On 6th May 2021, researchers from the Washington University School of Medicine published the findings from their research exploring the link between sugar-sweetened beverages (SSBs) and early-onset bowel cancer (bowel cancer before the age of 50) in women. They found that women, under the age of 50, who consumed two or more servings of SSBs per day were more than twice as likely to develop bowel cancer than women who consumed less than one serving per week.
This piece of work was part of the ongoing Nurses’ Health Study II (1991-2015) and included 95,464 women who were asked to record their food and beverage intake every four years for 24 years. Additionally, researchers collected information on potential risk factors for bowel cancer such as weight, diet, family history, smoking habits, physical activity and use of aspirin or non-steroidal anti-inflammatory drugs. Then, using statistical analysis, they explored any links between SSB intake and early-onset bowel cancer.
What Did They Find?
They found that women who consumed high quantities of SSBs in adulthood were more likely to be less physically active, consume red and processed meats and have a poor-quality diet. They also found that high consumption of SSBs in adulthood and adolescence was linked to a higher risk of developing early-onset bowel cancer (no link was observed with fruit juice consumption or artificially sweetened beverages). It is important to note that this link was observed after taking into account the main risk factors for bowel cancer (e.g. diet, exercise and other related factors).
Researchers reported that out of the 95,464 women who were studied over the 24 years, 109 went on to develop early-onset bowel cancer.
Although researchers found a link between early-onset bowel cancer and SSB consumption because this was an observational study, they were unable to provide information on the exact cause of bowel cancer in their study population; more research is needed to understand their findings. Furthermore, this study included mostly white females and additional work is needed to explore this link in men and other ethnic groups.
What Does This Research Mean for the Public?
This research provides further evidence of the negative impact that high levels of SSB consumption may have on the public’s health and highlights the need for the public to reduce their SSB consumption.
More Information
For more detailed information on this study, you can read the full research paper here.
You can also find general information about bowel cancer on Bowel Cancer UK’s website
Today’s blog post comes from Aaron D’Souza, a second-year medical student at the University of Medicine and Health Sciences in St. Kitts. While he has been active at school in multiple areas including playing soccer for the school and teaching high schoolers neuroscience with the BrainBee project, he is helping us as a new volunteer.
Aaron discusses the emotions and challenges faced by caregivers of patients with multiple myeloma. By recounting his mother’s experience as a caregiver, he identifies barriers that a caregiver may struggle with and provides scientifically supported practical advice to help those who have recently become caregivers of a loved one with multiple myeloma.
Cancer is a group of diseases that everyone is familiar with in some form. Formally, it is the uncontrolled replication of cells leading to various problems. One particular cancer that will be the focus of this post is multiple myeloma (MM). Specifically, we will focus on the caregiver burden of those caring for someone with MM, as there is a lack of emphasis on their well-being and personal experience, but first, a bit of background information.
What is MM? MM is a type of blood cancer that is progressively debilitating, painful and ultimately fatal (most commonly due to infection).
Who is at risk? It occurs 1.6x more often in males than in females. It is 2x as often in the Black population than in the Caucasian population. Additionally, Black people are more likely to get it at a younger age.
When is it usually diagnosed? The median age of diagnosis is 65 years old. In cases diagnosed and treated early, 60% of patients will survive up to 5 years; only a fraction will survive 10 years after diagnosis.
What causes it? While there is a confirmed genetic role, there is also evidence of many other factors contributing to its onset. Such factors include exposure to radioactive substances and certain chemicals, such as benzene. Usually, a large dose of benzene can only be acquired from being exposed to factory emissions for several years or wastewater.
What are some symptoms?MM has systemic complications ranging from severe bone pain/ osteoporosis to kidney failure and infection. Throughout the progression of the disease and administration of treatment, it is standard to see periods of remission, periods of high severity and periods where the side effects feel worse than the disease.
Can it be treated? Sadly, the majority of people with MM will pass away. Recovery is possible if the patient is diagnosed early and started on therapy. Treatment ranges from conventional chemotherapy to stem cell transplantation. You can find more information on how these treatments work on the American Cancer Society’s website.
Unfortunately, MM patients are often misdiagnosed or are diagnosed late because there is a lack of experience diagnosing it among physicians. The latter happened with my grandfather, and within 1 year of diagnosis, he passed away. While many understand the suffering of a cancer patient, not many understand the challenges the caregivers face; a role that my mother fulfilled for my grandfather. A caregiver is someone responsible for the needs of the patient, often without any compensation. Responsibilities of a caregiver include scheduling, transport, finances, housekeeping, legal support and emotional support. It is usually a spouse, adult, child, or other immediate family members that fill this role and the role of a caregiver can be simultaneously rewarding and challenging.
