Suffering, justice, and scarcity: philosophical reflections on the burden of cancer in LMICS using Nigeria as a case study.

Cancer represents a significant and growing public health emergency in Nigeria, where high mortality rates, late-stage presentation, inadequate infrastructure, prohibitive costs and pervasive stigma combine to produce a multidimensional crisis. While epidemiological data and health system analysis illuminate the scale of the problem, they fail to capture the deeper ethical, structural and existential realities that shape the lived experience of cancer. This paper employs key philosophical concepts, including distributive justice, social justice, structural violence, biopolitics, epistemic injustice, care ethics, existentialism, Ubuntu philosophy, vulnerability theory and the capabilities approach to analyze the complex realities of cancer in Nigeria. It is a critical reflection on the rationale for practices and policies that are often taken for granted, using the tools of formal philosophical inquiry, with a view to either grounding the practices in proper ethical understanding, or rethinking them along proper ethical lines. We argue that applying these philosophical frameworks reveal deep-seated inequities, challenges to patient agency, the corrosive effects of stigma rooted in epistemic failures, relational deficits in care, and the profound existential struggles patients and families face. By examining the interplay among scarce resources, cultural beliefs, systemic weaknesses, and fundamental questions of value and meaning, this paper argues that a philosophical perspective offers a roadmap for more humane, just, and culturally grounded reforms in cancer prevention, diagnosis, treatment, palliative care, and compassionate responses within the Nigerian context.