We need a robust public health education programme on cancer

Dear Editor,

Cancer is the greatest global public health challenge of the 21st century. The tragedy is in the staggering numbers of lives affected globally.

In 2014, 14.2 million cancers were diagnosed with 8 million deaths, by 2030 22 million cancers will be diagnosed with 14 million deaths

Almost 75% of all cancers will be diagnosed in Low & Mid Income Countries (LMIC), like Guyana.

Those countries are the least equipped to prevent, detect early and treat these patients. The tragedy is that more than 80% of all cancers in LMIC are not only preventable but diagnosed with late stage 3/4 metastatic disease, and the majority live 6-12 months with little or no access to palliative care. Most will die with unbearable pain.

The following are the challenges and some solutions to deal with cancer.

Prevention is the cure – There is overwhelming evidence that lifestyle choices drive cancer. Tobacco is the number 1 cause. Alcohol and poor nutrition, food such a fundamental staple has been stripped of nutrition and replaced with excess sugar, salt, fat and artificial flavour and chemical compounds. Calorie-dense foods consumed in excess and a lack of physical activity are a major driver of obesity which causes cancer, heart disease & Type 2 Diabetes which is given the acronym Non Communicable Disease (NCD) – a term that truly does not resonate with anyone.

We know NCDs kill 80% of the world population in LMIC, and more than 70% of these diseases are preventable.

Should we not change the name to preventable killer disease. Change can be a good thing.

Other risk factors that cause cancer are unprotected unsafe sex with exposure to five Sexually Transmitted Viral Infections that cause 10 cancers, the most common is cervical cancer in women caused by the HPV virus. Thankfully the government now has in place an HPV vaccination programme that will in future reduce this cancer. Every young girl should sign up for this vaccine.

Pollution with exposure to 124 different Carcinogens, (cancer causing compounds) according to the World Health Organisation is also a risk factor. (EPA please take note.)


We need a robust public health education programme to inform and educate the public that cancer is caused by poor lifestyle choices and a lack of discipline. If people choose to stop smoking, and drinking alcohol, eat healthy nutritious food, increase physical activity, practice safe sex and avoid pollution, we can significantly reduce exposure to cancer agents.

This public health education programme must start in schools and be part of the curriculum, at the University and workplace. The Government & NGOs must play a leading role in this respect and must include banks, insurance companies, unions, teachers, nurses, doctors and all professional bodies and the media. All must be involved, or all will be affected.

Health is the most precious gift we all take for granted, until we become sick.

Cancer screening – early detection & treatment save lives

Everyone needs to know the simple signs and symptoms of cancer -if anyone has these symptoms or signs it may be cancer.

Go to a doctor who understands and can screen effectively for cancer.

We need a national screening programme, that will detect early stage cancer 1 & 2.

Palliative care – WHO states that no cancer patient should die without access to critical pain relieving medicines. However the amount of narcotic drugs like morphine available to treat cancer is about 2 mg per patient when available. Yet in certain first world countries tens of thousands of people die from drug overdoses with narcotics. This lack of pain medicines to treat terminal cancer patients needs to be addressed urgently.

Cancer is a complex disease- there are some 100 types of cancers. To treat cancer is very expensive. Only rich people can afford to have cancer, yet it is mainly the poor who get cancer. With limited access to cancer screening, diagnosis and treatment, they suffer disproportionately.

Our current standard of care for advanced cancer is not encouraging, we lack the infrastructure, the human and financial resources.

However if we are willing I am certain we can solve this cancer crisis – all we need is the leadership and will to make this happen.

If not now. When?

Yours faithfully,

Carl Niamatali

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