My mother had her own mix of such emotions as a caregiver. At the time of my grandfather’s diagnosis, we had already lived in Canada for 10 years and in the United Arab Emirates before that, while my grandparents were living in India. Although my mom would go to India over the summers to look after my grandparents, she was otherwise dependent on friends and relatives to ensure my grandparents’ health and safety. The inability to be there with them for longer left her with a sense of guilt at the end of each summer, especially the last summer before my grandfather’s death. The uneven sharing of the caregiver role among family had placed an enormous strain on some of these relationships
As a caregiver, it is essential to note that uncertainty is the greatest obstacle for the well-being of both the patient and the caregiver. A caregiver’s well-being often reflects the status of the patient. Studies have identified numerous challenges to caregiver well-being. Most caregivers face at least a few of these challenges:
Initial shock: After having to endure the path to diagnosis, eagerly awaiting results, the confirmation of a diagnosis for any type of cancer will come as a shock. Additionally, caregivers must adapt by changing their lifestyles and take on new responsibilities to support their loved ones. Part of the difficulty is due to the unpredictable course of the illness. Many patients and caregivers must endure the shock several times as the disease re-surfaces. Lack of knowledge about the disease is an enormous source of stress.
Commitment: Being a caregiver sometimes involves giving up your previous lifestyle to reserve free time for an emergency and patient care logistics. Logistics include, but are not limited to, finances and housekeeping (which change as the course of the disease changes).
The emotional sphere: Caregivers often have feelings of anxiety and fear. Patients often feel that they are burdening their caregivers and relatives with their condition. Caregivers have been found to have a similar attitude, not wanting to burden others with the responsibilities or emotional baggage that comes with being a caregiver. Consequently, they suffer by themselves, unable to honestly express their feelings while being afraid to leave the patient to have well-deserved self-care. They often experience spiritual suffering, unable to find finding meaning in the disease.
As a medical student who is always looking for ways to help people, I have found many coping strategies backed by evidence that worked for my mother and other caregivers. The following is a list of strategies, that as a caregiver, may help you provide the best possible care while looking after your own well-being:
Ensure that you have a list of questions you can ask the doctor when going in for a visit. Make sure you cover the diagnosis, progression and what to expect, types of treatments, treatments in clinical trials, and end-of-life and palliative care. A full list of questions can be found at the National Cancer Institute. If possible, ask the hospital to send the results home before meeting up with the doctor to help you take in the news and develop better questions.
Establish your support system. Rather than bottling up emotions and avoiding burdening others, try to connect with others, spread the responsibility, and the emotional burden with close relatives or friends.
Know your support services. Joining a support group is an excellent resource for information on handling caregiver responsibilities, treatment options, possible side effects, warning signs, etc. It is also a safe space where you can vent your thoughts to those able to relate and learn from others about their coping strategies.
Keep doing the things you enjoy. It’s okay to leave the patient in the care of someone else for a few hours or a day so you can recuperate. It will only help you become a better caregiver and help you remember your loved one with fondness rather than as a burden.
Use mindfulness meditation and improve emotion-regulation. These will help you prepare for the hard days and the death of your loved one.
Understanding and anticipating the challenges will allow you to avoid some of the anxieties associated with caregiving and better manage your time so you can spend it with your loved one. Keep in mind that every caregiver-patient relationship is different. There is more than one way to be a great caregiver. I hope the strategies above (which are by no means an exhaustive list) will go a long way in promoting caregiver well-being physically, emotionally, and spiritually.
More Support
We’re aiming to support multiple myeloma patients and their family members through the JAA Fund. Small support grants are currently available for patients in St Kitts, Nevis, the British Virgin Islands, Trinidad and Tobago. If you’ve been affected by multiple myeloma, live in one of these countries and require some financial support, you can apply for a grant here
References
Aksoy, M., Erdem, Ş., Dinçol, G., Kutlar, A., Bakioğlu, I., & Hepyüksel, T. (1984). Clinical Observations Showing the Role of Some Factors in the Etiology of Multiple Myeloma. Acta Haematologica, 71(2), 116-120. doi: 10.1159/000206568
Howell, D., Hart, R., Smith, A., Macleod, U., Patmore, R., Cook, G., & Roman, E. (2018). Myeloma: Patient accounts of their pathways to diagnosis. PLOS ONE, 13(4), e0194788. doi: 10.1371/journal.pone.0194788
Monterosso, L., Taylor, K., Platt, V., Lobb, E., Musiello, T., & Bulsara, C. et al. (2017). Living With Multiple Myeloma. Journal Of Patient Experience, 5(1), 6-15. doi: 10.1177/2374373517715011
Multiple Myeloma. (2020). Retrieved 11 September 2020, from https://www.cancer.org/cancer/multiple-myeloma.html
Quiñoa-Salanova, C., Porta-Sales, J., Monforte-Royo, C., & Edo-Gual, M. (2019). The experiences and needs of primary family caregivers of patients with multiple myeloma: A qualitative analysis. Palliative Medicine, 33(5), 500-509. doi: 10.1177/0269216319830017
Waxman, A., Mink, P., Devesa, S., Anderson, W., Weiss, B., & Kristinsson, S. et al. (2010). Racial disparities in incidence and outcome in multiple myeloma: a population-based study. Blood, 116(25), 5501-5506. doi: 10.1182/blood-2010-07-298760
Today, we’re delighted to share a guest blog post from the team at Mesothelioma Guide. Mesothelioma Guide connects mesothelioma patients and their loved ones to top doctors, cancer centres and treatment options, plus legal resources. In today’s feature, they dispel the myth that the asbestos-related cancer, mesothelioma, has been eradicated since the introduction of legislation restricting the use of asbestos.
