steady rise. According to a report by World Health Organisation (WHO), an estimated 9.6 million deaths worldwide was reported in 2018, and data gathered by the International Agency for Research on Cancer (IARC), projects an increase in cancer deaths to 13 million in 2030.
However, Nigeria can learn from countries whose commitment to reducing cancer mortality rate in their clime is paying off. In the United States, for instance, the government, through the Affordable Care Act (ACA), helps lower cancer death rate by mandating that all health insurance plans cover the cost of screening. It also raised the income level of people to qualify for Medicaid, a programme of government-funded health services. Research shows that states that expanded Medicaid are already seeing lower rates of high-stage colon cancer.
This is not the only step the US government has taken. By hiking cigarette taxes, the rate of smoking, which accounted for 22 per cent of cancer-related deaths globally, dropped to historic lows.
Another reason for good outcomes is availability of treatment facilities to tackle cancer. While the US has 49 comprehensive cancer centres, Nigeria has seven poorly equipped cancer centres and one equipped centre, which is still under lock and key.
The result of steady reductions in smoking, advances in early detection and treatment in the US is a sustained drop in the country’s cancer mortality rate by 27 per cent in the last two decades, which translates to nearly 2.4 million deaths averted, a new study from researchers at the American Cancer Society (ACS) found.
Furthermore, latest ACS report in 2016 pegs the estimated number of cancer survivors in the US at 15.5 million with the figure expected to rise to 20.3 million by 2026. Conversely, in Nigeria, the cancer survival rate is abysmally low with the mortality rate as high as 90 per cent.
Also, foundations like the American Cancer Society supports cancer patients by finding free rides for them to treatment, and free accommodation when treatment is far from home. However, in Nigeria, the patient bears the cost of travels and accommodation.
The US is not alone. The government of India is also easing the burden of patients through its Cancer funding schemes — Health Minister’s Cancer Patient Fund (HMCPF), Prime Minister’s National Relief Fund (PMNRF) and National Programme for Prevention Cancer, Diabetes, Cardiovascular disease and Stroke (NPCDCS). Under the state government’s NPCDCS, cancers and government hospitals across India gets financial assistance up to RS. 60 million ($864,000) to provide cancer services to patients. The PMNRF meets part of the patient’s expenses while the HMCPF provides financial assistance to the poor patients.
In addition to free cancer treatment, the Indian government, through the Kidwai Memorial Institute of Oncology in Bangalore, provides cancer drugs on subsidised rates by at least 40 to 60 per cent for cancer patients living below the poverty line, and free treatment for 60 to 70 percent of its patients.
Apart from government interventions, a number of centres in India also provide subsidised cancer drugs and treatment for patients with the help of donations. But cancer treatment and drugs in Nigeria are neither free nor subsidised.
“Some cancer drugs are not readily available in the country, and those that are available are exorbitantly high,” said Malami, head oncologist at UDUTH.
Patients in India receive travel concessions when going for treatment. The patients enjoy free railway travel and 50 per cent slash in the price of basic fare on economy class. But, not in Nigeria.
Like the United States, some hospitals and foundations in India offer free cancer screening services to patients. According to a report by the Cancer Foundation of India (CFI), a non- profit organisation, the foundation’s mobile cancer screening clinics has successfully screened over 9,000 underserved women. Conversely, in Nigeria, free screening runs in select states once a year in commemoration of World Cancer Day.
These measures have had a significant impact on the cancer outcomes in India.
Recent data from cancer statistics puts the percentage risk of patients dying from cancer before the age of 75 years in India at 7.34 for males and 6.28 percent for females.
The risk of developing cancer before the age of 75 years in males according to the research is 9.81percent in males and 9.42 percent in females.
To combat cancer or side effects of cancer treatments, the Cancer Care Foundation of India offers patients alternative and complementary therapies using the principles of Ayurveda, Yoga, cow urine therapy along with diet and nutritional consultancy.
Many patients rely on notable herbal mixtures like Western herbal medicine, Tibetan or Ayurvedic medicine and Chinese herbal medicine, for cancer cure.
But, according to Cancer Research UK, there is no strong evidence from human studies that herbal remedies can treat, prevent or cure any type of cancer.
While some herbal medicines are safe, others can have serious and dangerous side effects. And they might interact with other cancer treatment the patient is having, the report states.
A review published by the American Journal of Clinical oncology found that common herbal remedies such as garlic, ginkgo, echinacea, ginseng, kava and St John’s wort, can interact with cancer treatments.
Some herbal remedies make the patient’s skin more sensitive to light, so patients are advised against taking them while having radiotherapy, according to research.
Unlike Nigeria, there are effective cancer centres in other countries dedicated to making discoveries aimed at defeating cancer by conducting research into prevention, diagnosis and treatment of the diseases. Some of such centres include The Institute of Cancer Research in London, National Cancer Institute in the United States, and National Institute of Cancer Prevention and Research in India.