CANCER specialist Dr Margaret Dingle Spence has seen enough people writhe in pain, then die from the disease to last a lifetime.

It’s a reality the consultant oncologist at Hope Institute wishes she didn’t have to experience, but the numbers she saw at the outpatient clinic at the National Chest Hospital alone last year show an increase in cancer of the lung in particular.

“We saw 565 patients in the clinics for the year, and of that, 126 were new… That’s three or four newly diagnosed lung cancer patients every week,” she said.

“If you look at how that looked in 2009, we saw 88 new patients compared to the 126 we saw last year, and about 70 per cent of those had lung cancer… that represents a 44 per cent increase in lung cancer diagnoses in the last three, four years.”

Whether that means that more people are being referred to the oncology clinic for treatment, or that there is a real increase in the incidence is moot.

“Either way, it’s worrying,” the doctor said during a panel discussion hosted by the National Council on Drug Abuse in observance of World No Tobacco Day on May 31.

The statistics show that men outnumber women seven to one, with the most common age being 48.

“These people are in the prime of life. We do see a male/female distribution of seven to one, and when we check the history, a majority of the men, not so many of the women, will unfortunately tend to be second-hand smoking,” said Dingle Spence.

In terms of occupation, the oncologist said farmers and construction workers were the most frequently seen. Teachers too, with a “20/30-year history of teaching and chalk dust exposure”, also showed on Dingle Spence’s radar.

“When we talk to the men, they started when they were 10 or 12… and would smoke for the rest of their lives, and the farming and construction workers were the ones who were most frequently seen, and that’s a bit of a worry because banning smoking in public space is not going to make much difference to those guys because they’re out in the field,” she said, adding that in those cases early detection was key.

Her comment followed a pronouncement by Health Minister Dr Fenton Ferguson that Government was close to passing a Bill banning smoking in public places. The ban, he explained, is a means of reducing the incidence of cancer which, together with diabetes, cardiovascular disease, and chronic respiratory diseases (non-communicable diseases), account for the major causes of death in Jamaica and cost the ministry over US$170 million to treat each year. He said Government was committed to reducing NCDs by 25 per cent by 2025.

Dingle Spence knows about the death toll all too well, having lost her partner of seven years, whom she described as an inveterate smoker, to cancer of the bladder two years ago.

“In two years, even at stage one, only six per cent of the people are still alive, and that’s the earliest stage. And at stage four — and most of the people are already at stage four by the time we see them — their life expectancy, even with treatment, is not great. So it’s not pretty… I would love to be put out of business so we don’t see this at all,” the oncologist said.

“One of the really rough things is that we often see people who come and it’s already spread, so cure is really very challenging,” she added.

Other than the physical toll of the incidence is the fact that resources dedicated to cancer care and treatment in the country are scarce. According to Dingle Spence, the Hope Institute is the only public sector oncology unit in the English-speaking Caribbean which provides free cancer care. It was built by the Jamaica Cancer Society in 1963, but is now operated by the health ministry, which took it over in the ’70s.

The 38-bed facility, which features a chemotherapy unit with four beds and four day chairs, also offers palliative, respite and terminal care. It doesn’t have a radiation therapy machine, but transports patients to KPH to use the equipment there.

The Hope Institute hosts weekly clinics on its premises, at National Chest, and at Kingston Public Hospital where Dingle Spence says she sees an “increasingly large” number of patients accessing palliative care. Palliative care eases the symptoms of cancer without curing the disease and is used in the late stages of the disease.

Dingle Spence said while lung cancer was linked to smoking, environmental pollution and irritants such as chalk dust were also culpable. In addition, she said though lung cancer may be the most common form of the disease among smokers, other areas of the head, face and neck, including the oesophagus, larynx, pharynx, and lips are prone as well.

She said, too, that smokers have an increased risk of developing leukaemia, as well as cancers of the breast, cervix and colon.

“I’m an oncologist, but I don’t love looking after people with cancer,” she told the Jamaica Observer in a post presentation interview.

“I do it because that’s my job and I chose it because there’s a huge need, but wouldn’t it be a great world where it’s a very rare disease and we could go and do something else?”