In the latter half of the 20th century, the general public learned of asbestos’ dangers. They learned the substance is, in fact, a carcinogen, one which can lead to aggressive diseases such as mesothelioma.
The awareness of asbestos’ harm led to increased regulations worldwide and scrutiny of businesses which used the mineral. Most people expected asbestos-related diseases like mesothelioma to level off early in the 21st century and eventually fade into obscurity.
This has not happened — nor will it any time soon.
According to the World Journal of Surgery, pleural mesothelioma cases in the United States increased from 2004 to 2014. The World Health Organization revealed that around 43,000 people worldwide die from this cancer. Despite more than 60 countries banning the commercial use of asbestos, the mesothelioma mortality rate has increased worldwide since the 1990s. This is proof that mesothelioma isn’t going anywhere.
National Cancer Database on Mesothelioma
In 2004, there were 1,783 pleural mesothelioma cases in the United States. In 2014, there were 1,961 reported cases. That’s an increase of around 10%.
Pleural mesothelioma accounts for between 70% and 80% of all U.S. mesothelioma cases and the same is true globally. Peritoneal mesothelioma and pericardial mesothelioma comprise the other 20-30% of cases.
According to numerous sources, including the Centers for Disease Control and Prevention, there are usually between 3,000 and 3,300 new mesothelioma cases in the U.S. each year. From 2012-2016, there were on average 3,253 new cases each year. In 2016 alone, 3,096 mesothelioma cases were reported.
The World Health Organization estimates that 10,000 new mesothelioma cases each year are diagnosed collectively in Australia, Japan, North America and western Europe.
In the United Kingdom, the incidence of mesothelioma has increased steadily each year from the 1950s (153 cases) to 2010 (2,360 cases). Like we said earlier, this disease isn’t going away.
But…
Mesothelioma Treatment Is Improving
Science continually evolves, which means treatment for diseases continuously improves. Mesothelioma treatment is getting better, which is good news for patients and their loved ones.
Earlier in 2019, The U.S. Food and Drug Administration approved the Novo TTF-100L medical device for pleural mesothelioma treatment. It is limited to humanitarian use device distinction, but this approval was a significant moment for mesothelioma patients and doctors.
Peritoneal mesothelioma treatment is expanding as well. Many patients receive cytoreductive surgery, plus heated intraperitoneal chemotherapy (HIPEC) immediately after the operation. In a study published by the Annals of Surgical Oncology, around 55% of participants who underwent this treatment combination survived for at least three years. Roughly 37% survived for at least five years.
This study only included a few peritoneal mesothelioma patients, and other studies have reported different percentages:
Between 50% and 65% for three-year survival
Between 35% and 47% for five-year survival
Mesothelioma Patients Undergoing Treatment More Often
The best route to healing from mesothelioma is undergoing treatment. Surgery is the first choice followed by chemotherapy and radiation. If more patients receive medical help, then more of them will survive longer.
In 2004, treatment and survival rates in the U.S. were as follows:
Approximately 34% of pleural mesothelioma patients underwent treatment.
Around 37% of them survived for at least one year after diagnosis.
Roughly 9% survived for at least three years.
In 2014, the rates were better:
Around 54% of mesothelioma patients received treatment.
Roughly 47% survived for at least one year after diagnosis.
Approximately 15% survived for at least three years.
We at Mesothelioma Guide can help patients find quality treatment and potentially extend their lives. Our patient advocate and registered nurse, Jenna Campagna, has connections to the top cancer centres in the USA.
If you or a loved one has mesothelioma, remember that treatment now is better than ever before. Jenna works with patients every day to improve their quality of life and prognosis. Email her at jenna@mesotheliomaguide.com if you wish to explore your treatment options.
