Cancer. No other six-letter word is spoken with so much dread in modern Dominica. Not because cancer can't be managed but treatment of the disease is terribly expensive. That's why the Dominica Cancer Society (DCS) has been placing so much emphasis on its annual "Walk for Cancer" fund raising drive.

"The walk has become very popular," said Vinna Royer, DCS's Public Relations Officer at the Official launch recently. "People are looking forward to the exercise. We want to appeal to you to be a little more excited about the fundraising which is the central purpose of the walk."

Initiated in 2012, the Cancer Walk, Royer said, aims at promoting awareness of cancer and raising much-needed funds to assist patients who cannot afford treatments for cancer.

"This week a man showed me a bill of $3,000 for his first four cycles of chemotherapy," Royer said. "All of us are touched by cancer."

The cost of treatment, accommodation and travel to Guyana, the country of choice for persons seeking less-expensive treatment, can range from US$3,000 to $8,000, Royer said.

"It is through these funds that they are able to travel to Guyana which is one of the main countries to go for radiation and chemotherapy," Royer said. "When we approach you, you can tell us come back month-end, but we want you to give something."

In recent times, cancer has become one of the leading causes of death in Dominica. According to Mignon Role-Shillingford, Coordinator of Health Promotion Resource Centre, from 2011 to 2016 there were 697 deaths in Dominica due to cancer- 2011(133); 2012 (110); 2013 (128);2014 (106); 2015(132); and 2016 (88).

For women breast cancer is the leading type of cancer (185 cases from 2010 to 2017; for men it is prostate cancer- 102 cases for the same period.

"In Dominica with a small population, and given the departure after Maria, that is significant," she said.

The Sun reported recently that Dominica ranked third among cancer deaths in the world. A report published earlier this year by the Journal of the American Medical Association (JAMA) Oncology ranked Dominica as having among the highest rates of cancer deaths in the world.

The JAMA 2016 global cancer study of 195 countries found that Dominica has the third highest cancer death rate in the world, with 203.1 deaths per 100,000 of population, leaving it behind only Mongolia and Zimbabwe.

Dominica has the highest rate of prostate cancer deaths, with 54.9 deaths per 100,000 of population, a long way above the global average of 6.1, along with a death rate from multiple myeloma of 5.9 per 100,000, nearly four times the world average of 1.5.

The Dominica Cancer Society said to The SUN that it was not in a position to confirm the ranking.

However, its president, Yvonne Alexander, told the SUN then that Dominica does indeed have a high rate of cancer deaths, attributed mainly to late detection.

"Because we don't have that culture of having annual medicals and screening for cancer, we don't have that culture of screening to see what's going on with our bodies, because of that by the time one gets a diagnosis it may be very, very late and as such it results in late diagnosis," Alexander tells The Sun.

"And because they may have it in an advanced stage, we do have individuals who die, sometimes within months of being diagnosed."

Even those who are cancer survivors become a little careless sometimes, leading to recurrence, she says. Many who have survived for a few years, she explains, "probably feel comfortable about having survived for a number of years and because of that they may not be as careful as they possibly can be with the prevention strategy which relies heavily on very good nutrition and exercise, rest and relaxation, and of course, your spiritual base".