Dickson Igwe. Photo: VINO/File

Gloria Fahie is a cancer survivor, President of the BVI Cancer Society, and well known Virgin Islands Community Stalwart. 

Is there a cancer problem in the VI? Many people this Writer has met believe so. However, without credible empirical evidence it is difficult to state, without equivocation, that there is a cancer problem in the country.

Now, Dean Greenaway is a Virgin Islands Sports Icon, Commentator, and Journalist. Engaged in dialogue with Greenaway on the afternoon of September 22, 2015, Greenaway highlighted a fact for the benefit of a fellow writer: that the incidences of chronic disease in the territory could be attributed to the swift change from a rural and agricultural community pre the 1980s, to rapid urbanisation and modernisation today.

Greenaway made the point that when the VI was an agrarian society people were a lot more physical. Life and daily survival demanded much greater physical effort and exertion than today. Residents ate the produce of the ground, and what the providence of nature provided.

Technology and computers have changed all that. Greenaway believes that present generations living in a services oriented economy will live shorter lives than Virgin Islanders and residents who grew up when the society was a farming and fishing community, and residents had to daily walk miles, over hills, and through the countryside, to school, farm, fishing dock, marketplace, and church.

What is clear is that the country moved away quickly from a diet based on the natural produce from local farming, to the importation of processed foods from the USA and elsewhere. That quick transformation from an agrarian to a services based economy could well be a factor in the increased incidence of chronic diseases such as cancer.

Then there have been non sourced assertions that there is a cancer cluster in the West of the island owing to the presence of an industrial estate at Pockwood Pond. Add to the list of factors that may cause cancer in the territory, resorts, hotels, restaurants, and bars in the country that continue to turn a blind eye to smoking, and smokers, despite the fact that it is illegal to smoke in public in this country. Smoking, especially second hand smoke, has been overwhelmingly linked with cancer and chronic disease. Smokers actually face the certainty that their habit will someday end their lives.

OK. A cancer diagnosis is frequently a frightening and life changing experience. And it affects everyone related to the person diagnosed. Thankfully, the possibility of survival today is much greater than in years past. This is due to the onset of time, and developments in cancer research and medical technology. Still a cancer diagnosis is financially catastrophic and sometimes tragic.

And, apparently, lifestyle can help prevent one getting cancer, and better the odds of surviving the disease, when a diagnosis of cancer has been given. However, it is imperative that adults, especially those with a history of cancer in their family, get regular checkups, and take extra care of themselves.

Good nutrition is one crucial factor in the fight against the onset of cancer. It has been stated that certain foods contain cancer fighting properties: oily fish, green tea, broccoli, citrus fruit, dark green leafy vegetables, sour sap, pomegranates, dark chocolate, tomatoes, red wine, grape juice, the list is endless.

The following narrative features two additional weapons in the war against cancer: exercise and a wonder drug called Aspirin.

Exercise is a panacea in the fight against cancer. In 2002, the Journal of Nutritional Sciences featured an article: “Physical Activity and Cancer Prevention.” In the story by Researchers Christine M Friedenreich and Marla R Orenstein, it was determined that there was evidence that there was a decrease in the risk of cancer with increased physical activity. To date the findings in the study have not been disproven.

Well, the evidence was classified as convincing for breast and colon cancer. It was classified as probable for prostate cancer, and slightly less probable for lung and endometrial cancers. There was insufficient evidence on the link between exercise and the decrease in other types of cancer.

Exercise, according to the researchers, also helped with “coping, rehabilitation, and survival after a cancer diagnosis.” Physical inactivity is one of the risk factors for cancer. Health experts, recommend at least 30 minutes of moderate to vigorous exercise daily.

Most interestingly, colon cancer prevention figures high in the link between cancer and exercise. “The most definitive evidence for an association between increased physical activity and reduced cancer risk, exists for colon cancer.” In 51 studies, colon cancer risk reduction averaged between 40 and 70% for men and women that exercised frequently.

The researchers stated that with the colon cancer studies, a very consistent risk reduction was found in the populations studied. In other words there is a clear and direct link between exercise and reduced incidence of colon cancer.

With breast cancer, researchers found that, the evidence for an association between physical activity and breast cancer was neither as strong nor as consistent as that found for colon cancer. Nonetheless, the positive effects of physical exercise for both breast cancer prevention and breast cancer treatment, rehabilitation, and survival, was classified as convincing.

The reduction in breast cancer risk of women who exercised regularly was notable. Of 32 studies, decreased breast cancer risk averaged between 30-40%. That is a significant reduction in risk for those who exercise daily. There is a caveat, however. “The relation between physical activity and breast cancer risk differs among subgroups of women. Then, the biological mechanisms for breast cancer are more complex than those for colon cancer, which make the link between reduced breast cancer risk and exercise more difficult to determine.”

With prostate cancer, “the evidence for an association between physical activity and prostate cancer was less consistent than what it was for either colon or breast cancer.” The link between exercise and decrease in the risk for prostate cancer was classified as probable by researchers. That means that a man that exercises regularly will probably reduce his risk of getting prostate cancer. In the study, there was a reduction in prostate cancer risk of men who exercised and who were physically active of between 10-30%.

Amazingly, a recent study showed that even the lifting of weights on a regular basis reduced the incidence of most cancers by up to 50%. So that visit to the gym to “pump iron” is not just for the “look good” factor, it could very well save life.

Now, an article in Nature.com of May 2012, by Researchers Michael J Thun, Eric Jacobs, and Carlo Patrono stated that “daily Aspirin use convincingly reduced the risk of colorectal cancer and the recurrence of adenomatous polyps in average risk populations.”

In fact, the researchers described how recently published secondary analyses of cardiovascular trials provided the first randomised evidence that daily aspirin intake may reduce the incidence of all cancers combined, even at low doses.

The caveat with the Aspirin prevention idea is that the questions are unresolved about the dose and treatment regimen needed for cancer prevention.

It also appears implausible that the low dose 75-100 mg recommended for cardio protection could effectively inhibit cancer. Still, in 6 trials of low dose Aspirin treatment, there was a 20% reduction in overall cancer incidence between 3 and 5 years after initiation and 30% after 5 years. Again, that is a significant reduction in the risk of all cancers by taking Aspirin.

Another caveat with Aspirin is the issue of internal bleeding. Anyone thinking about starting an Aspirin regimen should consult with a doctor first.

There is considerable evidence that lifestyle changes can impact the individual’s risk of getting certain types of cancer. That means if one lives in or close to Road Town, leave the car at home and walk to and from work every day. If one has to drive into town because of the distance between home and work place, leave the car at the work place and walk around town while at work.

In most developed countries, a culture is evolving where a great number people cycle to work where possible. Governments in these countries invest in cycle lanes and cycle safety as a matter of course. The social dividends include less pollution, less traffic, and a healthier population.

Lifestyle change means becoming more thoughtful about one’s diet. Increase the fruit and vegetable intake daily. Yes, Caribbean cuisine is tasty. But it is also loaded with starch and carbohydrates, and can be fatty. It may take effort to reduce the “fried stuff, and oily meats and chicken” but it is apparently worth that effort. Sodas and sweet juices too are also apparently harmful to the health. And smoking is the great “no no”.   

The fear of cancer in the VI is real. But we can help erase some of that fear by adopting an active lifestyle. Get moving, visit the gym, ride bikes, and take care about a healthy diet. Consult your doctor about the benefits of an Aspirin regimen. Get regular checkups. And of course, stop smoking!

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