Last week Dr. Marjorie Yee-Sing, Surgeon at the Princess Alexandra Hospital in Anguilla, gave an interview to The Anguillian in which she warned the people of the island against certain diseases. Part one, published then, dealt with gall bladder stones (caused mainly by fatty and greasy foods), diabetes and hypertension. Here now is part two of that interview in which she spoke on cancer cases and the dangers of some over-the-counter non traditional drugs.

“Other types of illnesses that have come to be of some significance to me as a surgeon, include the number of cancer cases that we are seeing in Anguilla,” she stated. “I don’t like to draw conclusions without having statistics. I would rather have statistics that would assist me in proving my point rather than creating anxieties and pinpointing things that are not necessarily the cause of cancer. Now I have seen the disease among the very young and the very old, across the board. In days gone by when you were studying as a medical student, you were told that cancer was usually seen in people over a certain age group – 55, 60 or 70; but now I am seeing it here in persons in their teens and this is alarming.”

According to Dr. Yee-Sing the cancer cases are mainly in the bowel. A few patients are being treated and some have died. “It depends on the stage at which you catch it,” she went on. “What was most alarming to me is one young patient who, by the time he came to me, (I was seeing him for the first time), already had the disease disseminated throughout his body. So at that stage you can’t do much for him, despite surgical procedures to try and bypass the area that was blocked. You still end up doing nothing much for him because it is too far gone.”

What general advice would you offer to persons? She was asked.

“First of all there is usually a history of cancer within the family,” she responded. “If you know this, whether it is breast cancer, bowel cancer, or other types of cancers, you should make it a point of duty to have yourself examined by a doctor especially in that particular area that you know your family member might have had cancer.

“For instance, breast cancer. Every woman should be taught how to examine her own breasts. Over the age of 35 or 40, you should have a mammogram done. If the mammogram is not suspicious of cancer, then you can have it done once per year because the incidence in the immediate family members is much higher than the general population in which there was never a family member who had it. A high index of suspicion should make you go for a physical examination every year to find out whether you have any cancer brewing anywhere.

“In the case of patients who have bowel cancer, the incidence of the family members getting it is very high - especially with particular diseases. You should therefore have yourself checked properly. Even if the procedure is not offered in Anguilla you can go elsewhere to have it done. If you do that once a year and it is found and detected early, then your chances of survival are greater.”

She said it would be helpful for an insurance company as well as Government to have screening tests done of persons seeking health insurance. She noted that a necessary test was an examination of the rectum to see whether there was any evidence of cancer there. “In so doing, we can pick up cases early…and that would save the Government a lot of money because patients who come in when it is pretty late, have to spend quite a bit trying to cure or treat the cancer. When they come early we could cure them sometimes but when they reach the stage when it is too late, it becomes more expensive with radio therapy, chemotherapy [and other such treatment]. People have to be aware of conditions that affect their family and interested in being healthy. A healthy nation would be more productive than one that is unhealthy.

“This is a why the Government should be interested in practising preventive medicine rather that trying to practise curative medicine… There are some cases you cannot avoid and will have to do curative medicine but preventive medicine must save the Government and patients a lot of expenses and would also decrease the amount of morbidity and mortality associated with the particular disease.” She stressed the need for a cancer registry – a matter she had been hinting at since her arrival. She hoped that it would soon be established as there was a need for statistics in order to have definite figures of cause or incidence of cancer diseases in Anguilla available. She also emphasised that it was important for doctors to perform thorough physical examinations and to ensure that the particular investigations were done.

The surgeon was of that view that there was a need for specific persons to lecture school children about practising healthy lifestyles. “It is best to start with the children because with knowledge they can avoid certain pitfalls,” she observed. “It is difficult to tell adults to stop doing certain things because they are so ingrained and so use to their type of lifestyle that it is not easy to change. Let us start with the children in school who are innocent and willing to listen to what they should avoid and how they should be eating. That’s very, very important.”

Dr. Yee-Sing continued: “There are a lot of over-the-counter drugs here and a lot of advertisement through the electronic media and otherwise on what you should do to lose weight and to get a nice skin. People endanger themselves by using these over-the-counter products without medical advice; and a lot of people are coming to doctors after they develop complications.

“You see a young girl coming in and she has blood in her urine, her pressure is high, she is developing diabetes and all that. When you find out, they are taking some strange drug to lose weight or some type of drug to make their skin come out white or smooth and there are serious side effects. People are now finding that some of these non-traditional drugs are dangerous to your health. They affect blood pressure, they affect the heart and some people are ending up with strokes. Physicians have to be aware of the current medical information that is given out and also how to advise their patients wisely and how to avoid some of these non-traditional drugs.

“We are not fighting against anybody. It is just that you have to be aware and anybody is now selling these products. It is just a job. You don’t know what medical condition a patient might have. You don’t know whether what you give them is going to counteract the medication they are taking and therefore they end up in the long run being affected either worse or none at all. You are giving them a product to make them better, they may as well don’t use anything because it is not going to have any long-term effect on the patient. But the ones that affect the patient are the ones that you have to be very careful about. If you are selling drugs and you don’t have medical knowledge, then it is dangerous because you are harming people without knowing it – for monetary gain of course.

“You have to be very careful about over-the-counter drugs that people buy. A lot of them have been freed up. You can now even purchase steroids over the counter which before you had to have a doctor’s prescription to buy. Some cough medicines over the last two years I think were taken off the shelves because of the side effects they were having on young children. They were dying of strokes from cough medicines and they had to take them off the shelves but then how many died before that was done? So you have to be so careful.

“Not everything that you see advertised on the TV and in the newspaper is good for you. In Jamaica, we have bureau standards and we have a pharmaceutical division of the Ministry of Health. Before any drugs can come in the country they have to be registered with the ministry and then they are researched before they are allowed in. That’s one way in which you can avoid the type of drugs coming into the country. That’s very, very important.”

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