By Chidinma Ewunonu-Aluko
For some months, Ms Sadijeamin Okobalosheh dismissed the constant heaviness in her lower abdomen as a “spiritual load” or the simple consequence of a heavy diet.
She spent months drinking herbal mixtures recommended by neighbors, hoping the bloating would finally subside so she could return to her bustling trade at the market.
By the time the pain became unbearable and Okobalosheh finally sought help at a city hospital, the diagnosis was a devastating blow.
The “indigestion” she had been treating with roots and prayers was actually stage-four ovarian cancer, a silent predator that had already claimed much of her health while she waited for a miracle.
Her story is a tragic blueprint for thousands of women across Nigeria.
For many Nigerian women, persistent bloating and pelvic pain are often dismissed as simple indigestion. However, experts warn these quiet symptoms are frequently the early signs of deadly ovarian cancer.
Tragically, over 70 per cent of local cases are only discovered at advanced stages. At this point, the disease has often spread, making successful medical treatment extremely difficult for patients.
A Consultant Gynaecologist Oncologist, Dr Sesan Oluwasola, advises women not to manage symptoms of ovarian cancer with herbs, emphasising that the ailment is killing women quietly.
Oluwasola, from the University College Hospital (UCH), Ibadan, urges Nigerians to know their body and when to see a doctor.
He notes that the disease also presents with dull pelvic or abdominal pain, feeling full after a small meal, and urinary urgency without infection.
Oluwasola adds that these signs are often mistaken for indigestion, fibroids, menstrual cramps, or a bladder infection, and sometimes even non-specialist doctors treat them without investigating further.
“Women are conditioned to endure discomfort quietly and seek care only when symptoms become unbearable; by that point, the disease is usually at an advanced stage.
He remarks that age, family history and positive Breast Cancer (BRCA) gene mutation are all important risk factors.
Oluwasola notes that women can assess their risk status and do appropriate testing.
“Know your body. Persistent bloating, pressure in your pelvis, difficulty eating, needing to urinate frequently — if these last more than two or three weeks, go and see a doctor.
“Do not manage it with herbs. Do not assume it is your “spiritual load,” these symptoms may just be your body speaking to you.
“Women with a mother, sister, or aunt who had ovarian or breast cancer, should please tell their doctor.
“Family history changes your risk profile and changes how we monitor you.”
Oluwasola explains some of the reasons why most women arrive hospital at late stage of the ailment.
“There are no reliable early warning signs of the disease and no affordable screening test; by the time a woman notices abdominal swelling or discomfort, the cancer has usually spread.
“The health system is slow and there is also poor health seeking behaviour of affected women in this part of the world.
“Poverty, poor health insurance and a shortage of specialists make women spend months at patent medicine stores or traditional healers before reaching a teaching hospital.
“Also, awareness is still low despite the growing efforts of Gynae-Oncologists, NGOs and the government.
“Over 70 per cent of Nigerian women with ovarian cancer are diagnosed at stage three or four when cure is rarely possible and treatment options are limited,” he said.
Citing Global Cancer Observatory (GLOBOCAN) 2020 data, he says Nigeria recorded over 3,200 confirmed cases, with Ibadan’s incidence rising by nearly 4 per cent annually.
While, Oluwasola notes that women can assess their risk status and do appropriate testing, he, however, says risk assessment is not a guarantee that someone who seems to have little or no risk cannot come down with ovarian cancer.
He emphasises that high index of suspicion, early diagnosis and prompt, appropriate management remain key.
“Diagnosis requires basic steps: high index of suspicion with an abdominopelvic ultrasound to map any mass followed by a biopsy for confirmation.
“In addition, a Cancer Antigen (CA)-125 blood test is also useful in taking decision and for monitoring.
“While CA-125 is available at UCH and private labs, cost and reagent shortages limit access at secondary and primary facilities.
“Biopsy and histopathology remain largely confined to university teaching hospitals,” he said.
He explains further that surgery remains the cornerstone of treatment.
The goal, he adds, is cytoreductive surgery — removing as much tumour as possible, ideally leaving no visible disease behind.
“Chemotherapy with carboplatin and paclitaxel usually follows.
