What it is?
Cancer is one of the four main non-communicable diseases in Fiji and around the world.
Cancer is the general name for a group of more than 100 diseases. Although there are many kinds of cancer, all cancers start because abnormal cells grow out of control. Untreated cancers can cause serious illness and death.
Cancer has become a global epidemic and affects people of all ages. Unfortunately, cancer cases in Fiji have steadily increased over the past several years and it is now the 3rd most common cause of death in Fiji.
In Fiji, statistics reveal that there is mostly an increasing incidence of breast, cervix and other reproductive tract cancers in women. In men cancers such as prostate, liver, rectum and lung cancer are becoming more common.
Cancer in Fiji
Though there are many different types of cancer and cancer sites, recent statistics (taken from the Ministry of Health’s 2013 Annual Report) indicate that the most common cancers in Fiji are;
Top 5 cancer sites in Men;
Top 5 cancer sites in Women;
1. Cervix (Reproductive system)
3. Uterus (Reproductive system)
4. Ovary (Reproductive system)
You can learn more about each of these types of cancer below.
How does Cancer start?
Cancer starts when cells in a part of the body start to grow out of control. Cancer cell growth is different from normal cell growth. Instead of dying, cancer cells continue to grow and form new, abnormal cells. Cancer cells can also invade (grow into) other tissues, something that normal cells cannot do. Growing out of control and invading other tissues are what makes a cell a cancer cell.
Cancer cells often travel to other parts of the body where they can grow and form new tumors. This happens when the cancer cells get into the body’s bloodstream or lymph vessels. Over time, the tumors replace normal tissue, crowd it, or push it aside. The process of cancer spreading is called metastasis.
What causes Cancer?
Cancer is a very complex group of diseases with many potential causes. There are several known factors that can increase your risk of cancer, many of which are lifestyle factors that are within your control to change.
Known Causes of cancer include;
- Tobacco Use
- Bad Diet
- Physical Inactivity
- Sun and UV exposure
- Other Carcinogens (environmental causes)
How can I reduce my Risk of Cancer?
Leading a healthy lifestyle is a very good way to reduce your risk of cancer, looking at the above list of known causes, there are some very clear steps you can take to reduce your risk of cancer, and also lead a healthier and happier lifestyle. These are;
- Don’t use tobacco
- Eat a healthy diet
- Be Active and maintain and healthy weight
- Reduce/Moderate Alcohol Intake
- Practice safe sex and avoid risky behaviours
- Get Immunised (HPV & Hepatitis)
- Know your family medical history and get regular screenings
Common types of Cancer
Hepatocellular carcinoma (HCC) is cancer that originates in the liver. This type of cancer is often caused by cirrhosis, a scarring of the liver, infection with the hepatitis B or C viruses, and hemochromatosis (too much iron in the liver).
Primary liver cancer tends to occur in livers damaged by birth defects, alcohol abuse, or chronic infection with diseases such as hepatitis B and C, hemochromatosis (a hereditary disease associated with too much iron in the liver), and cirrhosis.
More than half of all people diagnosed with primary liver cancer have cirrhosis — a scarring condition of the liver commonly caused by alcohol abuse. Hepatitis B and C and hemochromatosis can cause permanent damage and liver failure. Liver cancer may also be linked to obesity and fatty liver disease.
Here are some steps you can take to reduce your risk of liver cancer
- If you risk exposure to hepatitis, ask your doctor about getting immunised.
- Practice safe sex and avoid IV drug use.
- Drink alcohol only in moderation.
- If you work around chemicals linked to liver cancer, follow safety guidelines to avoid unnecessary contact.
- Do not use anabolic steroids unless medically necessary.
Learn More about Liver Cancer
There are often no early prostate cancer symptoms. Genetics, age and possible diet play a role in its development. Men over the age of 50 are in the high-risk category and should get regular screenings from the doctor.
See your health care provider if you have any of the following symptoms:
- Difficulty initiating or stopping a urine stream
- Frequent urination
- Pain on urination
- Pain on ejaculation
There is no evidence that you can prevent prostate cancer. But you may be able to lower your risk with;
- A diet that helps maintain a healthy weight
- Limiting high-fat foods
- Cutting back on red meats, especially processed meats such as sausages, canned meats
- Eating five or more servings of fruits & vegetables each day
Learn more about Prostate Cancer
Lung cancer and smoking often go hand in hand, quitting smoking is the best thing you can do to reduce your risk of lung cancer. As lung cancer stages advance, lung cancer symptoms include coughing, wheezing, shortness of breath, and bloody mucus. See our section on lung disease to learn more about lung cancer symptoms.
Learn more about Lung Cancer
Stomach cancer is a disease in which malignant (cancer) cells form in the stomach. Over time, the cancer may invade more deeply into the stomach wall and spread to nearby organs. Smoking and certain chronic conditions increase the risk of developing stomach cancer.
People with early stomach cancer don’t usually have any symptoms. If there are symptoms, they are typically vague. These can include:
- Indigestion and stomach discomfort
- A bloated feeling after eating
- Mild nausea
- Loss of appetite
In more advanced stages, symptoms of stomach cancer can include:
- Discomfort or pain in the upper or middle part of the abdomen
- Blood in the stool, which appears as black, tarry stools
- Vomiting or vomiting blood, which may look like coffee grounds
- Trouble swallowing
- Weight loss
- Pain or bloating in the stomach after eating
- Feeling of fullness after eating a small amount
- Weakness or fatigue associated with anemia
- A build up of fluid in the stomach called ascites
Learn more about Stomach Cancer
Colon cancer and cancer of the rectum can begin as a small polyp, detectable through regular cancer screening, such as colonoscopy. Colon cancer symptoms include a change in bowel habits or bleeding, but often there are no symptoms. With early detection, surgery, radiation, and/or chemotherapy can be effective treatment.
