FRUSTRATED by the hardship breast cancer patients in the public health system endure, Kingston Public Hospital (KPH) is moving to plug the deficits by establishing a breast oncology clinic to help them fight the disease.

Already, surgeons at the largest hospital in the English-speaking Caribbean have hit the ground running. For them, with Jamaica’s breast cancer mortality rate increasing in comparison to countries in North America and Europe, there cannot be further delays in the full treatment of the country’s patients.

Speaking to editors and reporters at yesterday’s Jamaica Observer Monday Exchange, held virtually, consultant general surgeon at KPH, Dr Hugh Roberts, said there is a “vast disparity” between how patients are treated in the public health system and those receiving treatment privately.

Likening treatment privately to a five-star hotel versus treatment in the public system, which he described as roughly a three-star experience, Dr Roberts noted that the problem with the public sector boils down to treating a high volume of patients at once, with limited resources.

The treatment for cancer patients in the public health system is free.

“Sometimes you lack the opportunity to spend that individual time with each patient, and that’s why you need support staff. So, even though [we] are the ones doing the operation and we actually spend time talking to patients a little bit, you still need support from the nurses and sometimes the psychologists,” said Dr Roberts.

Additionally, he noted that one of the major issues facing breast cancer patients treated at public hospitals is fragmentation. In other words, only one aspect of the treatment is available at a particular hospital, and so patients often times have to travel to another hospital for further or follow-up treatment.

“So, if you got to the University Hospital [of the West Indies] and you need chemotherapy and radiotherapy, you’re only going to get chemotherapy and surgery at University Hospital. After that, you have to get in your vehicle and go to KPH and get radiotherapy, or drive halfway across the country and get it at Cornwall Regional [Hospital], because radiotherapy in the public sector is only available at KPH or at Cornwall Regional Hospital,” explained Dr Roberts, who is also an associate lecturer at The University of the West Indies.

“So the system is quite fragmented and that’s added stress to the patient,” he added.

As a result of this dilemma facing already burdened patients, KPH is looking to launch a breast oncology clinic — the brainchild of general surgeon at the type A hospital, Dr Jason Copeland.

The clinic is aimed at bringing the various treatments and support services necessary for overcoming breast cancer under one umbrella, reducing the barriers patients face in their fight against the dreaded disease.

The treatment is expected to remain free, though the team, headed by Drs Copeland and Roberts, is urging members of the private sector to get on board as a means to facilitate this. Breast cancer treatment, the doctors noted, attracts a cost of anywhere between $4 to $5 million, miscellaneous excluded.

Dr Copeland, a breast surgical oncologist, explained that the idea was sparked by the findings of KPH’s Breast Cancer Registry.

He said that after observing that there was a high proportion of patients presenting with breast cancer before the age of 50, patients presenting with the disease at locally advanced stages, and patients waiting a long time to get the necessary therapy, the clinic was conceptualised.

“What we realised is that the problem we’re having with breast cancer mortality in Jamaica, and many other developing countries, is largely because the system that we have is so fragmented. Where I was trained in western New York is a comprehensive cancer centre, where literally everything is in the same building and the patient can get everything done in a very short space of time. These patients do extremely well. Not only has the mortality rate decreased, but the patient’s quality of life and the type of treatment they get [have improved],” said Dr Copeland.

“So what we want to do is to have a system like that at the Kingston Public Hospital now that we better understand the type of patients that we’re seeing, the nature of the cancer, the outcome, and the issues in the system. So we’re trying to fix these issues by having a single breast oncology service, so that the quality of care the patients receive at the public hospital increases,” he added.

Through the clinic, KPH is also hoping to reduce the morbidity associated with treatment.

To facilitate this, additional equipment is needed, Dr Copeland shared.

“There are a lot of equipment that we require. So we have to establish public/private partnerships because we know that the Government has limited funds, and we know that the Government right now is trying to deal with a pandemic, but that doesn’t change the fact that patients still have other diseases that still need to be treated at this time, and cancer is one of them,” Dr Roberts chimed in, adding, “So we have been given the permission to seek public/private partnerships.”

The main equipment needed is a mammography machine, which is used to detect the disease.

The majority of patients being treated at public hospitals are currently sent to the Jamaica Cancer Society for testing, as there is no machine available in the public health system. The machine can cost a minimum of $16 million.