As cancer diagnoses in the under-50s soar, researchers are focusing on environmental as well as dietary causes – including a possible link between microplastics and bowel cancer. In Part II of this series, Sarah Catherall considers how disengaging with the health system might hinder cancer detection.
Myra Barber (Ngāti Rakaipaaka, Ngāpuhi and Ngāti Kahungunu) was 47 when she noticed blood in the toilet. Her father had had three non-cancerous polyps removed during a colonoscopy at age 85, so she didn’t worry too much because she was so much younger. But his father had died of bowel cancer in 1994, “although they never used the word cancer and I only found that out later,” she says.
Three weeks after noticing her stools were bloody, her symptoms disappeared but she went ahead with a colonoscopy and then received the dreaded news: a tumour was growing in her rectum, close to three other non-cancerous polyps. From around the time of Cyclone Gabrielle, Barber had to go from her home at Waimārama Beach, 25km from Hastings, to Palmerston North for treatment, starting on her son’s 14th birthday. Rather than operating, they gave her radiation and 10 rounds of chemotherapy. But the tumour didn’t disappear and the now 49-year-old has finally had it removed, with a temporary ileostomy bag put in. The good news is she’s clear of cancer and determined to spread the word to other Māori – especially younger Māori like her –to get a colonoscopy or do a fecal screening test .
Though David Shorter (see Cancer rising part I) felt his diagnosis came out of the blue, the mother of seven, in a blended family with her second husband, wouldn’t have described herself as healthy. A size 14, she’s categorised as clinically obese. “Since I’ve had kids, I’ve been up and down with my weight. I hate processed food and fizzy drinks, but my downfall is chocolate.”
She now forgoes processed meat and bacon and eats only “real meat”. “I try to cook everything from scratch. It’s so hard in this age of convenience but I try to have healthy snacks, and I’ve started to get active again.”
Growing up in Nūhaka, near Wairoa, she was often constipated as a child and her mother gave her enemas. Her cousin in Australia had bowel cancer in his 50s, even though he was fit and healthy.
“Even the healthy ones are being diagnosed. My aunties all went and had colonoscopies and a lot of them had polyps removed.”
Her husband, Bayden Barber, former chair of Health Hawke’s Bay primary health organisation, is currently standing to be re-elected chair of Ngāti Kahungunu iwi. “He’s as healthy as a horse. But he found it really hard when I was diagnosed. We had four of our kids at home. It’s a gruelling thing to go through emotionally and for your whānau. But we’re religious and pray, say our karakia. I put a lot of faith in miracles.”
Cancer is taking people from all around her: a sister-in-law and several friends and relatives have died of cancer in recent years, all Māori. “I wonder if it’s something about how we as Māori live in this modern age. We used to live off the whenua, the awa and the moana before. Maybe some of us also have a lack of engagement with a health system we don’t trust because it has failed Māori. The health staff I had were amazing, but some Māori struggle with the system.
“Why don’t we give everyone a colonoscopy, especially those of us with higher risk? Why aren’t we offered that? If I had known the risks before, I would have paid for my own colonoscopy. If I’d had no polyps, I’d have had no cancer.”
Professor Sue Crengle (Kāti Māmoe, Kāi Tahu and Waitaha), a GP and Māori health researcher at Otago University, argues screening should start at least 10 years earlier for Māori so they have equal opportunity to benefit from the programme. “A Māori person has the same risk of getting colorectal cancer at 50 as a non-Māori at 60. That’s the argument. Reducing the screening age to 58 for everyone isn’t going to solve that problem.”
