Public Health Bulletin Edition 1, 2004 - SA Health - SA.Gov.au

The commonest cancers (excluding non-melanocytic
skin cancers) and those most frequently causing death
in South Australians are shown in Tables 1 & 2. Again,
the source of this information is the SA Cancer Registry 2 .
What the media reports do not say is that very few
of the reported discoveries are ever incorporated into
routine cancer management practice; those that are take
millions of dollars and many years to get there.
Public health practitioners believe that 50-75% of
cancer mortality is attributable to external, non-genetic
factors. Most of these are related to human behaviours
such as tobacco smoking, overuse of alcohol, improper
diet, lack of physical activity, overexposure to ultraviolet
radiation from sunlight, and sexual activity leading to
certain viral infections. 4,5,6 Modification of such behaviours,
and of the social factors that influence them, is a major
cancer control challenge for public health policy makers.
A cancer control policy, if it were to be comprehensive,
would have to pay more than lip service to consulting
stakeholders. It would need to take account of the
behavioural aspects of prevention and early detection,
the physical, social and psychological dislocations
associated with being referred to and treated at a major
centre, and the post-cancer distress so often requiring
specialised psychological support. 7 It would also need to
promote the clear benefits of integrated multidisciplinary
care, early involvement of palliative care expertise, and
so forth.
Perhaps for the first time nationally, the views of
people affected by cancer have recently been sought, as
well as those of their formal and informal carers. A great
deal of material upon which to base healthy public policy
is now readily available in Australia.
The Charter of Paris against Cancer was launched in
February 2000. This is effectively a bill of rights for people
with cancer and their carers (see box p.18). Among other
things the Charter of Paris established February 4th as
World Cancer Day, providing a stimulus in Australia, at
least for state Cancer Councils and some other agencies,
to embark on wide ranging consultation with regional
communities, health care providers, consumer advocacy
groups and other interested parties. 8
As researchers struggle to understand more and
more about the cellular and molecular biology of cancer,
clinicians, with help from pharmaceutical companies, are
conducting trials of new or different combinations of
drugs, often among patients whose disease no longer
responds to conventional treatment.
Media reports, almost daily, refer to yet another
cancer breakthrough, and it is a popular belief that a
universal remedy for all cancers is just around the corner.
Why would you bother to change your behaviour when,
soon, you’ll just have to swallow a pill
On 4 February 2001, The Cancer Council Australia
acknowledged the Charter of Paris and marked World
Cancer Day with an interfaith event in The Great Hall,
University of Sydney. During that year, under the auspices
of state Cancer Councils, 42 regional seminars were held
across Australia (four in South Australia). The aim was to
discuss The Charter of Paris and to document the views
of people affected by cancer, and those of their formal
and informal carers, about ‘the cancer care system’ and
how it might realistically be improved.
From this process, a large number of issues were
brought together and ‘workshopped’ at a national ‘Living
with Cancer Conference’ in Canberra, on World Cancer
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