CANCER: FOOD, FEARS AND POLITICS .

1. CANCER: FOOD, FEARS AND POLITICS. David Makumi Vice Chair, Kenya Cancer Association. David.makumi@aku.edu

2. Presentation outline • Cancer Burden • Risk Factors • Political issues around cancer

3. “Poverty, uneven distribution of wealth, lack of education, rapid urbanization, ageing population, social, gender, political, behavioral and environmental determinants of health are among the contributing factors to the rising incidence of non communicable diseases” UN NCD HLM political declaration clause 21 Sept 2011

4. Trends Create Challenges • Advances in science and technology. • Economic, lifestyle and epidemiological transition. • Rising costs of health care • Disparities • high/low resource • urban/rural • literate/illiterate • Shortage of cancer care professionals • Political instability (internal/external)

5. No correlation between the rising cases of cancer and consumption of GMO foods

6. Kenya cancer incidence and mortality: both sexes Globocan 2008

7. Common cancers in Men as seen in NCR- KEMRI

8. Common cancers in Women as seen in NCR- KEMRI

10. Prognosis and Cancer Stages localized cancer precancerous abnormal cells regional cancer metastatic cancer STAGE OF CANCER better PROGNOSIS worse prognosis dependent , on type and stage of cancer. Generally, the earlier the better.

11. RISK FACTORS

12. Genetics Estimates range from 5 to 15% of some cancers where a mutated gene is passed on .

14. Risk Factors: Tobacco. Smoking prevalence (% of adults) in Kenya male female Approx 3% of all deaths of men in Kenya annually can be attributed to Tobacco use. Sources: World Bank report, 2010; The 2012 Tobacco Atlas

16. Risk Factors: Environmental Carcinogens • Chemical pollutants eg Asbestos • Poor indoor air quality • Ionizing radon radiation (Radon, a naturally occurring gas is the most prominent source of environmental radioactivity.) • Ultra Violet radiation • Industrial carcinogens. egSome metals arsenic, beryllium, cadmium, chromium, lead, and nickel--have been associated with lung, kidney, skin, and liver cancer.

17. Risk Factors: Aflatoxins! Kenyan herbal drugs 'highly' contaminated. By ARTHUR OKWEMBAPosted Sunday, February 7 2010 at 14:54 A huge percentage of Kenyan herbal medicines contain unacceptably high levels of disease causing organisms. The government’s National Quality Control Laboratory (NQCL) tested 18 samples of herbal drugs sold to Kenyans and found all of them to be contaminated. The products studied were collected from some of the leading clinics and outlets in Nairobi. A number of them were found to contain an organism notorious for the production of aflatoxins. Aflatoxins are a leading cause of cancer. The news will come as a shocker to millions of Kenyans who depend on herbal drugs because of the high costs of conventional medicine. Aflatoxin- Kitui District On Alert The People Daily Page: 4 on Sat 19th May 2007,

18. Risk Factors: Infectious Agents • About 1 in 4 cancers in developing countries is caused by infection. World cancer burden caused by infections2008 Total caused by infection 17.8%

19. Risk factors: obesity and physical inactivity. Obesity is linked to increased risk for: breast cancer (in older women), endometrial cancer. kidney, colon, and oesophagus Cancers

20. Risk Factors: Foods Alcohol Increased risk of cancers of the mouth, gums, tongue, throat, larynx, esophagus, liver, breast, & colorectal. Coffee. No evidence that coffee or caffeine increases the risk of cancer.

21. May the guilty bottle please stand up !

22. Risk Factors: Foods Meat. Increased risk of colorectal cancer • Red meats • Processed meats: culprit - nitrites, added to, hams, hot dogs, etc

23. Fear and Cancer.

24. GMO Foods and Cancer. • Rise in Cancer long before GMO foods hit the market in 1994 • No evidence to link GMO foods and rising cases of Cancer. • Pseudo sciences and poorly informed advocates responsible for misinformation leading to fear and panic. - National Council for Science and Technology Royal Society in London French Academy of Sciences and Medicine Food and Agriculture Organization (FAO) World Health Organization(WHO) African Union (AU) /NEPAD verdict on biotechnology Union of the German Academies of Science and Humanities

25. knowing the facts and finding a balance! 1 2 ? or This anti-GMO army is going against the grain GMOs banned as cancer fears grow

26. Food & Cancer Prevention Fish, Vegetables, Fruits, Fiber. • Fish is a rich source of omega-3 fatty acids which are cancer protective in animals, may play same role in man. • Vegetables, fruits, and other plant-based foods may reduce the risk of GI cancers. • Diets rich in fiber associated with a lower risk of colorectal cancer

27. Nutritional Supplements. • No evidence to show micronutrients taken as supplements are good for your long-term health. • Not superior to vegetables, fruits, beans, and grains from which they are extracted. • No evidence to show they protect people from cancer.

28. Exercise & Cancer Prevention

29. Cancer Presentations Nose Breast Eye Colon

30. Areas of Need Financial Psychological Physical Social Emotional Cancer patient Spiritual Practical Informational M. Fitch/CCO Supportive Care Program Committee/2002

32. Political and ideological dimensions in cancer causation and funding

33. The Lancet Editorial The good news about cancer in developing countries. The Lancet, Volume 378, Issue 9803, Page 1605, 5 November 2011 Fight against cancer, kidney diseases gets 4bn Euro boost Posted On  Tuesday, February 26, 2013 |  BBC NEWS Magazine Cancer: Not only a rich-world disease. 4 December 2012 By Joanne Silberner MAKUMI: Festive season health and food: How multinationals influence our choices Posted Monday, December 26, 2011 | By DAVID MAKUMI David.makumi@aku.edu MAKUMI: More attention is needed to defuse the cancer time bomb ticking in Kenya Posted Thursday, February 3, 2011 | By DAVID MAKUMI Friday is World Cancer Day. This day is in the same league as the World Aids Day. Both are meant to draw attention to two serious health problems...

35. News GMOs ban to hit relief food efforts. Political Question: who misled the Government and Why? Medical Diagnosis: Severe Protein Energy malnutrition

36. Eating as a Political issue. • Would our politicians support the regulation of • advertising of unhealthy foods to children or would they be compromised by the industry? • “Big blow to biotechnology research as Kenya bans GM foods.” • Why wasn’t there a uproar in Parliament, and a public outcry ?

37. TAKE HOME MESSAGE Focus on reduction /elimination of exposure to cancer-causing factors and lifestyle modification. • Immunization against, or treatment of cancer causing infectious agents • Ban Tobacco altogether? • Reduction of excessive alcohol consumption • Prevention of occupational exposure to carcinogens. • Dietary & physical activity interventions. LEAVE GMO FOODS ALONE !