Rogelio Manuel Diaz Moreno
HAVANA TIMES — My friend Erasmo Calzadilla is worried by what he perceives to be the frightening spread of oncological conditions in Cuba. I would like to add a number of comments that could help clarify the ideas he addressed. I write from the modest experience I’ve accumulated working at the National Oncology and Radiobiology Institute (INOR).
The INOR is Cuba’s chief medial institution devoted to fighting this serious condition. Thousands of patients from around the country are treated there every year. They are admitted suffering from all possible variants of the condition which, as we know, encompasses a broad and complicated range of pathologies. These are treated through internationally established procedures, namely surgery, chemotherapy and radiotherapy, in dependence of the human resources and materials available at the center and the country.
Let us begin by recalling that cancer, as Calzadilla rightly points out, has become the leading cause of death among Cubans. In this sense, our health panorama more closely resembles that of developed countries than Third World nations. In the latter, infectious and diarrheic diseases, tuberculosis and others whose incidence has been greatly reduced in Cuba since the 1960s, are the most widespread illnesses.
As for heart conditions, these were the main cause of death in the country until recently. Many resources have been devoted to overcome the problem and they have yielded positive results, albeit slowly. According to statistics available at Cuban Ministry of Health sites, heart conditions now represent the second most common cause of death in Cuba. This is why cancer, which had occupied the second place, rose to first.
Regrettably, cancer is a much more complex condition than cardiovascular pathologies. Many of its forms, such as prostate cancer, are common among elderly people, and those who skirt death earlier in life, threatened by a different condition, become candidates for an oncological complication later on. It may seem paradoxical, but it’s a fact: overcoming other health problems increases the likelihood of being afflicted with cancer later in life.
One aspect of treatment where much work remains to be done is prevention. Prostate cancer is one of the most common among the population (with prostates). Detected in its early stages, it requires a fairly uncomplicated treatment that is effective and guarantees a degree of survival not unlike that of people who have never been affected. But the examination that could detect it effectively and simply is an affront on the profound dignity of the Cuban male. This illustrates that our difficulties go beyond the strictly clinical and enter the social and cultural domains.
The form of cancer with the greatest incidence in Cuba, however, is definitely lung cancer. I see it at the INOR every day, just as I see patients and medical doctors who smoke with great enthusiasm. Many are the announcements that warn of the dangers of nicotine through the mass media, but people appear to turn a deaf ear on them. As though that weren’t enough, preventive campaigns are being stabbed by the State itself, which organizes tobacco festivals, and by Cuban companies that advertise their cigarettes on banners, at kiosks and other similar establishments. Smoking has also been associated with greater risks of throat and esophagus cancer, which are also very common at the INOR and cause both disability and death among men and women alike.
Another type of cancer that’s shot up is one that affects women: uterine cancer. It is frequently caused by the human papillomavirus (HPV), which is sexually transmitted. Cubans are more than informed about the importance of using protection during sexual intercourse, particularly as a means of preventing HIV. Despite this, there is still much irregularity in terms of condom use. Greater precautions would considerably reduce the incidence of many infections and this type of cancer.
We cannot forget that other common forms of cancer – such as breast cancer – have a strong genetic component. Progress in the area can perhaps be achieved with DNA sequencing techniques, more sophisticated genetic research and the like, but prevention through simple examinations continues to be the best form of treatment. In its early stages, breast cancer is curable.
This may have sounded as a sermon that lays most of the blame on people and absolves modern civilization of all sins. It has certainly not been my intention. It is true that, today, we have lifestyles that are far from simple and that we are exposed to environments and elements that are strange in comparison to those of the past. Among these, many doubtlessly entail potential dangers and none should be taken lightly. Chemical fertilizers and pesticides, asbestos, residual gases stemming from the burning of fossil fuels, synthetic materials such as plastics and others, lead to health complications, even though we see much less of them at the INOR.
It is important to keep oneself properly informed about the consequences of these aspects of our daily life. This will allow us to be aware of each of the different risks and the best ways to prevent them. This way, we can individually and collectively think of the best ways to reach a healthy old age.