“Targeted therapies like PARP inhibitors cost tens of thousands of dollars annually and are not routinely available in Nigeria,” he explains.
The Gynaecologist Oncologist dismisses the belief that ovarian cancer is spiritual, describing it as a biological disease driven by genetic mutations and hormones.
“Prayer and faith can absolutely be part of your journey but they must walk alongside medicine, not replace it,” he said.
He also flaws the myth that surgery spreads cancer, noting it is frequently curative when done early and that refusing it allows the disease to run unchecked.
Oluwasola remarks that younger women are not exempt.
“UCH is now seeing women in their 30s, sometimes younger, particularly with germ cell tumour subtypes that are more common in younger African women.
The News Agency of Nigeria (NAN) reports that the 2026 theme of World Ovarian Cancer Day is “No Woman Left Behind”.
On this theme, Oluwasola says it must move from slogan to policy.
“A woman in a rural Local Government Area and a woman walking into UCH Ibadan should have the same fighting chance.
“But right now, they do not,” he decries.
As part of solutions to improve screening, detection and treatment outcomes, Oluwasola urges governments to fund at least one functional comprehensive cancer centre in, at least each geopolitical zone, if not in every state.
He further enjoins the government to ensure National Health Insurance Authority (NHIA) covers cancer diagnostics and treatment to a larger extent than it is currently doing.
Late diagnosis has been said to be driving high ovarian cancer mortality in Nigeria.
Studies suggest that about 60 to 70 per cent of Nigerian women diagnosed with ovarian cancer die from it, with 75 per cent of those diagnosed presenting in advanced stages when survival chances are low.
Dr Damilola Olanrewaju, a Resident Doctor in Community Medicine at UCH Ibadan, decries Nigeria’s cancer population-level data to be fragmented and outdated.
He adds that global estimates and local studies point to a rising burden.
According to him, the 2022 Global Cancer observatory ranks ovarian cancer as the fifth most common cancer among women and the most lethal gynaecologic cancer in Nigeria.
He emphasises that recent local studies in 2025 show it accounts for 20 to 25 per cent of gynaecological malignancies.
Olanrewaju blames late presentation on non-specific symptoms like bloating and abdominal pain, absence of routine screening, low health literacy, reliance on traditional medicine and poverty.
“Also, less than 10 per cent of patients have health insurance, forcing most to pay out-of-pocket for costly treatment,” he says.
The community physician notes that unlike cervical cancer, there is no routine screening for ovarian cancer.
He advises a focus on primary prevention through awareness of risk factors including age above 50, family history, BRCA1/2 mutations, early menstruation, late menopause, nulliparity, obesity and smoking.
Olanrewaju also advises doctors to always maintain a high index of suspicion in high-risk patients for early referral.
He notes that about 25 per cent of cases have a hereditary component, making family-based genetic counselling important for women with a first-degree relative affected by breast or ovarian cancer.
The biggest barriers, he says, are late diagnosis, loss to follow-up due to poverty, and the disease’s high lethality.
“A 2023 local study in Enugu reported a 70 per cent case fatality rate and global data suggests a 20 to 40 per cent five-year survival in advanced stages,” he says.
For awareness, he advises that if bloating or abdominal pain persists for a month in women above 50, they should see a specialist.
However, he also emphasises that same symptoms can also occur in younger women.
He warns against medical jargon or fear-based campaigns that don’t drive action.
On government action, Olanrewaju says funding, infrastructure and manpower must be strengthened to make treatment accessible and affordable.
He also says Nigeria’s target to cut premature cancer deaths by 30 per cent by 2030 is achievable only with proper implementation of proposed strategies.
He cites the budget implementation in the health sector to have remained very poor, with only a small fraction of allocated funds being actually released.
For Nigeria to turn the tide on ovarian cancer, the experts agree it will take more than awareness campaigns.
According to them, it requires functional cancer centres across the country, affordable diagnostics and treatment under NHIA, and a shift in how women respond to their own bodies.
Until early symptoms are no longer ignored, misdiagnosed or managed with herbs, the disease will continue to kill quietly due to one delayed visit to the hospital at a time. (NANFeatures)
0 Comments