Since high school, Miriama Narayan (Ngāti Kahungunu ki Wairoa, Ngāti Tūwharetoa, Ngāti Raukawa) has been fascinated by the transformation of substances from one state to another. And it’s the contents of our country’s wastewater systems that are the current object of her fascination.
“There is so much data to discover in wastewater! It has biomarkers for all sorts of diseases we are excreting in our pee and poos. There is huge potential to gain knowledge about a population’s health in human waste,” she says.
Miriama is currently undertaking a PhD at the University of Auckland and is part of NPM’s MAI Te Kupenga programme. She says her research team is the first in the world to identify a biomarker (PSA) for prostate cancer in wastewater, and it may have implications for how we identify the disease within communities.
PSA protein levels are an indicator of prostate abnormalities (including cancer) because the amount of PSA increases significantly when the prostate is unhealthy. As a result, high PSA levels in wastewater (per capita) can indicate which regions require more screening and support.
“This research is important because prostate cancer is the highest cancer type diagnosed in the country, and unfortunately, Māori and Pacific men are dying at almost double the rate of other New Zealanders,” says Miriama.
Miriama is collecting data from 21 wastewater plants throughout the motu, and has targeted some of the more isolated wastewater plants in the country “People in the more isolated areas often have less access to health services and have to travel further to get tested, meaning high travel costs, on top of healthcare costs and needing to organise childcare. These areas were essential to include in this research,” she says.
Miriama’s research will be identifying the areas with the highest PSA levels (per capita) in the hope that it will help drive more focused use of public health resources to the areas with the highest levels. “We will be sending our research findings to the Ministry of Health and regional health boards so they can target resources to these specific regions,” she says.
Community engagement and communication strategies are a big focus of the research. “My research will hopefully start conversations about prostate cancer, symptoms and getting tested as we make the results freely available to the public. We hope these conversations can encourage men to get tested.”
Because Māori and Pacific communities have higher rates of prostate cancer, she says she will be working with the Māori communications team at PHF Science (The New Zealand Institute for Public Health and Forensic Science) to communicate results and information directly to these communities. Once the results are known, Miriama is also hoping to work with iwi and hapū to raise awareness about prostate health.
While access to health services is one issue, research also shows there is a variation in assessment and management for prostate cancer between Māori and non-Māori in New Zealand.
“Research on prostate cancer is personal for me. My koro passed away from prostate cancer, and I also have a family friend who recently got tested as a result of a conversation about my research. Unfortunately, he found out that he has a prostate tumour; however, it appears to be in the early stages, and he has a good prognosis. This demonstrates the power of conversation. Prostate cancer does not mean a death sentence. Early detection through screening combined with appropriate assessment and management can significantly improve your chances of staying healthy,” she says.