More Information
If you have any questions on mesothelioma or would like any further information, you can leave your question for Mesothelioma Guide in the comments section below. Alternatively, you can visit Mesothelioma Guide’s website here, like their Facebook Page or follow them on Twitter.
Effect of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy on Quality of Life in Patients with Peritoneal Mesothelioma. Annals of Surgical Oncology. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/31069554. Accessed: 05/16/2019.
Survival prognostic factors in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy treatment: analysis from a single oncological center. WorldJournal of Surgical Oncology. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4815060/. Accessed: 04/12/2019.
World Cancer Day is on 4th February and it gives the world the opportunity to come together to raise awareness and campaign on key issues to improve the care, support and treatment given to patients.
Organisers, the UICC, announced that the theme for World Cancer Day is #IAmAndIWill and this theme highlights that fact that whoever you are, you have the power to reduce the impact of cancer for yourself, the people you love and for the world.
The campaign therefore encourages everyone to make a commitment by using the hashtag and sharing who you are and what you will commit to in order to tackle cancer.
Our #IamAndIWill Commitment for 2019-2021
Our World Cancer Day commitment is to focus on children and raise awareness of the fact that overweight or obese children are more likely to become overweight or obese adults, and being overweight as an adult increases a person’s risk of developing cancer. In fact, the World Cancer Research Fund has found that being overweight or obese throughout adulthood is linked to an increased risk of developing 12 types of cancer.
Our campaign appeals to parents to reduce their children’s future cancer risk by ensuring they’re a healthy weight now, and this can be achieved by ensuring that children:
Are physically active and take part in 60 minutes of physical activity every day
Eat a healthy diet
Childhood obesity is a significant challenge here in St Kitts and Nevis. A PAHO report revealed that 33% of secondary school children in the twin island state were overweight and 14% were obese. More recently, in 2017, a UNICEF report stated that 26% of children in St Kitts and Nevis are obese. We have to tackle childhood obesity to improve the health of our children to ensure they become happy, healthy adults.
We believe that by beating childhood obesity we can also contribute to beating cancer, and other non-communicable diseases (NCDs).
“I am Lake Health and Wellbeing and I will make an impact by spreading the word
about childhood obesity increasing a child’s future cancer risk” – #IamAndIWill
What We’re Doing Beyond World Cancer Day
Our work doesn’t stop after World Cancer Day, we’re working to beat childhood obesity all year round through our new childhood obesity prevention project.
We’re currently working on developing innovative resources to get children active so they can easily get to and maintain a healthy weight.
How You Can Get Involved
You can get involved by raising awareness on social media and sharing your thoughts on this issue. You can use any of the images below or the short video clips below.
Also, we’d love it if you could support us by making a donation, which will go towards our childhood obesity prevention project.
You can make a donation below:
[asp_product id=”5804″]
Thank you for any support you’re able to provide and we hope you’ll join us for World Cancer Day to #BeatChildhoodObesity and #BeatCancer
Yesterday, we were delighted to attend the St Kitts World Cancer Day Luncheon. This was an event organised as a celebration of hope to honour the lives of cancer survivors in St Kitts and Nevis. The event was organised by the Health Promotion Unit at the Ministry of Health with support from Lake Health and Wellbeing and the Department of Youth Empowerment.
The event featured talks from high-profile guests including the Minister of State with responsibility for Health, Social and Community Services and Gender Affairs, Minister Wendy Phipps and Chief Medical Officer Dr Hazel Laws.
We also heard from cancer survivors who shared their experience very powerfully through poetry and testimonies. Carla Astaphan recited her poem Left Breastie which she wrote shortly after she was diagnosed with breast cancer and Agness Farell spoke of her experience of being diagnosed in 1998, she recounted her ups and downs and the formation of her support group Reach for Recovery.
In addition to these presentations, the Coordinator of Community Nursing Services, Nurse Eulynis Brown gave a very informative overview of cervical cancer and the HPV vaccine which will soon be introduced in St Kitts and encouraged attendees to support the Ministry in its roll-out as it’s a very effective method of preventing cervical cancer.
The highlight of the event was the presentation made to the longest living, oldest and youngest cancer survivors. It was moving to see the longest living cancer survivor being recognised, she was diagnosed 21 years ago and faced both breast and lung cancer. Despite all her challenges, now at the age of 82, she is so positive, happy and full of life; a true hero and inspiration to us all.
This was a positive and uplifting event which demonstrated the strength of the human spirit and we were honoured to have attended and been asked to deliver the vote of thanks.
