ON­COL­O­GIST SAYS MORE NEEDS TO BE DONE

The Star (St. Lucia) - - LOCAL - By Faye-Chan­talle Mon­de­sir

A2007 study re­vealed that, per capita, Saint Lucia had the high­est num­ber of per­sons with diabetes in the world. Dr Michael Graven was one of the re­searchers who screened more than 31,000 Saint Lu­cians dur­ing the study.

Dr. Steven­son King, who was health min­is­ter at the time, de­scribed the sta­tis­tics as star­tling and said that gov­ern­ment would move swiftly to make a num­ber of in­ter­ven­tions such as for­mu­lat­ing poli­cies and de­vel­op­ing pro­grammes to change peo­ple’s life­styles.

Just as wor­ry­ing at the time (2006-2008) was the num­ber of can­cer-re­lated deaths: 544, sec­ond to deaths re­lated to heart diseases.

It is now 2015 and the ef­fects of diabetes on the pop­u­la­tion are still ram­pant. Ad­di­tion­ally, there ap­pears to be a sharp spike in can­cer-re­lated deaths, par­tic­u­larly among men, with an in­crease in the num­ber of prostate-re­lated cases. Lo­cal on­col­o­gist Dr. Owen Gabriel be­lieves that such cases are now on a par with diabetes and hy­per­ten­sion and prob­a­bly have a greater im­pact on our pop­u­la­tion as far as mor­tal­ity is con­cerned.

Af­ter Can­cer Aware­ness month in Oc­to­ber, Dr. Gabriel sat with the STAR to dis­cuss the state of can­cer and health care in gen­eral in Saint Lucia, firm in his be­lief that more can be done and should be done.

“In Saint Lucia we’ve al­most al­ways had can­cer, it’s just that it has never been some­thing that has been top­i­cal be­cause we prob­a­bly did not have all the fa­cil­i­ties to iden­tify its pres­ence here. It was not some­thing for which there were any spe­cial­ists around. Cur­rently I am the only lo­cal, res­i­dent, na­tive on­col­o­gist on-is­land and in some cases in the re­gion and the OECS,” Dr. Gabriel pointed out.

He said that nowa­days there are celebri­ties who have can­cers, like David Thomp­son, Pa­trick Swayze, Steve Jobs, Jimmy Carter, and it has now been some­thing which is even more top­i­cal.

“I think in Saint Lucia we have changed our life­styles and we are no longer an ac­tive so­ci­ety, no longer do we walk long dis­tances. We now drive more than we walk; we are not ac­tive in phys­i­cal ac­tiv­i­ties as stu­dents. Be­fore we’d leave school and go play a sport, now this is not the case. We have a lot more fast foods avail­able, more chem­i­cals in the en­vi­ron­ment, more tox­ins in our wa­ter, in our food, through the soil and the agrochemical prod­ucts. This is why we are now suf­fer­ing the ef­fects,” Gabriel said.

Asked about the most com­mon types of can­cer in Saint Lucia, Gabriel replied: “Can­cers of the prostate in men ex­clu­sively, can­cer of the breast in women, more so than in men, and can­cer of the cervix in women.”

“We’re now see­ing an in­crease in the num­bers of can­cers af­fect­ing the di­ges­tive tract, the gas­tro-in­testi­nal tract from the oe­soph­a­gus to the stom­ach, down to the small and large in­testines. If you look at the sta­tis­tics for both men and women, those can­cers will soon oc­cupy the num­ber one po­si­tion as the most com­mon can­cers for both sexes,” Gabriel ex­plained. “In re­gards to can­cer of the colon, we think that there is a direct co-re­la­tion with our life­style. If you heard re­cently, the World Health Or­gan­i­sa­tion has now clas­si­fied that canned meats, corned beef, tuna, sausages and salamis which are pro­cessed and cured meats are now known to be car­cino­genic. Now there is con­clu­sive ev­i­dence that th­ese things even­tu­ally cause can­cer. The mes­sage has been out there, we have al­ways told peo­ple that canned pro­cessed meats, canned and boxed drinks have con­tained some in­gre­di­ents which act as preser­va­tives and MSGs which are car­cino­gens and used in a lot of foods.”

For Dr. Gabriel the fight against can­cer has to be done in a num­ber of for­mats. “It can’t be that we just say treat­ment is a way to fight can­cer. I tend to think that we need to speak about shared re­spon­si­bil­ity so, on an in­di­vid­ual level, we have a re­spon­si­bil­ity to pro­tect our­selves and our chil­dren from th­ese toxic sub­stances, to dis­pose of our garbage prop­erly and to avoid en­vi­ron­men­tal con­tam­i­na­tion and poi­son­ings.

“When we con­tam­i­nate our wa­ters, our plank­ton, our seaweeds and so on we then con­tam­i­nate the source of food for th­ese fish and there­fore we con­sume that same con­tam­i­nant. In Saint Lucia we’ve done a study on preg­nant women in their third trimester; we mea­sured the pres­ence of those com­pounds and we were able to show that th­ese could be trans­mit­ted through the breast milk and into the ba­bies, which will even­tu­ally lead to ei­ther be­havioural prob­lems, birth de­fects, mal­for­ma­tions, ab­nor­mal­i­ties or can­cers.”

