Your health, your responsibility - Early detection can nip cancer in the bud

In our June talk, we visited the topic of carcinophobia – the irrational fear of cancer. We saw that the entrenchment of this fear began with the bad reputation of the disease throughout history and continued with ever-present personal testimonials of suffering.

We began to appreciate the ubiquity of the fear as affecting those not diagnosed, possibly diagnosed, diagnosed, and those once diagnosed. We began to understand why this fear delays a person from seeking early care, why it leads to ill-informed decisions by patients and physicians, and why it multiplies the distresses for terminal care. How do we depower this fear? Let us look at the probability of a perpetual possibility – the precancer stage – and the personal responsibility that comes with it.

CANCER STATISTICS

The hard truth is that we all make, and will continue to make, cancer cells for as long as we live. These cells are kept in check and destroyed by our complex, healthy immune systems. The chances of developing cancer, as a disease, are mathematically and scientifically calculated as cancer statistics. These risk calculations are used to identify individuals who are at higher-than-average risk of getting and dying from the disease. In the 1600s to 1700s, discoveries were made of cancer-causing agents called carcinogens and likely carcinogens, like tobacco. The public health importance of these discoveries laid the foundation for cancer statistics.

By the late 1700s, cancer censuses or population surveys, known as cancer registries, slowly gained momentum. These surveys gathered information on who (gender and age) has what (type of cancer), when (time in their life), where (they live, work or play), why (their exposures), and for how long (the disease would last).

In other words, by keeping an ongoing record of the number of new cancer cases and deaths from cancer in populations we understand the spread of cancer, the likely causes, and the likelihood of developing specific cancers during our lifetime. These statistics have given us an idea of our risk together and as individuals. For example, you may have heard that globally, one in every eight women will develop breast cancer. While this is true, the chance of developing cancer as an individual may be even higher or lower, depending on age, race, habits, family history and environment. Doctors and nurses use these statistics to advise us: on healthful lifestyle habits that prevent the development of cancer; when to start screening tests; and the red-flag warning signs to catch cancer early. Screening tests like Pap test and faeces test, which catch precancerous cells before they become cancer disease and early detection, nip cancer in the bud.

EMPOWERING KNOWLEDGE

Essentially, having this knowledge of the probability of developing cancer should be psychologically empowering in helping us to become better at managing our own risk.

Many parallels have been drawn from the COVID -19 pandemic and Jamaica’s cancer situation. There has been corporate or collective responsibility, community responsibility and personal responsibility. We contend with seeming governmental failures in prioritising public health over traditional ways of maintaining economies. We are frustrated by failures in community responsibility, as our behaviours vehemently declare that we are not our brother’s keeper. We continue to congregate and cram in spaces with maskless faces, we lie on medical screens about our symptoms, and disregard quarantine orders. Maybe at each level there is a pervading perception that the pandemic is gone and we are no longer at risk, or there was no risk to start with. Maybe there is defiant invincibility that it cannot happen to us, or maybe there is insufficient knowledge or awareness of the risks. It may be that at each level, there is a bottomline recklessness that irrespective of the risks, death by something is inevitable. Our behaviours can be endangering to ourselves and to our communities. The lesson to learn from the probability of a perpetual possibility is that active, knowledgeable self-risk management can reduce prohibitive cancer fear that stunts all possible good outcomes. In the borrowed sentiments of the alcohol industry and the Ministry of Health and Wellness, ‘drink responsibly’, ‘Your health is your responsibility’. Let us be responsible risk-takers!

Dr Tamara Green is a family physician, committee member of International Psycho-Oncology Society, and member of the Jamaica Cancer Society. Email feedback to maragreen.ta@gmail.com.