Today is World Cancer Day, a day that gives the entire world the opportunity to come together to show solidarity on an issue that pretty much touches everybody – whether that be directly or indirectly through a family member, friend or colleague who has been diagnosed. The day aims to be a positive day with the focus being on empowerment, celebrating the lives of those who have been diagnosed and highlighting that everyone has a part to play in fighting cancer.
The theme for today is “We can. I can.” and is part of a three-year campaign exploring how everyone can contribute to reducing the global burden of cancer. Organisers of World Cancer Day, the Union for International Cancer Control (UICC), have developed a set of key messages that show exactly how everyone, as a collective or as an individual, can play a role in reducing the impact of cancer. These messages are:
We Can:
Inspire action, take action
Prevent cancer
Create healthy schools
Create healthy workplaces
Create healthy cities
Support others to return to work
Challenge perceptions
Improve access to cancer care
Shape policy
Build a quality workforce
Make the case for investing in cancer control
Join forces to make a difference
I Can:
Make healthy choices
Understand that early detection saves lives
Ask for support
Return to work
Take control of my cancer journey
Love and be loved
Make my voice heard
The aim of these messages is to reduce the millions of preventable cancer deaths that sadly take place throughout the world each year by giving everyone clear information and pushing governments to make cancer a priority.
World Cancer Day in St Kitts.
As you may know, we are now based in St Kitts, and for World Cancer Day we are delighted to have partnered with the Health Promotion Team at the Ministry of Health to take the key messages of World Cancer Day out in the community.
We started with a social media campaign using the wonderful resources developed by the UICC and of course the #WeCanICan theme but added #SKNCan (i.e. St Kitts and Nevis Can) to raise awareness of what residents of St Kitts and Nevis can do to reduce their cancer risk.
As part of our social media activity we took the messages (physically, on selfie cards!) to the streets of Basseterre and asked members of the public, businesses and government departments what messages resonated with them and did they feel they might consider taking forward to do their part in beating cancer. We then took pictures of people holding the selfie cards with the message that best represented what people thought would be most effective and these were used to raise awareness last week, in the run-up to World Cancer Day.
This was a great way to raise awareness in the community, it was fun and a bit light-hearted, but still got important messages across to the public whilst creating some teachable moments as people asked questions about what they could do specifically to prevent cancer.
We’re also in the process of organising a cancer awareness lunch to be held on 11th February where we’ll be celebrating survivors, providing information on what the public can do to reduce their risk of developing cancer and promoting early detection through awareness of signs and symptoms and seeking help promptly.
You Can Get Involved
There is still time to get involved in this campaign.
You can visit the World Cancer Day’s website, download a selfie card, take a picture and post it on social media to show what you can do to help in the fight against cancer. Don’t forget to include the hashtags #WorldCancerDay, #WCD2018 and #WeCanICan. If you’re in St Kitts and Nevis, then go ahead and add #SKNCan.
For all the St Kitts residents out there, you can attend our cancer awareness lunch next Sunday. Stay tuned to our events page for all the details!
Over the years there have been numerous questions and concern about the impact chemicals in hair products have on our health. This concern has been heightened in the black community for some time, particularly with respect to relaxers (chemical hair straighteners).
Several studies have been conducted exploring if there is a link between hair products and fibroids, cancer and other conditions, but these have been inconclusive. When a link has been shown researchers have been cautious explaining that association doesn’t mean causation – i.e. they couldn’t prove that relaxers actually contribute to the development of fibroids or cancer and therefore they all recommended that more research should be conducted.
Latest Research
In June of this year, researchers from Rutgers University in New Jersey published the results from their research into specific hair products and whether their use is associated with an increase in breast cancer risk. In this study, researchers looked at 4,285 African America and white women; 2,280 had breast cancer and 2,005 didn’t. The study compared those with breast cancer to those who didn’t have breast cancer to determine if differences existed that may be linked to breast cancer risk. The women were aged 20-75 and were from New York City and ten counties n New Jersey.
The study aimed to determine if hair dyes, relaxers and deep conditioners containing cholesterol or placenta were associated with an increased risk in developing breast cancer. In order to explore this researchers collected vast amounts of data on the women who took part in the study. This included socio-demographic data and their exposure to known risk factors such as family and personal history of breast cancer, smoking, alcohol consumption and more. They also asked participants about their use of the previously mentioned hair products, what shade of dye they used and how long they used these products for.
What did they find?
The researchers found that for African American women there was a 51% increase in their risk of developing breast cancer among those who used dark brown or black hair dye. They also found that in African American women there was a 72% increase in oestrogen-positive breast cancers amongst those who used dark brown or black dyes and a 36% increase in oestrogen-positive breast cancers in those who used dyes more frequently.
