PORT MORESBY - We are all susceptible to cancer regardless of age, sex, race, health and socioeconomic situation.
Cancer strikes indiscriminately. It takes alike the old and young, weak and robust, eliminating a former common misconception- one of many myths of cancer - that it is mainly an ailment consigned to the older age bracket.
In recent years males are catching up to cancer’s prevalence amongst females - shattering another misconception that females are more prone to cancer.
Unlike death and its inevitability, cancer can be fatal, but is also avoidable and treatable, given the right drugs and equipment.
And it can be curable as well if diagnosed and treated at the earliest stage.
I was privileged to speak to the late Dr John Niblett about this in July 2013. At the time this great and selfless man was director of the Angau Memorial Hospital’s cancer treatment centre.
Dr Niblett (God rest his soul) died on 4 July 2017 – an especially tragic passing given his cruel expulsion from the treatment centre by an ingrate National Department of Health and the Health Minister at the time.
In light of the Marape government’s recent announcement of a sizable capital injection of K60 million into the country’s two top hospitals to ensure cancer treatment will be available next year, I am prompted to revisit my enlightening conversation with the late Dr Niblett.
Then a leading cancer specialist and the only resident radiation oncologist in PNG, Dr Niblett said given the underdeveloped, underfunded, understaffed and under-informed cancer response by the health department, early detection was the only hope anyone afflicted by cancer had to be given a fighting chance to survive.
Back in 2013, the statistics painted an almost hopeless picture of the cancer situation in the country. Of an estimated 2,000 cancer cases each year, an average of 400 were detected and referred to the cancer centre for treatment management.
This was a mere 40% compared to the outstanding 60% of undetected cases, implying that some 1,200 unfortunate people suffered in what can only be described as dreadful circumstances without treatment and without hope.
The progressive physical ravages of cancers of the mouth, throat and breasts are horrific, not to mention other parts of the body.
The disease eats (for want of a better descriptive word) relentlessly into the afflicted area and the pain and misery can only be described as unthinkable from the screams and moans punctuated by heart wrenching pleas for death to intervene and end it quickly.
I was there and witnessed it all first hand when I was ‘wasman’ for my late partner who went through months of a rigorous combination treatment regime of chemo and radiation therapy in 2013 only to succumb between-treatments in 2016 while teaching at a remote secondary school in Chimbu Province.
The situation was even grimmer as Dr Niblett disclosed that most of the 40 inpatients at the treatment centre had arrived with stages 2 and 3 malignancy which were terminal and beyond treatment.
In such cases, the centre was left with no choice but to discharge the terminal cases to return home to await the inevitable outcome in utter misery and despair.
I though this a rather cold clinical decision and said so, but Dr Niblett explained that it was necessitated by limited beds, medication, equipment, doctors and clinical staff.
Since 2013, I can only imagine that the cancer situation has worsened while the national response has declined, prompting the level of response by the prime minister last week.
Angau Memorial Hospital in Lae has now been allocated K30 million to redevelop and improve cancer services and Port Moresby General Hospital K28.5 million to develop a second cancer facility.
That is on top of K20 million allocated to Angau previously, according to health minister Elias Kapavore.
“Drawings have been completed for two radiation therapy cancer machine bunkers, nuclear medicine department with PET scan and Gamma Camera, and 15-bed day care chemotherapy centre,” Kapavore said this week.
“Construction would start this month and services are expected to start in the first quarter of next year.
“The Linac system for cancer treatment has been ordered and the contract awarded to Varian Medical Systems Varian,” he said.
Kapavore said the running costs of using both Cobalt-60 and the Linac systems are very high and specialist medical and technical staff are required and the cost of each person is about K2 million a year.
He said the government is committed to make sure that this important service is available.
“In order for hospitals to treat cancers, early detection is vital,” Kapavore said, adding that services and information required to support early detection were available but not always used.
He said access to screening machines and prostate checks were available in both public and private hospitals.
That is the crux of the matter. Medical science has made significant progress with cancer in its many forms but is yet to answer some most critical questions about its causes and cures.
According to the late Dr Niblett, the increase in PNG cancer cases can be attributed to the increasing availability of processed foods and the drastic dietary and lifestyle changes happening in the country.
Dr Cathy Timothy, a physician at Angau, also said that cancer to some extent is hereditary.
But both doctors concurred that cancer is predominantly a lifestyle disease that can be avoided if appropriate changes can be made at the personal level.
First published in The Morobean magazine in 2014