7. Other challenges

## 7.1. National Cancer (MM) Registry

There is no standard National cancer (MM) registry or Surveillance Epidemiology End-Result (SEER) cancer statistics review center in most developing countries including Nigeria. This has hindered getting accurate statistics of the disease in most developing countries.

#### 7.2. National Guideline for management of MM

There are no standard guidelines for the treatment of MM in many developing countries including Nigeria. This is responsible for the disparities in some of the outcomes. A lot of confounding issues have arisen as a result of disharmony in the management of the disease in many developing countries. There is a need to control all confounding issues that may arise as a result of heterogeneous management of the MM in developing countries. Each country is expected to design its own consensus guidelines that will best serve the patients putting international best practices in mind.

#### 7.3. Psychosocial input

One of the components of a good palliative care of people living with terminal diseases such as MM is the psychosocial care. In developed countries, the social workers and the spiritualists have their roles to play in order to improve the quality of life of the patients. For instance, some patients who have financial challenges in procuring their treatment may not access social workers either because they are not there or they might be there but they are not functioning. This may create more health burden or even cause death of the patients in some cases.
