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Making informed choices crucial – doctor

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Raising awareness: Dr Chris Fosker, of Bermuda Cancer and Health Centre, gave a speech at the Hamilton Rotary Club to mark Movember (Photograph by Akil Simmons)

Clinical oncologist Chris Fosker has reiterated the importance of making informed choices in relation to cancer.

The medical director of Bermuda’s first radiation therapy facility spoke to the Hamilton Rotary Club as the island marks Movember.

“The overall message is about making informed choices,” Dr Fosker, who works on-island with Bermuda Cancer and Health Centre and Bermuda Hospitals Board, told The Royal Gazette.

“Firstly, in relation to understanding the importance of lifestyle and how it can impact on both your cancer risk and your treatment outcome.

“Secondly, the importance of understanding cancer risks and cancer facts to emphasise the importance of working in collaboration with you doctor.

“Finally, in relation to having the choice to have the best treatment for cancer by having access to radiation here in Bermuda.”

Started in 2003, Movember has grown from a focus on prostate cancer to become a general men’s health promotion that encourages men to talk about their health.

“It now has four main areas of focus: prostate cancer, testicular cancer, mental health and physical inactivity,” Dr Fosker explained. “As an oncologist, I can talk most accurately about these from a cancer perspective.”

According to Dr Fosker, “research shows that men experience fear, depression and a sense of isolation after a cancer diagnosis”.

This can be compounded by being away from family, as is the case with overseas treatments, he said. “It has been shown that men who have good support through and after treatment have a greater sense of normality and less fear and depression.

“It has also been shown that those who have supportive family around them through and after treatment have a greater chance of being cured of their cancer.”

Lifestyle, which is responsible for 45 per cent of men’s cancer, is also important, he stressed, adding that regular exercise can increase the chance of cure.

And he added: “Those who exercise regularly through treatment and after treatment have less physical and mental side effects from their cancer treatment.”

In highlighting cancer statistics [below], he also reiterated the importance of patients discussing their options with their doctors and understanding their treatment choices.

Dr Fosker also noted the benefits of having radiation therapy available locally through the facility being built at the Bermuda Cancer and Health Centre.

He said the treatment was being brought to the island in light of the increasing burden of cancer globally and in Bermuda and to give patients the best treatment choices.

Dr Fosker said there were about 300 cases of cancer reported to the tumour registry in Bermuda a year, although this number is approximate because registration is not mandated.

Using worldwide research, Bermuda Cancer and Health Centre estimates about 200 patients in Bermuda should benefit from receiving radiation per year. And the facility will be able to treat 95 per cent of cancers on the island.

Cancer stats

Dr Fosker shared the following cancer statistics during his presentation to emphasise the complexity of choice and the need to have a relationship with your doctor to be able to make informed decisions.

• World Health Organisation is predicting a 70 per cent increase in new cancer cases worldwide over the next 20 years.

• The proportion of men’s cancer attributed to lifestyle (smoking, diet, lack of fruit and vegetables, lack of exercise, obesity) is 45 per cent.

• Men have a 50 per cent lifetime risk of being diagnosed with cancer and a 35 per cent higher chance of dying of cancer than women.

• Some studies indicated that men have an 80 per cent chance of having prostate cancer when they are 80. Others suggest that there is a 10 per cent chance of finding prostate cancer in 20-year-olds.

However, no one anywhere in the world is advocating men under 40 years of age get checked for prostate cancer. Why? It is very complicated and to understand an individual’s need to be checked for prostate cancer should involve an informed discussion with your doctor.

• There is a 99 per cent chance men will not die of prostate cancer 10 years after diagnosis if it is defined as low-risk at diagnosis and they received radiation or surgery at that time. However, there is also a 99 per cent chance they will not have died from prostate cancer 10 years after diagnosis if it is defined as low-risk at diagnosis and they received NO treatment at that time. So why do up to 80 per cent of men have treatment? It is a complex choice.

• Of all cancers that are cured, 40 per cent are cured by radiation, 50 per cent by surgery and 10 per cent by chemotherapy.

• Two thirds or 66 per cent of new cancer patients should receive radiation as part of their treatment if guidelines are followed correctly.

Fighting cancer: Dr Chris Fosker of Bermuda Cancer and Health (Photograph by Akil Simmons)
Minimising impact: Dr Chris Fosker of Bermuda Cancer and Health (Photograph by Akil Simmons)