In white women they found a 74% increase in breast cancer risk in those who used relaxers and a large increase in risk in women who used both relaxers and hair dyes. They also found that use of hair dyes resulted in a 54% increase in risk of developing oestrogen-positive breast cancers whilst relaxer use caused a 2.6 fold increase in oestrogen-negative breast cancers.
There was no link between deep conditioners and breast cancer.
What does this mean?
The researchers concluded that “these novel findings support a relationship between the use of some hair products and breast cancer.”
When speaking about their work, lead author of the research paper, Adana Llanos said
“Just because we found these associations doesn’t mean that if you dye your hair dark, or any colour, you’re going to get breast cancer, but at the same time, the study points to something else we should be mindful of.”
The results exposed a significant association with oestrogen-positive breast cancers so the current hypothesis is that the dyes may contain chemical compounds that are similar to oestrogen or stimulate pathways that cause the production of oestrogen. It was hard to determine this as women in the study weren’t asked what brands of products they used so researchers couldn’t explore the actual chemicals within these products that women were exposed to. But Alana Llanos said:
“There must be some role for oestrogen for sure.”
Her research team recognise that there were limitations to the study and that further work is needed to truly understand the link between hair products and breast cancer risk.
Our Thoughts
The Lake Foundation is pleased to see more research in this area being conducted and this work needs to continue until we have a definitive answer as to whether hair products affect our health or not. In the meantime, we would advise that women take a look at this research and make an informed decision as to whether they should continue using hair dyes and relaxers. We always say people should exercise caution in the use of products where there is found to be a credible association with cancer, or any disease, until a clear answer can be provided on whether that association means that a particular product contributes to the development of a disease.
More Information
You can read the full research paper for this study here
Friday 17th November was the second annual Caribbean Alcohol Reduction Day. This year’s theme was: Drink Less, Reduce Cancer and to mark the day the Healthy Caribbean Coalition, in collaboration with PAHO, CARPHA and CARICOM, hosted a webinar on Alcohol and Cancer in the Caribbean. This was a very informative and interesting webinar which featured three speakers:
Dr Kevin Shield – Alcohol Consumption and Cancer in the Caribbean
Dr Maristela Monteiro – Alcohol Policies in the Caribbean
Dr Rohan Maharaj – Alcohol use among the elderly in the Eastern Caribbean: Associations with NCDs and psycho-social issues
Alcohol Consumption and Cancer in the Caribbean
The first presentation was delivered by Dr Kevin Shield. He started by providing some background into cancer in the Caribbean explaining that the latest data, from 2012, shows that in the Caribbean about 21,000 new cancer cases are diagnosed every year and just over 13,000 deaths per year in the region are due to cancer. When we look at the number of cancers in the Caribbean caused by alcohol, it is estimated to be 650 cancer cases per year or put another way 3.1% of all cancers diagnosed in the Caribbean are due to alcohol consumption. Looking at the number of cancer deaths in the Caribbean due to alcohol, 2.9% of all cancer deaths are due to alcohol consumption or 387 deaths per year.
Dr Shield stated that in the Caribbean, on average, an adult consumes 1.2 alcoholic drinks per day, but there is a difference amongst countries with some countries drinking less and other drinking significantly more.
Infographic from Cancer Research UK
Dr Shield explained the link between cancer and drinking stating that numerous studies have been conducted that have determined how drinking causes cancer. Data suggests that alcohol causes cancer in the following ways:
By our bodies converting alcohol into a cancer-causing chemical (i.e. a chemical that can damage our DNA)
By affecting our hormone levels and various pathways in the body
Through research links have been found between alcohol and cancers of the mouth, upper throat, food pipe, voice box, breast, bowel and liver. The number one cancer impacted by alcohol is breast cancer.
Based on all of these factors the International Agency for Research on Cancer has classified alcohol as a type 1 carcinogen, which means there is the highest level of evidence to suggest that it does cause cancer. So drinking is a major problem.
The question then is: how can we prevent the cancers that are caused by alcohol? The solution is to reduce alcohol consumption and Dr Shield stated that there are three cost effective and feasible approaches that can be taken:
Infographic from Cancer Research UK
Restrictions on access
Banning advertising
Increasing excise taxes
This presentation ended on a fairly positive note highlighting that many Caribbean countries have not fully introduced these three measures which means that there is potential to make a huge difference in tackling alcohol and cancer in the Caribbean.
Alcohol Policies in the Caribbean
We then heard from Dr Maristela Monteiro who gave an overview of alcohol policies in the Caribbean. She started by explaining that as part of the voluntary global non-communicable diseases target for 2025 there is a goal to reduce harmful use of alcohol by 10%. WHO and PAHO, in consultation with a number of organisations, developed a global strategy to reduce harmful use of alcohol and they provided recommendations on 10 policy areas and countries are to try to implement as many as possible. They describe particular recommendations as “best buys” especially for low to middle income countries and these were the three areas mentioned by the previous speaker (restrict access to alcohol, enforce bans on advertising and raise taxes on alcohol).
