Two major cancer reports have outlined a plan to improve prevention and treatment of the disease in New Zealand.
Pūrongo Ārai Mate Pukupuku, the Cancer Prevention Report, from Te Aho o Te Kahu, the Cancer Control Agency, focuses on recommendations for addressing risk factors including tobacco; alcohol; poor nutrition and excess body weight; a lack of physical activity; excessive exposure to ultraviolet radiation; and chronic infections.
Around 25,000 people are diagnosed with cancer each year and Te Aho o Te Kahu said up to half of these could be prevented through improved prevention measures.
Approximately 10,600 Kiwis die each year from cancer.
The report states if all risks are addressed through prevention measures, 4400 fewer people could die.
“If we look at tobacco, for example, something like one in six of all cancer deaths are caused by tobacco,” Te Aho o Te Kahu chief executive Professor Diana Sarfati said.
The recommendations range from improving access to health treatment for at-risk people with chronic infections such as hepatitis to subsidising the cost of fruit and vegetables.
Health Coalition Aotearoa Board Member Selah Hart welcomed the report.
“Nobody wants to have to care for or watch a loved one die when that was absolutely preventable and we know and can see through the report that the impacting factors actually come from some of the things we could get rid of – tobacco, alcohol, unhealthy foods – all of the things that we know contribute to these deadly diseases that our whānau are suffering from,” she said.
Hart said Waitangi Tribunal hearings had shown inequitable outcomes in health.
The health system and Government need to understand and examine the impacts of colonisation on the health of Māori, she said.
“First and foremost, we need to look at the services that we're able to provide to whānau: are they accessible, are they fit for purpose, are they in the places and spaces that our families need them?" she said.
“We also need to understand that for many, many years we haven’t had health services or community support mechanisms that actually enable families and whānau to thrive.”
Hart said it was time for cancer treatment to be approached by giving equal rights to Māori to create suitable solutions.
Health Minister Andrew Little said cancer prevention and treatment measures are always being reviewed.
“The whole reason for setting up the Cancer Control Agency was exactly that – we get a more coordinated approach so I'm confident we're doing everything we can to keep across what we need to be doing to reduce the instances of cancer,” he said.
Little pointed to improvements to the cervical screening service, the Smokefree action plan and the consideration of sunblock regulation as steps the Government is taking to reduce cancer incidence.
“Once we start implementing the health reforms with Health NZ and the new public health agency in the Ministry, I think that will start to make a big difference. It will bring a much stronger focus particularly on those public health measures I know that can make a big difference to a broader range of people,” he said.
“The more we can do to improve access, which the reforms will help us to do, that will improve outcomes for those people as well.”
Little said funding for Pharmac, the Government medicine funding agency, has increased by 25 per cent during Labour’s four years in Government.
“We gave them additional funding a couple of years ago specifically for new cancer treatment which they took on board," he said.
“We're continuing to work with Pharmac to make sure they're getting the funding they need to provide the best possible range of treatments they can."
The largest ever New Zealand breast cancer study from the Breast Cancer Foundation was also released on Friday.
The study, 30,000 Voices: Informing a better future for breast cancer in New Zealand, collates national register patient data from 30,000 patients living in urban areas diagnosed with breast cancer from 2003 to 2019.
The 176-page report said the risk of dying of breast cancer within five years has halved since 2003, which Breast Cancer Foundation chief executive Ah-Leen Rayner said is “really encouraging.”
“We have to look at the 10-year survival rate where the data is not quite as good for survival,” she said.
Māori were 33 per cent more likely to die within 10 years than Pākehā, and Pasifika women were 52 per cent more likely to die.
Women aged under 45 had an 82 per cent 10-year survival rate compared to 89 per cent for women aged 45 to 69.
“We have to continue with early detection and screening, so essentially restoring screening levels to pre-Covid levels is absolutely necessary," Rayner said.
"It also shows that timely paths to treatment is absolutely required and also rigorous follow-up with Māori, Pasifika and younger women because we know that those are vulnerable high-risk populations."
The study also states patient data shows the rate of breast-conserving surgery in New Zealand 'has been lower than ideal'.
Wellington breast cancer patient Kate Twigg was diagnosed with an aggressive form of breast cancer last November.
“I did have that mammogram in November  which had nothing, didn't show anything," she said.
“Within a year it had grown to a golf ball size and because of all the stuff I have done for breast cancer, I am someone who regularly checks and because my mum has had breast cancer.
“I felt like it just popped up one day and it was just there and it was the size of a golf ball and I was able to get in to see someone quickly and didn't delay it and I think that has helped me a lot."
While Twigg said the oncologist and surgeon she had now were “amazing”, her experience of communicating with another surgeon “added a layer onto what was already a really tough, tough time".
“If you feel like the person that you've got is not the right fit for you and are not feeling comfortable with how you've been treated … then definitely feel like there are other options,” she said.
Twigg said talking to someone who has experienced breast cancer has helped a lot.
“She was amazing for me that she had a really positive mindset as well and I was like, 'That is the only way to get through this'.
“Stress, crying… I'm feeding my tumour with all of that. I need to get on top of this with mentally being positive and seeing the positive in more things than I was in that initial diagnosis.”
Twigg thought she would need a double mastectomy but her surgeon explained a less-invasive lumpectomy – the removal of some breast tissue – may be an option for her.
“I think it’s important your surgeon gives you those options and doesn't make you feel like you have to go one way or the other,” she said.
Surgery options will be confirmed once test results come back showing whether Twigg has a genetic cell mutation or not.