Cancer prevention from Jordan to Cameroon

Since 2015, the Prevent Cancer Foundation has partnered with the Union for International Cancer Control (UICC) to support over 40 technical transfer fellowships. These UICC fellowships facilitate the international exchange of cancer control information and allow health care professionals to learn new techniques and skills in the early detection and treatment of cancer at top research and cancer institutes. The majority of awarded fellows come from low- and middle-income countries.

In 2019, Florence Manjuh, RN, from the Cameroon Baptist Convention Health Services (CBCHS) received a technical transfer fellowship to travel to Jordan and work with the Information and Research Center – King Hussein Foundation to receive training on breast cancer screening programs and learn how to set one up at her health center. After returning to Cameroon, Manjuh reported that she and her team at CBCHS were able to screen over 19,000 women for breast cancer and provide additional services to those who needed them.

The Foundation spoke with Manjuh in 2021 to learn more about her time in Jordan and how the program helped her back in Cameroon. Note: This interview has been edited for length and clarity.

What is most memorable about your month-long training in Jordan?

One of the most memorable things from the visit is that it takes time to build a strong institution. A key strategy to achieve this is to start small with what is currently available and generate a demand for screening services by raising awareness and promoting self-checks and clinical breast exams. As the demand grows, services can be upgraded and expanded according to the needs of the population. As renowned as the Jordan Breast Cancer program is, it all started as an insignificant service. With commitment and resilience, it is what it is today. The CBCHS Women’s Health Program [WHP] is the largest well-structured cervical cancer screening program [in Cameroon], and our desire is to get to this level or a higher level with the breast component of this program.

Describe a challenge that you faced in setting up the breast cancer screening program in Cameroon. How did you overcome it and keep going?

Setting up a breast cancer screening program was very welcomed by my organization, and the major challenge was the lack of equipment to use for screening and diagnosis. It is difficult to successfully institute a breast cancer screening program without a steady mammogram given the huge role it plays in breast cancer screening. The CBCHS operates in both rural and urban communities and currently cannot offer mammography. This is a big challenge for the breast cancer early detection unit. However, trainings were organized for clients presenting with breast masses without the use of mammography. The breast cancer screenings that I organized focused mainly on regular clinical breast exams and additional procedures for cases with breast lumps, including ultrasounds and biopsies. Clients are then referred for mammography [in other cities] if needed, although cost is prohibitive for many of them as they have to pay out of pocket.

Describe an opportunity that you had, either during your training in Jordan or after you got home, that was especially helpful in setting up the program.

When I got back home after my training, all the staff at the WHP were excited, ready and willing to learn from my Jordan experience. This was very helpful as I organized debriefing meetings about the screening process and what was needed for proper diagnosis. All the staff were engaged and worked so hard to see that clients are offered the best care. Register books to keep track of clients were created to help with follow-up care. This has helped a good number of clients learn how coming in for a screening can help diagnose cancer early enough to be treated. The greatest opportunity was successfully implementing the trucut biopsy technique which has improved diagnostic accuracy for breast lesions.

Share a story that shows what the program means to your female patients who come for breast cancer screening.

The WHP of the CBCHS runs both facility and outreach clinics, especially to remote communities with limited infrastructure. Many women want to grasp the opportunity and do their tests at outreach clinics. This is the case of one of our clients who attended an outreach clinic and found a breast lump on her clinical breast exam. An ultrasound showed a suspicious lesion and suggested further exams. A biopsy revealed invasive ductal carcinoma grade 2. She was then referred to an oncologist, where she had eight sessions of chemotherapy and a mastectomy. She has become one of our great peer educators as she encourages women to go for their screenings to help detect cancer earlier.

Learn more about Florence and previously funded fellows. The UICC fellowships are generously supported by the FitzGerald Family. The Prevent Cancer Foundation looks forward to continuing support for these fellowships as the 2022 cycle for applications is open.