Pacific people need to seek help early to reduce deaths from cancer, writes John Maslin
We cannot pass a generation by without doing something.
A Wanganui surgeon is calling for broader education to battle cancer among Pacific Island people.
Dr Semisi Aiono, a general surgeon working for the Whanganui District Health Board, says cancer is the second biggest cause of death among his people and compounding the problem is that many people leave it too late before seeing their doctor.
Late last year Dr Aiono addressed a Pacific workforce and leaders' conference in Palmerston North about the most common forms of cancer among Pacific Island people and why they are occurring.
The conference was hosted by the Central Cancer Network and he says he wanted to be involved because, as a Pacific Islander and a New Zealander, "I felt I might be able to contribute something. I was trying to link my subject in how we can get these messages out to the Pacific people who need to know, and also to the healthcare workers who are caring for these people".
"One of the big problems is that by the time these people see their doctor with a problem it's too late to help them," says Dr Aiono, adding that part of the problem lies with people's beliefs. "They don't trust the health system so they don't present until it's too late to help them. They're also frightened."
He says there are a number of interesting methods and innovations that people are trying to get women to participate in, but it remains a major problem.
"This really is all about education and getting women to be able to feel they can come forward, because there remains a lot of fear among them. When you get to poorer parts of our society, many of them are working at two jobs as well as raising a family and caring for relatives. They just don't have the time to come forward and look after themselves, and I believe that's a factor.
"Poverty is always a factor in terms of health in all sectors of our society and not just the Pacific community," Dr Aiono says.
He told the conference that breast cancer is the commonest form of cancer among Pacific women, and these numbers are increasing.
"Trying to get these women to be part of a breast cancer screening programme should be a focus, and we have seen an improvement in that area. But, compared to mainstream ethnicities, Pacific women are still under-represented in these programmes. "While the Ministry of Health has a target of more than 70 per cent of women presenting, Pacific women are still down around 59 per cent."
He says cancers common to Pacific Island women include cancer of the uterus. Cervical cancer is less common than in European women but in the older age groups - those over 60 - cervical cancer is increasing.
"The wart virus we know now is one of the causative factors here and the uptake of the vaccination only just introduced and the cervical smear programmes are again aimed at getting women to come forward."
Dr Aiono says the statistics for the Pacific population are, to a large degree, mirrored among Maori. "Certainly in terms of breast cancer. Stomach cancer is higher in the Maori population, as is ovarian cancer. And as far as ovarian cancers go, we are talking numbers twice that of European women.
"The rates of ovarian cancer among Pacific women is about 47 per 100,000. In European women it's 17 per 100,000, and that's why the screening programmes are so vitally important."
He says dietary changes are having an impact. Dr Aiono has worked in Samoa and seen similar trends developing. "Their diet is changing and people are eating the wrong foods and gaining weight. And they're smoking more, too."
Among Pacific males, prostate cancer is the most prevalent type, followed by lung cancer. "Again, smoking, diet and lack of exercise have an impact on prostate cancer, while lung cancer is preventable if people don't smoke."
Again, he says making use of screening programmes is vital for men. Dr Aiono says there are changes people can make in their lifestyles which would have a positive effect on their lives. "People can modify their lifestyles to make a positive difference. The effects might not be immediate, but we cannot pass a generation by without doing something."
He says for poorer people, with large families and struggling to get by, eating a proper diet and exercising is not a priority. "For many, they don't have the time because they're too busy surviving."
Dr Aiono says educating people is key. "That, and empowering people to take those steps for themselves. It's a message that is valid not just for cancer, but for heart disease and diabetes. And those two are a big cause of death in our society. So then it becomes not just about Pacific Island people; it's the whole of society.
"We just have a language and cultural barrier to get through as far as Pacific peoples are concerned. But that's not insurmountable."