Background: Cancer incidence and mortality is increasing worldwide. In 2018, there were an estimated 18.1 million new cancer cases and 9.6 million cancer deaths. In Nigeria, it is estimated that 100,000 new cases occur annually, with a high case fatality ratio. The burden of cancer in Nigeria is significant, as the country still grapples with infectious diseases and has limited data on cancer epidemiology. Our study is descriptive using data from a hospital-based registry. Objectives: This retrospective study assesses the characteristics of patients that presented to a private cancer center in Lagos, Nigeria. We aimed to update knowledge on the current trends of cancer in Nigeria as exemplified by the experience of this cancer center and set a foundation for guiding future research and policy efforts in cancer screening, prevention, and control. Methods: The records of all the 548 oncology patients registered at the Lakeshore Cancer Center (LCC) cancer registry from January 2015 to June 2018 were reviewed for this study. Results: Most common cancer types were breast cancer for females (46%) and prostate cancer for males (32%). 92% of the tumors were malignant and 97% of the patients were symptomatic. Among patients diagnosed with cancer, 49% were ≤ 50 years old, 90% paid for their healthcare out of pocket, and 67% did not complete treatment.Conclusions: This study highlights the state of cancer care in Nigeria and should guide future research, with a focus on public awareness, screening programs and implementation of novel cancer control policies and infrastructure that supports early detection.

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Purpose Although totally implantable venous access ports (TIVAPs) have been safe and valuable in the management of cancer and other chronically ill patients who require long-term intermittent venous access, a few complications have been reported with their use. Data on the use of TIVAPs in sub-Saharan Africa and other low- and middle-income regions is limited. In this study, we determine the complications that arise from TIVAP use at a cancer centre in Nigeria. Patients and Methods Between 4 January 2018 and 15 September 2020, 100 patients received TIVAPs at our centre, primarily for the administration of chemotherapy for the treatment of solid tumours. Data were retrospectively extracted from the institutional electronic medical records and descriptive analysis of patient and disease characteristics, port-specific data and data on complications and outcomes was conducted Results The 100 patients who were implanted with TIVAPs at our cancer centre had their devices in situ for a total of 27,183 days, with a mean duration of use of 272 catheter-days (SD: 267 days; range: 2–952). TIVAP-related complications were identified in 13 patients (13%), i.e., an incidence of 0.478 complications/1,000 catheter-days. The mean time to onset of complications was 61 days (SD: 105 days; median: 23 days; range: 0–389). The complications observed include port-site bleeding, pocket infection, cutaneous site infection, arterial puncture, wound dehiscence, difficult access (due to port malpositioning and port site fibrosis) and others. No deaths, pneumothorax, haemothorax, catheter occlusions, or catheter-associated venous thromboses were recorded. Conclusion Our study shows that TIVAPs can be used successfully in our environment and presents a case for more widespread use to improve both the patient experience and the ability of healthcare providers to deliver optimal treatment.

Despite a range of management options, pleural effusions and empyema continue to present therapeutic challenges in the clinical setting. With treatment options ranging from simple use of antibiotics to more complex surgical procedures, several important considerations need be made as to what type of treatment is best for each patient on a case by case basis. One treatment modality of increasing interest is the use of intrapleural fibrinolytics to facilitate drainage of effusions. This presents a viable option especially in patients in whom surgery is not preferred. But, as with many therapeutic approaches, the use of intrapleural fibrinolytics is laden with significant controversies and has been a subject of considerable debate over the last couple of years. With accruing evidence for and against this modality of treatment, the ensuing discussion has been whether or not it should be a routine treatment choice and which group of patients should this consideration be made for. This paper gives a background on the epidemiology and etiology of parapneumonic effusions and empyema and briefly outlines the available options of management. Furthermore, we extensively discuss available evidence on the use of intrapleural fibrinolytics as a management option for parapneumonic effusions and empyema, with particular emphasis on use of tissue plasminogen activator (tPA) and DNase.

<p class="abstract">Mycosis fungoides and its variant, sézary syndrome are rare neoplastic conditions which are part of a larger group of lymphomas that primarily affect the skin known as cutaneous T-cell lymphomas. We report a case of fatal aggressive mycosis fungoides/sézary syndrome in a 55-year old Nigerian man who initially developed pruritic hyperpigmented spots on his skin which progressed over the course of 5 years to widespread scaly mixed hyperpigmented and hypopigmented plaques and nodules with features of organ involvement despite being managed with Psoralen and ultraviolet A radiation (PUVA), total skin electron-beam (TSEB), local electron-beam radiation, bexarotene, and oral prednisolone and chlorambucil (Winklemann regimen). In the process, we highlight the rarity of the condition, its ease of misdiagnosis and its predilection for people of Sub-Saharan decent.</p>

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