Dr Monterio then went through each of these three policy areas giving an assessment of how successful Caribbean countries have been with their implementation. She started first with whether countries have a national alcohol policy in place. Out of the 14 Caribbean countries that they looked at only three had some form of national policy.
Dr Monterio then looked at policies to restrict access to alcohol:
Licensing: most Caribbean countries have a licensing system, 12 out of the 14 countries. Licensing systems restrict access by imposing rules and penalties to those who wish to sell alcohol such as not selling to minors, the license also has a fee and this may limit the number of businesses who choose to sell alcohol.
Restrictions on hours, locations and days of sale of alcohol: only three Caribbean countries were fully compliant in this area.
Minimum drinking age: most Caribbean countries have a minimum drinking age, only three don’t. The majority of countries in the Caribbean with a minimum drinking age have set this at 18, some have set this at 16. It was felt that 18 was a relatively low age restriction and this could be increased to 21 to have more of an impact.
Dr Monteiro then discussed taxation. She stated that in the Caribbean most countries have some taxation of alcohol, but these taxes were introduced many years ago and have not been adjusted for inflation. This means that taxation is not having the impact that it should as taxes are fairly low and are not acting as a deterrent.
Finally Dr Monteiro discussed restrictions on advertising and explained that this was the least developed area of policy in the Caribbean. She explained that this is a major problem as 20% of students are exposed to alcohol advertising daily and research has shown that this is associated with an increase in alcohol consumption. She explained how persuasive these advertising campaigns are and some of the tactics used to encourage people to drink – companies focus on alcohol as an antioxidant, that consuming alcohol causes weight loss and improves your mood (this communicates the message that alcohol is healthy) and equating drinking alcohol to business success.
Action needs to be taken to address advertising as research as shown that youths are more exposed to advertising than adults so there is a concerted effort by the alcohol industry to reach young people and make them life-long drinkers.
Alcohol Use and the Elderly
Finally we heard from Dr Rohan Maharaj who summarised a very interesting piece of research carried out across four Caribbean countries on alcohol use and the elderly. The research consisted of participants from Puerto Rico, Barbados, the US Virgin Islands and Trinidad. The data was collected from April 2013 to May 2015 and they determined whether people were ever-drinkers, current drinkers, problem drinkers or heavy drinkers and related this to various psycho-social and health issues. Their main conclusions were:
Generally there was wide use of alcohol across all participants
5-6% of participants were involved in potentially harmful alcohol use
Males were more likely to be problem or heavy drinkers
There was an association between alcohol use and stage 1 hypertension
There was an association between alcohol use in ever-drinkers and cancer
A higher proportion of those with lower educational achievement admitted to alcohol use
Those who were employed were more likely to be drinkers (thought to be because they had more disposable income)
Those who reported earlier initiation of sexual activity reported heavy drinking
Those who had issues with domestic violence (current or past) had reports of problem drinking
Heavy and problem drinkers tended to be lower educated males, living in Trinidad, married, physically active and employed with high rates of hypertension and being diabetic.
Dr Maharaj and his team will be doing a follow up study with participants in the next 2 to 3 years and this will give them the opportunity to further explore the link between alcohol use, cancer and other non-communicable diseases.
Conclusion
This was a very informative webinar and it’s so important that we get some of this information out to the public as we know that many people are not aware of the link between cancer and alcohol consumption.
For more information you can listen to a recording of the webinar here
We recently came across this really interesting video on TED and thought we’d share it with you. In this video you’ll hear from Dr Elizabeth Wayne, a biomedical engineer, who discusses the work her lab is undertaking to explore a more effective method to treat cancer. They researching how they can develop “a mean killing machine on wheels” by using cells in our immune system to target cancer cells.
Last week, we had the pleasure of attending the launch of Prostate Cancer UK’s Stronger Knowing More campaign. This campaign is aimed at black men and puts the spotlight on the fact that black men have a higher risk of developing prostate cancer. Black men have a 1 in 4 chance of developing prostate cancer, which is double the risk faced by white men.
The campaign was formally launched on 17th January at 15 Hatfields . The event started with a networking session where we were able to speak to staff members involved in developing this much-needed campaign, hear from men who have been affected by prostate cancer and view the very powerful images being used for Stronger Knowing More.
Powerful Imagery
Our first mission as we walked around the beautiful venue was to look at the exhibition of images which were created for the campaign.
