Radiotherapy in Nigeria: a silent emergency in cancer care.

Radiotherapy (RT) remains an essential component of modern cancer management, both for cure and palliation, yet access across Nigeria continues to lag far behind global standards. Despite being Africa's most populous nation, Nigeria has only a handful of functional RT machines, with frequent breakdowns, erratic power supply, and inadequate maintenance crippling service delivery. Many patients are forced to wait weeks or months for treatment, often with disease progression during the delay. Of the eight government-funded RT centers, only two consistently treat patients with functional linear accelerators. At the same time, most rely on outdated 2D techniques and lack imaging support such as CT or MRI simulators. The shortage of trained personnel exacerbates the crisis: the country lacks clinical residency programs for medical physicists, offers limited opportunities for continuing education, and has an insufficient number of radiation oncologists to meet the growing cancer burden. These limitations not only reduce treatment capacity but also deepen inequities in cancer outcomes, as timely RT becomes a privilege for a few rather than a standard of care. Improving access demands sustained investment, transparent procurement, regular maintenance, and workforce development. International collaboration, public-private partnerships, and strong political will are critical to reversing decades of neglect. The current state of RT in Nigeria is more than a technical shortfall; it is a silent emergency in cancer care that demands immediate attention, strategic planning, and committed implementation.