“On the other hand, our au­thor­i­ties, not to say gov­ern­ment, must have a role to play and it has to be a se­ri­ous role. They must net­work with stake­hold­ers so they can reg­u­late the kind of sub­stances we im­port for our agri­cul­ture. They can also reg­u­late the kinds of emis­sions our in­dus­tries pro­duce. They can en­force the mea­sures whereby our food sup­pli­ers al­low us to make a choice as to what kinds of foods we con­sume. I would like to see on su­per­mar­ket shelves, la­bels that sug­gest low calo­rie foods or GMOs, so that a per­son now can make a con­scious de­ci­sion to choose their food, whereas oth­er­wise they would have just cho­sen what is af­ford­able, which some­times is more harm­ful to us,” said Gabriel.

Ac­cord­ing to the doc­tor, for over ten years now mem­bers of the med­i­cal fra­ter­nity have been try­ing to col­lab­o­rate with “of­fi­cials.” “The fun­da­men­tal is­sue here is that our au­thor­i­ties do not have those health is­sues as the pri­or­ity on their poli­cies and their mech­a­nisms of where they ex­ert their ef­forts in what­ever min­istries. We are some­times to blame be­cause we do not de­mand that of them, be­cause we are so care­free. The health pro­fes­sion­als have been sound­ing the trum­pet, but most of it falls on deaf ears be­cause we don’t seem to re­al­ize why we need to pro­tect our en­vi­ron­ment and why th­ese au­thor­i­ties need to be able to reg­u­late and pro­tect us, some­times even from our­selves,” he said.

When asked what was the best ad­vice he would give to Saint Lu­cians as an on­col­o­gist he re­sponded, “One of the things is to get ed­u­cated with in­for­ma­tion con­cern­ing can­cer. Sec­ond thing is to know your risk fac­tors, your per­sonal history, your med­i­cal and fam­ily history, be­cause some can­cers are hered­i­tary and can be trans­mit­ted though fam­i­lies, such as prostate can­cer.”

Ac­cord­ing to Dr. Gabriel the most fun­da­men­tal thing, is for us to be open to change. “And I am say­ing this at the in­di­vid­ual level, the pop­u­la­tion level and the author­ity level. Some­times you speak of some­thing and be­cause peo­ple are not fa­mil­iar with it or are averse to it, it un­for­tu­nately takes some­one from over­seas to tell us what our lo­cal peo­ple have been preach­ing for years for us to take heed. I think one of the big­gest chal­lenges is the re­luc­tance of peo­ple to ac­cept ad­vice and change ac­cord­ingly. The re­luc­tance to change. The sec­ond thing is the kind of po­lit­i­cal so­cioe­co­nomic struc­ture of our coun­try in which per­sons who are pol­icy-makers or de­ci­sion­mak­ers some­times have lit­tle knowl­edge of the na­ture of the field. Those are the ones who make the de­ter­mi­na­tion as to what hap­pens in the field - un­for­tu­nately.”

He went on: “Our con­sti­tu­tion must al­low us to be dif­fer­ent in the way we con­ceive of min­is­te­rial po­si­tions, so maybe things like min­istries of ed­u­ca­tion, health, so­cial de­vel­op­ment, youth and sports might be un­der an um­brella that has no po­lit­i­cal in­flu­ence per se so that you are able to work, ir­re­spec­tive of who is there in gov­ern­ment, be­cause your man­date is to the coun­try over­all. It may change when you talk about in­dus­try and tourism and agri­cul­ture. A par­tic­u­lar gov­ern­ment might have a par­tic­u­lar in­cli­na­tion to­ward a par­tic­u­lar av­enue of de­vel­op­ment, but those things that are the pre­req­ui­sites for a healthy pop­u­la­tion, an ed­u­cated pop­u­la­tion have to be with­out any ex­ter­nal in­flu­ence, es­pe­cially for peo­ple who are not ex­pert in the field that we are talk­ing about.”

Ac­cord­ing to Gabriel it would ap­pear that the health care fo­cus, or lack thereof, is mis­guided. “I usu­ally tell peo­ple in a 167,000 pop­u­la­tion that al­though we are a low re­source coun­try, we should be cre­ative in our think­ing, in terms of pro­duc­ing meth­ods of ad­min­is­ter­ing health care to make it ac­ces­si­ble to ev­ery­one. It has not been the case for can­cer or any other dis­ease be­cause we want to fo­cus on nice build­ings and new struc­tures when, in the pri­mary level of preven­tion, we are lack­ing in the im­pact there. So you can have a nice, brand new, for ex­am­ple, for ar­gu­ment’s sake, hos­pi­tal but if you do not con­trol peo­ple’s at­ti­tudes and be­hav­iours you can’t re­solve and solve the prob­lems . . . we need to put things in place and, as I men­tioned ear­lier, take in­di­vid­ual re­spon­si­bil­ity and au­thor­i­ties too, with reg­u­la­tions in place, so that we re­duce the ex­po­sure we have to car­cino­gens and there­fore re­duce the num­bers and in­ci­dence of can­cer in the long run.”

If things do not change fast Dr. Owen Gabriel sounds this alarm: “In de­vel­op­ing coun­tries like Saint Lucia and other coun­tries in the East­ern Caribbean, we will see 70% of deaths be­ing caused by can­cer. Early di­ag­no­sis, preven­tion and screen­ing helps!”

“Our con­sti­tu­tion must al­low us to be dif­fer­ent in the way we con­ceive of min­is­te­rial po­si­tions . . . like

health,” says on­col­o­gist Dr. Owen Gabriel.

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