Health Watch: Cancer - Are We Any Further On?
Byline: SANDRA CHAPMAN
Few illnesses spread as much fear as cancer. In Northern Ireland it is the second most frequent cause of death after circulatory disease. Men here have a one in six chance and women a one in eight chance of dying from it before the age of 75 years. More than two years into the new Millennium are we any further forward in making inroads into this disease?
Every year in European Union countries alone, more than 1.5 million new cancers are diagnosed with about 750,000 deaths.
Experts believe that efforts to combat cancer will only be successful if there is a sustained campaign against the risk factors which cause cancer by increasing the uptake of screening programmes, improving the quality of treatment and care services and by ongoing research.
According to the Health Promotion Agency, in Northern Ireland the Department of Healths approach to the problem is to support the Europe Against Cancer programme with its main emphasis on prevention.
The belief is that we can all take steps to prevent or lower the risk of cancer.
The most important one is not to smoke; others include keeping weight within a healthy range, and eating a diet low in fat and high in fruit and vegetables, reducing alcohol consumption and avoiding excessive exposure to the sun.
The Department of Health, recognising that policies needed to be developed to cover prevention, early detection, effective investigation, treatment and palliative care, put together the Investing for Health report which was published last March.
This report seeks also to shift the emphasis from treatment to prevention by addressing the wider determinants of good health. It also aims to reduce health inequalities and has identified tackling smoking as a priority.
An earlier report in 1996 worked on the basis that the quality of cancer care could be significantly improved by encompassing cancer centres, cancer units and referral from primary care. It recommended one regional centre to be established which would also provide services for local catchment populations and the setting up of four additional cancer units at Altnagelvin, Antrim, and Craigavon hospitals with Belfast City/Royal Hospitals acting as a cancer unit and cancer centre.
Northern Ireland also co-operates with other medical experts in Southern Ireland and in the United States through an historic agreement signed in 1999.
Research into the disease is funded by an estimated 250 charities (the two main ones in NI are Ulster Cancer Foundation and Action Cancer), numerous government bodies and the pharmaceutical industry. Northern Ireland is also party to the National Cancer Research Institute which provides a focus for all aspects of UK cancer research.
Cancer research in the UK has an annual spend of pounds 257m. yet prevention of the disease is given only 2 per cent of the funds.
In Ulster 13 research projects are underway.
All cancers have a genetic basis. Damage to our genes with increasing age through the environment, sunlight, radiation (natural and through x-rays), dietary toxins and degenerative ageing changes within the cells in the body all damage DNA.
This is why the biggest risk factor for cancer is increasing age as mutations or genetic changes to DNA accumulate steadily as we get older.
By 2020 almost 50 per cent of the population will develop cancer in old age, as health professionals will have reduced mortality from other sources such as heart disease and stroke.
Most of these cancers, however, occur in older age due to the factors mentioned above, rather than being heritable.
Early onset cancers are often hereditary, ie caused by genes which are inherited from one or other parent. Around 5 per cent of cancers, such as breast and bowel, are now recognised to be familial.
Over the last few years cancer genetics has arisen as a new sub-discipline of clinical genetics. …