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Impact of Breast Cancer Support Services on Breast Cancer Treatment Completion among Women in Nigeria

Abstract

Breast cancer is an important public health concern in Nigeria and remains a major cause of illness and mortality among women. Successful breast cancer management often requires patients to complete multiple stages of care, including diagnostic evaluation, surgery, chemotherapy, radiotherapy, hormonal therapy, targeted treatment where indicated, and regular follow-up. However, many women may experience difficulties completing recommended treatment because of financial constraints, transportation challenges, treatment-related side effects, long treatment schedules, inadequate social support, fear and stigma, limited access to specialized cancer services, and fragmented coordination of care. Breast cancer support services provide psychosocial, informational, financial, navigation, transportation, peer-support, and follow-up assistance that may help women overcome barriers to continuing and completing cancer treatment. Strengthening these support services may therefore improve treatment continuity and completion among women receiving breast cancer care in Nigeria. Against this background, this study investigates the impact of breast cancer support services on breast cancer treatment completion among women in Nigeria. The study will be anchored on the Social Ecological Model, Andersen's Behavioral Model of Health Services Use, and the Continuity of Care Model. The Social Ecological Model emphasizes the interaction between individual, interpersonal, community, healthcare-system, and broader socioeconomic factors in influencing cancer treatment outcomes. Andersen's Behavioral Model explains healthcare utilization through predisposing, enabling, and need factors, with breast cancer support services serving as enabling mechanisms that may reduce barriers to continued treatment. The Continuity of Care Model emphasizes coordination, consistency, communication, and sustained support across different stages of cancer care. Collectively, these theoretical perspectives provide a suitable framework for explaining how breast cancer support services may influence treatment completion among women in Nigeria. The study will adopt a quantitative prospective cohort or quasi-experimental research design. The study population will comprise women diagnosed with breast cancer and receiving treatment in selected public and private oncology centres, teaching hospitals, specialist hospitals, and cancer treatment facilities in Nigeria. A multistage sampling technique will be used to select states, healthcare facilities, oncology centres, and eligible women receiving breast cancer treatment. Breast cancer support services will be assessed using indicators such as availability of patient navigation, psychosocial counselling, cancer education, treatment counselling, financial assistance, transportation support, accommodation assistance, peer-support programmes, family support, appointment reminders, treatment follow-up, side-effect management education, referral coordination, social work services, and assistance with accessing treatment facilities. Breast cancer treatment completion will be assessed using indicators such as completion of prescribed treatment cycles, completion of recommended surgery and adjuvant therapy where applicable, adherence to scheduled treatment appointments, completion of radiotherapy sessions where indicated, completion of chemotherapy cycles where indicated, continuity of hormonal or targeted therapy where prescribed, follow-up attendance, treatment interruption, treatment abandonment, and reasons for incomplete treatment. Data will be collected using structured questionnaires, oncology treatment records, patient medical records, treatment registers, appointment records, patient navigation records, social work records, referral documents, and follow-up reports. Descriptive statistics will be used to summarize participants' demographic and clinical characteristics, types of support received, treatment patterns, and completion outcomes. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of breast cancer support services on treatment completion. Where a quasi-experimental design is adopted, treatment completion among women receiving structured support services may be compared with completion among women receiving conventional care, or outcomes before and after implementation of enhanced support services may be compared. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that breast cancer support services have a significant positive impact on treatment completion among women in Nigeria. Women who receive comprehensive support are expected to demonstrate higher treatment completion rates, fewer treatment interruptions, improved appointment attendance, and lower levels of treatment abandonment than women with limited access to support services. Patient navigation and treatment counselling may help women understand complex treatment schedules and coordinate appointments, while financial and transportation assistance may reduce practical barriers to accessing oncology services. Psychosocial and peer-support services may also help women cope with treatment-related stress, fear, stigma, and side effects, thereby strengthening their ability to remain engaged in care. However, limited availability of oncology services, inadequate funding for support programmes, high treatment costs, long travel distances, shortages of trained cancer-support personnel, treatment side effects, and weak referral and follow-up systems may reduce effectiveness. The study therefore expects accessible, coordinated, patient-centred, and adequately funded breast cancer support services to contribute significantly to improved treatment completion among women in Nigeria. The study is expected to contribute to the literature on breast cancer support services, cancer treatment completion, patient navigation, psychosocial support, cancer care, treatment adherence, treatment abandonment, oncology services, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Cancer Control Programme, state ministries of health, teaching hospitals, specialist cancer centres, oncologists, oncology nurses, social workers, patient navigators, cancer advocacy organizations, development partners, and policymakers regarding strategies for improving breast cancer treatment outcomes. The study will also provide evidence-based recommendations for expanding patient navigation services, strengthening psychosocial and peer-support programmes, improving financial and transportation assistance, strengthening treatment counselling and appointment follow-up, integrating social support into cancer care, improving referral coordination, and reducing socioeconomic and healthcare-system barriers to treatment completion among women with breast cancer across Nigeria.

Keywords: Breast cancer support services, breast cancer treatment completion, breast cancer, women, patient navigation, psychosocial support, treatment adherence, treatment abandonment, oncology services, cancer care, Nigeria, public health.