PURPOSE Diagnosis and treatment of cancer are associated with significant psychological distress, and patients face a broad range of challenges that create a vacuum of unmet needs felt by patients, such as a loss of personal control and frustration. The aim of the current study was to determine the magnitude, distribution, and correlates of unmet needs in Nigerian patients with cancer. PATIENTS AND METHODS Using a descriptive cross-sectional approach, we assessed 205 patients with cancer who attended oncology outpatient clinics at the Lagos University Teaching Hospital. Eligible patients were administered the Supportive Care Needs Survey (SCNS) –Short Form 34 with a focus on five domains of need: psychological, health system and information, physical and daily living, patient care and support, and sexuality. RESULTS Mean age was 47.4 ± 12.3 years and patients were predominantly female (96.6%). The most common diagnosis was breast cancer (92.2%), and mean duration since diagnosis was 20.9 ± 21.9 months for all patients. Mean SCNS score was 83.9 ± 24.8 and at least 46% of participants indicated unmet needs in 15 items of the SCNS. The most frequent unattended needs were related to the health information (53.4%), physical and daily living (49.4%), psychological (48.5%), sexuality, and patient care and support domains. None of the factors considered—age, sex marital status, family type, educational attainment, employment status, economic status, the presence of financial support, social support, and cancer type—was significantly predictive of unmet needs in these patients ( P > .05). CONCLUSION Nigerian patients with cancer experience considerable levels of unmet needs. These needs require urgent and long-term interventions to help patients achieve increased care satisfaction and a better quality of life.

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BackgroundGlobally, cancer is a major leading health problem with an estimated 10 million incidences and 6 million cancer deaths annually. In Nigeria, an estimated 72,000 cancer deaths occur annually, and 102,000 new cases are diagnosed from its population of 200 million people. These are, however, estimates, it is necessary to document the yearly trends and patterns of cancer mortality with regards to the different regions in the country.Methodologywe conducted this study at the Lagos State University Teaching hospital (LASUTH), Ikeja, Lagos to document mortality patterns from 2009 to 2018. Data extracted included those from the patient’s case notes, admission and death registers, and death certificates. we also had records from the hospital records department and medical wards. We then documented cancer mortality over the study period.ResultsA total number of 6,592 deaths were recorded over ten years, and 1,133 cases were cancer-related deaths. This number puts the percentage of cancer-related deaths at 17.2%. Male patients accounted for 54.0%, and female patients are 46.0%. Breast cancer accounted for the highest mortality, followed by prostate cancer. The highest number of deaths were recorded in 2010 at 821, followed by 2011 at 799, 2015 at 780, and the least in 2017 at 513. There is also a significant general increase in odds of mortality with an increase in decades of life.ConclusionThis study shows that about one in five deaths, over the last ten years, from this tertiary institution, is related to a cancer diagnosis. Even though a yearly decline in the number of cancer deaths was noticed, probably due to increased awareness and governmental intervention, the percentage still remains high.

Purpose: Active heart surgery programs are few in sub Saharan Africa outside of South Africa, with majority being low volume centers performing small numbers annually. We reviewed our long term outcome to identify factors associated with increased morbidity and mortality, to guide future choice of prosthetic valves in our mostly indigent patients afflicted with rheumatic valvular disease. Methods: Retrospective analysis of patients who underwent heart valve replacement at Lagos State University and Ahmadu Bello University Teaching Hospitals from November 2004 to February 2009. Results: Twenty six patients, 19 (73.1%) females, age 12-47; mean 26.69 ± 9.87 years, underwent heart valve replacement. 19 (73.1%) patients had mitral and 7 (26.9%) aortic valve replacement. Mechanical valve was implanted in all except in 2 (7.7%) patients. Left ventricular ejection fraction was >50% in 14 (53.8%), 24 (92.3%) were in New York Heart Association class III/IV, 10 (38.5%) had severe pulmonary hypertension and logistic euroscore was 5.84 ± 3.81. Operative mortality was 11.5% (3/26) and morbidity 7.7% (2/26). Follow-up for survivors was 83.0 ± 27.9 months. 10-year freedom from bleeding and thromboembolism was 70.0% and survival 86.0%. Linearized rate for bleeding was 4.58 and thromboembolism 1.52. Conclusion: Late complications in survivors were primarily anticoagulant related occurring predominantly in child bearing age females especially during pregnancy. Bleeding complications were often associated with noncompliance due to poor socioeconomic status. With average life expectancy of 53 years for females, bioprosthetic valves despite higher structural failure rate, may be best suited especially in child bearing age females still desirous of childbirth to decrease valve related complications. Longer duration of follow-up and meta-analysis of future reported series from the sub