Battling kids’ eye cancer in Nigeria, Israeli doctors introduce pinpointed chemo

Week-long mission from Sheba Medical Center aims to teach local doctors to perform the complex procedure that spares patients the side effects of full body radiation

Nathan Jeffay is The Times of Israel's health and science correspondent

Dr. Mattan Arazi, ophthalmology resident at Sheba medical Center, consulting with a child in Nigeria as part of a humanitarian mission on January 10, 2023. (Courtesy: Sheba Medical Center)
Dr. Mattan Arazi, ophthalmology resident at Sheba medical Center, consulting with a child in Nigeria as part of a humanitarian mission on January 10, 2023. (Courtesy: Sheba Medical Center)

Israeli doctors on a week-long humanitarian mission to Nigeria said Friday that they had introduced pinpointed chemotherapy, in a move expected to have widespread benefits in treating children with eye cancer in the West African country.

Dr. Mattan Arazi, an ophthalmology resident at Sheba Medical Center, returned to Israel on Friday, along with four colleagues, and told The Times of Israel that they introduced a form of chemotherapy that is far easier for children to sustain. They trained local doctors and treated children together with them.

“It was very challenging and rewarding to treat these children, and work with local doctors to address this life-threatening disease,” Arazi said.

“At the end of the trip we held a symposium with Nigerian doctors, and as it came to a close we all started to dance in happiness at what we managed to accomplish together,” he added.

Retinoblastoma, which normally affects young children and can be deadly if not caught early, is rare globally, but relatively common in parts of Africa. And treatment there lags behind the West.

Chemotherapy, when given, is generally delivered across the body, rather than using a newer method that delivers concentrated doses of cancer-killing medicine directly to the affected area of the eye.

After the Sheba delegations’ visit, for the first time Nigerian doctors are using this updated method, called intra-arterial chemotherapy (IAC).

The Sheba doctors ran workshops at the University of Ilorin on the complex technique, which involves running a catheter from the leg to the brain and another catheter onwards to the eye. They also treated several children together with local counterparts at First Consultant Hospital in Lagos.

Dr. Mattan Arazi, ophthalmology resident at Sheba Medical Center, examines a child in Nigeria as part of a humanitarian mission on January 10, 2023. (Courtesy: Sheba Medical Center)

IAC is well-placed to address the major challenge of retinoblastoma in Nigeria, by effectively treating cases that only reach doctors at a late stage. Arazi said: “It’s unfortunate to see that these children typically present late with very advanced disease due to social obstacles, such as access to  care, education and the challenge of financing treatment.”

Sheba recruited physicians to go to Nigeria after Prof. Ido Didi Fabian, an ocular oncology specialist, received a request from Dr. Dupe Popoola, consultant ophthalmologist at the University of Ilorin Teaching Hospital.

Speaking to Nigerian media during the mission Popoola said advances made with the Israelis will help enable local doctors to “keep children alive, eyeball intact and their vision safe.”

Arazi said it was “exciting” to perform IAC with local doctors and see them increasingly take the lead.

Prof. Ido Didi Fabian, ocular oncology specialist, carries out a procedure during a humanitarian mission to Nigeria, on January 10, 2022. (Courtesy: Sheba Medical Center)

Arazi explained that despite being difficult and complex, there were many benefits in avoiding the side effects of treating the whole body with chemotherapy.

“Now the reason why this treatment is so good is because while systemic chemotherapy is the main treatment that most centers use, the problem is that you are injecting chemotherapy to the rest of the body, while the tumor is only in the eye. So there are a lot of systemic side effects, such as low blood counts, fevers, infections, and other problems,” he said.

Yoel Har-Even, director of Sheba’s international division, said that the hospital sent doctors to Nigeria because its “commitment and dedication to extending a hand to those in need across the globe is a fundamental guiding principle.” He added: “There is a great sense of pride to be able to contribute to humankind and offer hope without boundaries.”

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