RESEARCH & INNOVATION
More Help Needed to Fight Cancer
by Carol Williams
Concern about the increasing incidence of some cancers in developing states has prompted two UWI medical researchers to advocate for increased education towards early identification and treatment of the disease. H aematologist, oncologist and Senior Lecturer in Clinical Haematology in the options of using minimally invasive screening tests available in Barbados, like faecal immunochemical testing (FIT-Testing) and M2- PK kits where the stool is tested for blood and altered DNA that can be recommended even in the absence of symptoms.
Faculty of Medical Sciences at Cave Hill Dr. Cheryl Alexis ; and researcher, Lecturer in
Public Health and Co-Chair of the Colorectal Cancer (CRC) Working Group for the African- Caribbean Cancer Consortium (AC3) , Dr. Natalie Greaves say more education is required across the board. Their advocacy follows publication of the latest report by the Barbados National Registry (BNR) entitled, Cancer in Barbados Report 2022 . The BNR is housed in Barbados at the George Alleyne Chronic Disease Research Centre of The UWI. In 2018, some 960 new cancer cases were recorded, marginally below the yearly average of 977 recorded between 2013 and 2018. Of the 2018 figure, prostate cancer was the most prevalent among men while breast and colorectal cancers were most prevalent in women. For the latter, the incidence and mortality continue to be high. Dr. Alexis said this was particularly concerning since deaths related to breast cancer in developed countries are decreasing. She suggested this may be due, in part, to the cost of investigation and treatment for cancer patients without insurance. “To provide directed treatment for breast cancer, which is the standard of care, patients should not only have immunohistochemistry (tests to determine what proteins and hormones the tumour is releasing), but genetic testing for example, BRCA 1 and 2 gene
The World Health Organization has estimated that cancer accounted for one in six deaths globally (9.6 million deaths) in 2018. In the Americas, 1.4 million people died from the disease in 2020, with almost half being people 69 years of age and younger, according to the Pan American Health Organization . A statement from the BNR noted the increased likelihood of a cancer diagnosis of individuals as they age, with many elderly persons possibly not having the financial resources and support they need. The challenges extend further, Dr. Alexis noted. She said health systems in the region have inadequate access to gold-standard, diagnostic and treatment modalities such as positron emission tomography (PET) scans, linear accelerators, proton stereotactic radiation machines and any other precision or individual care methods. The release of the findings of the BNR coincided with the commemoration of World Cancer Day on 4 February, which had as its slogan “Close the care gap” . The BNR report provides information that is critical to the planning and management of cancer by the Ministry of Health and Wellness , clinicians, the Board and Management of the Queen Elizabeth Hospital , non-governmental organisations and other partners. l
Dr. Natalie Greaves
Dr. Cheryl Alexis
tests. Other newly available ‘gene-oncotype tests’, which allow doctors to give patients a score indicating the likelihood of the cancer coming back, can be used to determine how aggressively the cancer should be treated.” Although Dr. Greaves noted that silence and fear may still exist around cancer, she was adamant that knowledge brings power. “I think that a broad-based, whole-of- society approach to cancer education is key,” said the researcher who is among a team of international investigators conducting a pioneering genome-related cancer study. “Much of what needs to be done revolves around fully adopting the four- pronged approach to cancer control: that is, prevention, screening and early detection, diagnosis and treatment, and palliation. I think the Ministry of Health and Wellness is moving in this strategic direction with the national non-communicable disease plan which has cancer integrated. Once our health system accelerates this systematised approach to cancer, we will see the gains over the coming decades.” Dr. Greaves said health education activities focused on the signs and symptoms of CRC were crucial. Further, she said clinicians should educate clients on their
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