Funding for Micronesian cancer research via Hawaii, Guam
Updated
A health survey of cancer patients in Micronesia has just received an injection of funds to continue the research. The US National Cancer Institute has awarded a combined grant of $US12.6 million to the University of Hawaii's Cancer Research Center of Hawaii, and the University of Guam, to continue the work.
Presenter: Geraldine Coutts
Speaker: Dr Carl Wilhelm-Vogel, Principle Investigator with the Research Centre of Hawaii at the University of Hawaii
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WILHELM-VOGEL: The state of Hawaii as you may or may not be aware is characterised by a multi-ethnic population and while we all get cancers, the different groups, the ethnic groups that are at stake exhibit vastly different risks at different cancer sites or organ sites. So we have a unique laboratory if you want to study the causes of cancer. Is it genes, is it access to health care, or is it culture, or is it education, any diet, environmental factor, any of these combinations? And so the United States national government tries to address health care disparities and we are the cancer centre of course are interested in the studies of cancer.
Now, the outreach to the Pacific adds another complexity. First of all, we are dealing with different ethnicities here and also we are dealing with very remote locations, we are dealing with small population numbers, we are dealing with substandard health care infrastructure, access to health care structure, health care services and of course we are dealing with paucity of local trained investigators and health care professionals.
COUTTS: Dr Vogel, what are the cancers that are peculiar to Micronesia?
WILHELM-VOGEL: I mean Hawaii is not in Micronesia, and technically speaking we are the tip of Polynesia, because our local Hawaiian population is Polynesian ancestry. There is really no cancer centre to speak of in all of Micronesia. However, we have been engaged in this partnership with the University of Guam for approximately six years and there is now a Cancer Research Centre on the campus of the University of Guam. It is of course probably the smallest cancer research centre in the United States, but it is one of the first that came from the collaboration to increase awareness and research and outreach in cancer in Guam and in Micronesia. But to put this in perspective, as we speak, there is not a single both certified oncologist on Guam or anywhere in Micronesia.
COUTTS: What are the cancers you're seeing now? We're talking about culture and there's betel nut chewing culture, so what problems is it throwing up?
WILHELM-VOGEL: Well, as I said, there are multiple causes for cancer and there are environmental factors that can cause or can contribute to the causation of cancer. Locally in Micronesia and in certain islands betel nut consumption as you just pointed out. It's a cultural habit. Unfortunately, the chewing of the betel nut compounded by adding tobacco in there is a serious risk factor for oral cancer and so we are trying to address this with research projects to understand the cacogenic properties of betel nut, as well as to may be come up with very culturally sensitive study designs, interventions that might address the use of betel nut.
COUTTS: As I understand it, it is a combination of the leaves and lime, with the betel nut that is causing the cancer in the mouth, so is that part of it, so may be they need to have a look how to chew betel nut with safety?
WILHELM-VOGEL: Yeah, how they chew it and also of course as I said the addition of tobacco clearly is an added risk factor from oral cancer and other cancers. But of course on certain islands, it is very prevalent and people chew all day long and if you look at their mouth, their gums are all red, discoloured and the lips and so it is really the chronic exposure that contributes to the development of oral cancer.
COUTTS: There are a number of cancers we'd like to discuss, but before we get to that you want to also start a tumour registry?
WILHELM-VOGEL: Yeah, if you are going to get a handle of cancer locally, relevantly, you need to have a base line knowing what cancers occur. And in the developed countries we have cancer registries and usually by law every physician, every hospital, every pathology laboratory has to report every new cancer case and the stage, and the treatment and the outcome etcetera. So you in Australia and we here in the United States and many other developed countries have very, very good data.
Guam did not have a cancer laboratory and certainly the islands jurisdictions in Micronesia didn't have tumour registry. So over the last six years we actually developed a very well functioning tumor registry now in Guam. And other investigators to our cancer centre with funds from the United States Centre for Disease Control are actually establishing a regional Micronesian cancer registry. So this is the first step to collect data on what cancers occur and also this is analysed in terms of ethnic background, gender etcetera.
