Benue State Teaching Hospital is currently in the news for the wrong reason.
A woman who had undergone eight sessions of chemotherapy, 25 rounds of radiotherapy and a mastectomy, has discovered that she was misdiagnosed as a cancer patient.
When Serah Shimenenge Yugh started losing weight while undergoing her National Youth Service Corps (NYSC) assignment in Ekiti State, she went to the hospital seeking a solution but tests carried out on her didn’t point to anything.
While self-examining her breasts in 2017, she felt a tiny lump on her left breast, which led her Federal Medical Centre, Makurdi before going to Benue State University Teaching Hospital (BSUTH) at her sister’s suggestion.
When a biopsy was performed, BSUTH, described it as “a single very tiny piece of greyish biopsy tissue that may be inadequate for process.”
However, Serah while at the hospital told them she wanted to know the type of lump she had. Unfortunately, what was supposed to be a simple test developed into three years of seeking help from one hospital to another, FIJ reports.
The hospital carried out three tests on Serah. Histopathology diagnosis of the first test showed she had Atypical Epithelial Hyperplasia (an abnormal growth pattern that is associated with a small increase in breast cancer risk), which has been shown to be pre-cancerous but is not cancer. The second diagnosis was an Invasive Ductal Carcinoma which, according to Johns Hopkins Medicine, represents 80 percent of all breast cancer diagnoses.
However, while waiting for the result of the third test, the hospital went on an industrial strike in September 2017 and by the time the strike was called off in January 2018, she had undergone five rounds of chemotherapy.
During Serah’s treatment, her doctor, Dr. Stephen Atokolo, urged her to do a mastectomy (surgical removal of all breast tissue from a breast as a way to treat or prevent breast cancer). Following his advice as a medical practitioner, the woman underwent the surgery at National Hospital Abuja, a leading cancer centre in Nigeria, where had Serah underwent radiotherapy for six months.
They performed the surgery based on the suggestion from her Doctor at Benue State University that she gets a mastectomy quickly.
Sadly, when the third test result was out, the histopathology diagnosis showed that Serah only had fibroadenoma – a non-cancerous breast tumour that most often occurs in young women – and that she had been misdiagnosed.
Serah herself got the result of some of her tests and went to National Hospital in Abuja and there, her oncologist pointed out the discrepancies in the results she presented.
Oncologists at the Abuja hospital also requested an immunohistochemistry test which Serah initially paid for at BSUTH in 2017. The test was to be done before radiotherapy since it determined the next steps of treatment.
Meanwhile, efforts to get the test results proved abortive as BSUTH kept sending her on a wild goose chase for about 2 years.
Since 2017, she had been coming to BSUTH from Kaduna and Abuja, asking for her immunohistochemistry test from Dean of College of Health Sciences, Dr Joseph Ngbea. The test result was to enable the doctor at National Hospital decide on the treatment to give her.
According to the publication, Dr Ngbea said he was not in charge of Serah’s case. While Serah had paid for the test to his secretary at his request, each time she went, she was told the results would be given to her. She recalled that the last time she waited to see him at his office, he shouted at her.
She opted to do another test and when the result came out in 2019, the diagnosis read: “Breast tissue – no residual malignant”.
In 2019, the woman went viral as NGOs solicited funds for her cancer treatment and it caught the attention of health minister, Osagie Ehanire, who said the federal government is planning to roll out a cancer treatment fund to reduce the burden of treating cancer.
He said this at the National Health Dialogue that held in October 2019 in Abuja.
Mr Ehanire and Ms Yugh were both panelists at the dialogue and they discussed the topic, “Cancer control in Nigeria.”
After her chemotherapy, Serah returned to Kaduna. She then found Kunak and Project PINK BLUE, two NGOs that gave her support. Project PINK BLUE, an organization engaged in cancer awareness, paid for her radiotherapy. But prior to then, Serah had to get an immunohistochemistry test that was supposed to further pin down the diagnosis of a cancer.
Up until December 2019, two years after her mastectomy, Serah still believed she had cancer. The doctors at Benue State University Teaching Hospital did not reach out to her to inform her of any misdiagnosis.
Still, despite the no-cancer diagnosis, Serah did not yet understand that the results showed she did not have cancer.
According to her oncologist, her tumour marker test showed that she was clear of cancer, but the specimen which showed invasive ductal carcinoma was not what was sent to the lab.
To find out what had happened, Serah went back to BSUTH, to get her tissue block but she was told they could only find the first and third tissue blocks. The second tissue block said to contain cancer cells could not be found.
When a patient has a biopsy or surgery, the surgeon often will remove diseased tissue for examination by the hospital’s pathology department, this is what is referred to as tissue block.
On March 2020, Serah wrote a letter to the Chief Medical Director of Benue State University Teaching Hospital demanding for her immunohistochemistry test, and her tissue block from the second test she did.
When she received no response, Project PINK BLUE wrote to the Chief Medical Director, Dr. Terlumun Swende, in May 2020 to appeal for the tissue block. The hospital, through the Chief Medical Director, responded to Project PINK BLUE on July 2020.
Rather than provide the tissue block, BSUTH started setting up meetings with Serah’s family members.
Speaking while almost in tears, Serah said; “Before I knew what was happening, the H.O.D (Dr. Raymond) called my uncle telling him that it was an error. I told him, I am the victim here. When you were telling me I had cancer, did you call my uncle?
So why are you calling my uncle telling him that I don’t have cancer. I am the one with the problem don’t call my uncle. If I could handle the news that I have cancer, then I can handle ‘I don’t have cancer it was an error’. They said they have a method of doing things.”
This revelation made her demand to see the Chief Medical Director. The HOD during the meeting told Serah; “It was in the meeting that Dr. Raymond revealed that specimens were discarded in 2018 because the lab was filled up. Serah’s specimen was also discarded. Having read the three reports of the tests done on Serah, Dr. Raymond didn’t think the immunohistochemistry test would be necessary.
According to an oncologist, Dr Chinedu Arua, histology and immunohistochemistry tests are prerequisites for patients seeking breast cancer treatment.
However, Dr. Raymond defended himself, saying; “Those three reports, the one that was at variance was the second one. When I looked at it, I now thought within me, if we decide to do immunohistochemistry it might not yield much.”
At the meeting set up to discuss her misdiagnosis, Serah asked that the Benue State University Teaching Hospital write a letter to her doctor at the National Hospital, Abuja, that they made an error and therefore she should stop treatment. No letter was written. And while verbally the doctors have acknowledged they made an error, it’s not been documented officially.
The woman expressed; “When they told me I had cancer it didn’t affect me this much. But it’s the battle of fighting the error that has taken more from me. When I think about it, eating becomes a problem.”
Due to BSUTH’s misdiagnosis, Serah lost her relationship, and her dream to pursue a Ph.D.
At a meeting with Dr Raymond Vhriterhire, the former Head of Department of Histopathology, and Dr Joseph Ngbea, who was newly appointed as Commissioner for Health, Benue State, Serah was offered a breast reconstruction, and a job. She rejected both.
She said she simply wants to know why they had not yet given her the immunohistochemistry test. Serah said the offers made by the hospital came across to her as a ploy to silence her from asking questions — questions she had been asking since September 2017 when a mastectomy was performed on her.
Even though she says she fears for her life and the repercussion her speaking up might bring to her, she is demanding an official apology from Benue State University Teaching Hospital.