Prostate Cancer UK worked with photographer Dennis Morris to create a collection of photographs of black men from the worlds of sport, politics and the arts as well as prostate cancer survivors in a show of strength against prostate cancer. The collection of images featured former WBA World Heavyweight champion David Haye, Olympic gold medallist, Linford Christie Labour MP, Chuka Umunna, writer and musician Benjamin Zephaniah, ex-England footballer Viv Anderson and Red Dwarf star Danny John-Jules.
Reading through the captions of the each picture was really inspiring, moving and empowering and we’re sure that as men see these it was make them reflect on their health and perceptions of prostate cancer.
It was also interesting to read the behind the scenes view of the creation of the pictures with photographer Dennis Morris explaining that each shot was carefully thought through. For his photo shoot he asked each of his subjects to select a location where they felt the strongest and he was able to capture moments of defiance, strength and vulnerability. It is hoped that the pictures will tap into the inner strength of men and when combined with information will defeat the silence and stigma around prostate cancer.
Moving Stories
During the networking session we spoke to several men with experience of prostate cancer and were so moved by their experience and the fact that despite their health they were working tirelessly to raise awareness and support other men. It was also interesting to learn of how some men came to be diagnosed, many by chance encounters with people who made them think which really highlighted that small gestures can make a huge difference in someone’s life.
We spoke to one man whose first words to us were: “that man saved my life” as he pointed to one of Prostate Cancer UK’s most well-known patient volunteers, Errol McKellar. He told us that he was waiting at a train station one day when Errol began speaking to him about prostate cancer and ended the conversation by giving him a leaflet, which he only took to “shut him up!” He said that leaflet stayed on his desk at work for two weeks and then during a slow day at work he read the leaflet and realised he had some of the symptoms of prostate cancer. He visited his GP and was later diagnosed with prostate c,ancer, which he said was devastating. All he could think about was not being there for his wife and children and not being around to see his children grow up, “they are still so young”. Luckily he was diagnosed at a fairly early stage and his future is bright, but had he not met Errol McKellar his story could have been so different.
Inspiring Speeches
After the networking session it was time for speeches. We first heard from Tom Shrophire, Trustee of Prostate Cancer, UK who gave some background to the campaign and how it came into being. He said that there was a need to publically acknowledge the heightened risk black men have and start implementing a solution that seeks to raise awareness as many men don’t realise they are at an increased risk. He said this work is part of Prostate Cancer UK’s aim to tame prostate cancer in the next 10 years and this means they have to make black men, black families and black communities a priority.
We also heard from Prostate Cancer UK ambassador, Errol McKellar, who shared his touching story about his experience with prostate cancer. He was diagnosed after reading a leaflet about the PSA test and then decided to have the test done. He explained how prostate cancer totally changed his life and was the most difficult challenge of his life. He described the importance of having a good support system and said he would have never made it through this disease without the support of his wife (“my wife was my strength”). He gave hope to men by saying his prostate cancer diagnosis had knocked him down, yes, but it hadn’t knocked him out. He gave a realistic view telling the audience that he is still battling some of the side effects of treatment and of the disease itself and it has taken him a long time to come to terms with how it has affected his life. He also described his more vulnerable moments, like when he was diagnosed, he said “he cried like a baby.”
We were so inspired by all the work Errol has done since his recovery. After he recovered from his treatment and was fit to return to work he was contemplating how he could make difference. So he decided that he would speak to every man that came into his mechanic shop about prostate cancer.
On his first day back to work he started with his first customer and asked him: “When last did you get your prostate checked?” He then offered his customer a 20% discount if he got a PSA test done and reported back to him. Sure enough a few months later the man return for his 20% discount having completed his PSA test but was shockingly diagnosed with early stage prostate cancer. The man said that Errol should donate the discount to charity and keep raising awareness. That was back in 2011 and since then Errol has spoken to hundreds of men about prostate cancer which has resulted in 26 men being diagnosed with prostate cancer, sadly two of those men have since passed away.
Finally we heard from actor Rudolph Walker, who has been working with Prostate Cancer UK for a number of years to raise awareness. Whilst he hasn’t had prostate cancer himself he spoke of his close friend who sadly lost his life to prostate cancer, but had he known the symptoms and been diagnosed earlier he may still be here today.
Getting Involved
On the night Prostate Cancer UK asked us all to make a pledge to support their campaign and raise awareness and we’ve pledged to do just that.
You can also get involved in this campaign and Prostate Cancer UK have said you could do any of the following:
Read the ‘information for black men’ guide, wear your ‘man of men’ charity pin badge, and spread the word. Give the second guide and badge to someone who needs it
So let’s all get involved in raising awareness, breaking down the walls of silence and work towards saving our husbands, fathers, brothers, uncles, grandfathers, cousins and friends from prostate cancer.
