Long wait for cancer diagnosis

KPH lab's backlog impacting patient care

BY ALPHEA SAUNDERS
Senior staff reporter
saundersa@jamaicaobserver.com

Friday, September 20, 2019

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PEOPLE have to wait a nerve-wracking two to three months, or longer, before learning whether or not they have cancer, as the laboratory at Kingston Public Hospital (KPH) struggles to deal with a backlog of tests.

According to consultant general surgeon at the hospital, Dr Hugh Anthony Roberts, the accumulation does not only include specimens for possible cancer patients, but specimens for other pathologies as well.

“And that's not two to three months to only get the results after surgery; to be able to make the diagnosis where you had a biopsy, it also takes about two to three months, and this is not the lab's fault, this is just the resources that they have,” he told reporters and editors at this week's Jamaica Observer Monday Exchange, where guests discussed CIBC FirstCaribbean International Bank's 'Walk For The Cure' fund-raiser for cancer care. The event is slated for September 29 at Hope Gardens in St Andrew.

“There are times when you can call the lab and they will try to rush specimens and try to help you,” he said, pointing out that the facility recently received equipment to process specimen for some cancers, but that there is still a gap in need of urgent attention.

“They are trying, but there are still significant strides that need to be made,” Dr Roberts noted.

For some patients, however, it may be too late by the time they receive the results for a disease that “does not sleep”, as breast cancer survivor Carolind Graham pointed out.

“In that time when they're waiting, the disease is still progressing from stage one, to stage two, to stage three — God forbid it progresses to stage four, and when it reaches to that point you're now adding on morbidity to the patient, and financial expense,” Dr Roberts outlined.

For the consultant general surgeon, one of the troubling realities of screening and early detection is the absence of a mammography unit at KPH.

The equipment is instrumental to screening for breast cancer, the leading cancer and the leading cause of cancer-related deaths among Jamaican women, according to the Jamaica Cancer Society.

“You have the number one cancer not only in the island, but across the Caribbean; you have the largest English-speaking hospital in the Caribbean; you have the primary referral centre for Jamaica, and you don't have a mammography [unit] — that's the reality,” he stated.

Dr Roberts said most of his patients at the hospital, who present for suspected breast cancer, turn up without a mammogram.

“I am leaving here to go to my clinic right now, and I am going to see two to three new patients that probably have breast cancer and they don't have a mammogram,” he said.

The lack of critical resources also extends to other types of cancers, such as colon cancer.

“At KPH, I know for a fact that colonoscopy was down for a while, and the way to do a biopsy to diagnose patients for colon cancer is only by a colonoscopy,” Dr Roberts said, noting that he was aware of an instance in which medical personnel had to use their personal equipment.

He stressed that there is no shortage of skilled doctors, nurses and other support personnel, but that their work is being hamstrung by a shortage of resources.

“If you're going to get real on the fight of cancer, you have to get the resources. That's what leads to the backlog of cases... If someone comes to me and it looks like breast cancer, I can't operate just because it looks like that... You have to do the biopsy, you have to wait for the results to come back,” he stated.

“We really need to talk about prevention. We can't stop cancer from occurring, but if we can catch it at an early stage, it decreases the number of treatment modalities that the patient may need, which impacts on finances, and it gives a better chance of survival,” he said.

Dr Roberts said, while patients with chronic illnesses such as hypertension and diabetes may not see the complications and effects of those conditions for years, the devastating effects of cancer manifest much sooner.

It is for this reason that the surgeon is calling for more significant investment in cancer support, in order to ease the burden on those afflicted with the disease, and by extension the public health system.

“You have to invest in screening, you have to invest in early detection, you have to invest also in the support services that are required for patients,” he insisted.


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