Learn more about Colorectal Cancer
Cervical cancer is mostly caused by the human papillomavirus, or HPV. An HPV immunisation may reduce the risk of cervical cancer. In Fiji, the HPV immunisation is now offered free to girls in class 8. Ask your doctor about the HPV immunisation. Symptoms of cervical cancer can include painful sex, vaginal bleeding, and discharge.
Learn more about Cervical Cancer
The first sign of breast cancer often is a breast lump or an abnormal mammogram. Breast cancer stages range from early, curable breast cancer to metastatic breast cancer, with a variety of breast cancer treatments. Male breast cancer is not uncommon and must be taken seriously.
In its early stages, breast cancer usually has no symptoms. As a tumor develops, you may note the following signs:
- A lump in the breast or underarm that persists after your menstrual cycle. This is often the first apparent symptom of breast cancer. Lumps associated with breast cancer are usually painless, although some may cause a prickly sensation. Lumps are usually visible on a mammogram long before they can be seen or felt.
- Swelling in the armpit.
- Pain or tenderness in the breast. Although lumps are usually painless, pain or tenderness can be a sign of breast cancer.
- A noticeable flattening or indentation on the breast, which may indicate a tumor that cannot be seen or felt.
- Any change in the size, contour, texture, or temperature of the breast. A reddish, pitted surface like the skin of an orange could be a sign of advanced breast cancer.
- A change in the nipple, such as a nipple retraction, dimpling, itching, a burning sensation, or ulceration. A scaly rash of the nipple is symptomatic of Paget’s disease, which may be associated with an underlying breast cancer.
- Unusual discharge from the nipple that may be clear, bloody, or another color. It’s usually caused by benign conditions but could be due to cancer in some cases.
- A marble-like area under the skin.
- An area that is distinctly different from any other area on either breast.
Learn more about Breast Cancer
Endometrial cancer is the growth of abnormal cells in the lining of the uterus. The lining is called the endometrium. Endometrial cancer is also called cancer of the uterus, or uterine cancer.
Endometrial cancer usually occurs in women older than 50. When it is found early, there is a good chance of curing it before it spreads.
Women who have this hormone imbalance over time may be more likely to get endometrial cancer after age 50.
The most common symptoms include:
- Bleeding or vaginal discharge not related to your period (menstruation).
- Pain during sex.
- Pelvic pain.
Learn more about Uterine Cancer
Ovarian cancer warning signs include ongoing pain or cramps in the belly or back, abnormal vaginal bleeding, nausea, and bloating. Depending on the cancer stage, ovarian cancer treatment includes surgery and chemotherapy.
Ovarian cancer may cause early symptoms. Talk to your doctor if you have one or more of the following symptoms almost daily for more than 2 or 3 weeks:
- Pain in your belly or pelvis.
- Trouble eating, or feeling full quickly.
- Urinary problems, such as feeling an urgent need to urinate or urinating more often than usual.
These symptoms may be common for some women. They may not mean that you have ovarian cancer. But the early symptoms of ovarian cancer follow a pattern:
- They start suddenly.
- They feel different than your normal digestive or menstrual problems.
- They happen almost every day and don’t go away.
Learn more about Ovarian Cancer
How is it treated?
Cancer treatment may include chemotherapy, radiation, and/or surgery. There are many factors to consider and your doctor is the best person to recommend the type of treatment you need. Treatment can depend on the type of cancer, how advanced it is and what treatment is available.
Currently all cancer cases are being managed in the 3 divisional hospitals (Oncology Units). The local treatment used is in the form of surgical intervention and limited chemotherapy. Those requiring radiotherapy are referred overseas through Government assistance.
Chances of beating cancer are much greater if it is caught early, so be aware of your body and the symptoms and ask your doctor if you have any concerns.
Ministry of Health: Action on Cancer
The Health Ministry remains committed towards the reduction of cancer morbidity and mortality, improving the survival rates of cancer cases and improving the quality of life of cancer victims.
Since 2009 the Health Ministry has made vast improvements in terms of new advocacy and prevention programs including;
- Improved national database in collating cancer statistics.
- A newly set up liquid Cytology screening lab.
- Introduction of HPV virus vaccination initiative supported by the Fiji and Australian Governments.
- V.I.A (Visual Inspection with Acetic acid and Cyro-cautery) as cost effective means to treat precancerous lesions on the cervix undergoing trials.
- A rudimentary Domiciliary Palliative Service is operational in Suva and the West with the support of the Fiji Cancer Society.
- Fiji has become a member state of the International Atomic Energy Agency (IAEA) and representatives from the International Atomic Energy Commission will be here to assist in the establishment of a cancer hospital supported by the government, (the first of its kind in the Pacific Region). Having a Cancer Hospital will centralize all the relevant treatment and management protocols and provide a serene environment for patients and families.
- The Health Ministry through its Wellness Concept has continuously advocated and created awareness on cancer prevention and control program through healthy lifestyle.
- The Health Ministry is working with the International Women Agencies and is the final stages of setting up a wellness center for women in Suva. We are also working in partnership with UNFPA and other agencies towards the setting up of a wellness center in Lautoka. This center will provide awareness ,information and services to women on sexual, reproductive health, cancer screenings and counseling sessions.