Cancer, this country’s second leading cause of death, is on the rise and the chairman of the T&T Cancer Society (TTSC) Dr Asante Le Blanc is concerned.
Her organisation operates on funds received from corporate sponsors and the Government to provide screening at a reduced cost and promotes awareness to citizens. Three years ago, their “subvention was almost taken away” but they were able to show the Government the work they have been doing and “got their subvention,” she revealed.
However, the State’s funding is a drop in the bucket to the work the TTSC has been undertaking. Every month the TTCS screens between 300 to 500 patients for breast, cervical, prostate and colorectal cancers.
Commenting on recent cancer statistics, Le Blanc said based on the TTCS’s latest data “we did not see what we wanted to see which is a decrease.” She is worried because if corporate T&T pulls its funding, it would put the society on shaky ground.
“You can’t bemoan the Government has a lot on their plate,” she said.
Since the closure of T&T’s borders last March, the TTCS has seen an uptake of patients. Le Blanc said the TTCS wants to undertake studies with PSA testing and prostate cancer and are currently doing research on the prevalence of childhood cancers in a certain part of Trinidad to see if environmental factors have been contributing to the disease.
Le Blanc is of the view that T&T does not have sufficient public health care facilities to treat cancer patients.
“We have to do more when it comes to oncology in T&T,” she said.
There is a need for a centralised oncology unit that can provide coordination of all treatments and post-treatments, counselling, nutrition, acupuncture and institutionalisation.
In 2002, then prime minister Patrick Manning promised a National Oncology Centre as the main treatment facility for cancer. The cost of construction, initially estimated at $144 million, was put at $800 million in 2012. After spending $300 million on a foundation, Health Minister Terrence Deyalsingh announced in 2018 the termination of the centre’s contract.
Last June, Prime Minister Dr Keith Rowley said at the launch of an $84 million Linear Accelerator Wing at the St James Medical Complex that his Government could have spent more money on equipment to treat cancer had it not been for past corruption.
“There is a lot more work to be done. When you think of how much it costs to treat one cancer patient, just one, the millions of dollars for just one patient, this is why the society is promoting prevention, education and screening because if we get early detection we will spend much less money and we will save lives,” Le Blanc said.
Admitting the health system has faced shortages of drugs, machines malfunctioning while doctors are overworked and overwhelmed, Le Blanc said no system is perfect.
“But I can tell you honestly they have improved and they are trying,” she said.
Last month, Health Minister Terrence Deyalsingh said it costs the State $500,000 to treat one lung cancer case. Between 2013-2017, there were 641 lung cancer deaths.
As to how many new cancer cases are detected annually, one of the country’s leading oncologist Dr Kavi Capildeo puts the figure at 4,000. Capildeo, who is based at the St James Medical Complex, treats 1,500 of these patients and attends to six to seven of them every week.
A year supply of the drug Trastuzumab to treat a patient with breast cancer said can cost the State $100,000,” he said.
“There are treatments that are difficult to get in the public service and there are some procedures that we can’t get locally at all, for example, bone marrow transplantation, stem cell transplantations, stereotactic radiotherapy.”
If someone has relapsed lymphoma and the treatment requires bone marrow transplantation, “you would have to look at whether you are able to fund that in Cuba or the US or Colombia, and then, the cost can become very much an issue.”
What is the cost of a bone marrow transplantation overseas?
“In the States that can hit US$200,000 and more. In Colombia, it is probably half that,” Capildeo said.
He said if T&T were to consider doing such a procedure “it wouldn’t be about doing one as a demonstration and pulling together resources that aren’t normally available because that will take us back to the issue of dealing with blood cancers . . . haematological cancers and to upgrade that aspect of treatment delivery.”
To start with, we need to strengthen the blood transfusion services and that would then bring us to the issue of building up a better donor base and donor supply because for a long time we have been dealing with replacement donations, rather than voluntary donations, Capildeo explained.
Even as the Health Ministry continues to foot the bill for treatment, some patients have to purchase their medication and pay private labs for blood tests and scans.
According to Capildeo, finances are the biggest obstacle in health care, not only in T&T but globally.
While it was impossible to move ahead with the national oncology centre, Capildeo said having a hub for treatment, research, training and strategic planning—each feeding into one another could have been helpful.
When Bhattoo was diagnosed with leukaemia in 2015, she reflected on the agony her 37-year-old brother endured before dying of lymphoma cancer.
“When I got the news that I have cancer I could not swallow my own saliva. I went immediately back to my brother,” she recalled.
Bhattoo decided to hide the devastating news from her family.
“I started to think about my husband and family. They are the world to me and I couldn’t put them through that pain . . . .to look at me every day in the hospital . . just living to die because that was the end result of my brother,” she said.
As she lay on the hospital bed, Bhattoo contemplated her next move.
“I had medication with me to keep me calm after losing my daughter in a horrible accident and I did the most terrible thing to myself. I took out the medication and I am certain there were more than 30 pills in the bottle. I prayed and I asked God to make a place for me with him because I thought I was going to die. I wanted the easy way out. I am going to save my family the trouble of seeing me suffer,” Bhattoo said, wiping away tears.
She dissolved the tablets in water and drank them. When she awoke in the Intensive Care Unit at the Sangre Grande Hospital, Bhattoo cried like a baby.
To this day, she constantly asks God for forgiveness.
While she underwent four months of treatment, the medication she required was unavailable at the hospital. Bhattoo had to take 13 tablets which cost her $1,066 daily. That medication, which she took for two and a half months, crippled her financially. She also had to pay for scans and blood tests privately.
This left her to draw one conclusion: “If you don’t have the financial support you might as well be dead.”
In three months, Bhattoo deteriorated from a robust 140-pound woman to skin and bones. Her hair fell off, fingernails turned black and her eyes into their sockets, making her unrecognisable to her grandchildren. Now in remission, Bhattoo has lived to tell her touching story.
Denyse Persad cringes every time she hears the word cancer. Last January, she had to rush her 29-year-old son Stephan to the dentist after he complained about a toothache. The medication prescribed barely eased hiss pain which prompted Persad to have a series of medical tests done that showed he had leukaemia.
Persad vividly remembered her son’s initial reaction to the shocking news.
“He always said to me, mom I could handle anything once it is not cancer,” Persad said.
Stephan was admitted to the San Fernando General Hospital. However, little could have been done for him medically.
“They did not have the blood products to support the chemo. They did not have medication to support his type of leukaemia, so there was nothing here for him,” she said.
Doctors advised Persad to take her son to Cuba for treatment which she did. After five months of treatment, Stephan returned home in good health but needed to be readmitted at the San Fernando Hospital for follow up care.
That turned out to be a disaster.
“The doctors called. There is no room at the hospital. Someone is still occupying the room so he can’t come,” Persad recalled.
Stephan had to be put in one of three sterile rooms. The wait seemed like an eternity as Stephan’s health deteriorated. When he was finally admitted, the unexpected happened.
“He got a relapse while awaiting follow up chemotherapy treatment. It was a nightmare. It was difficult to see your child in that position and he is feeling helpless because that is what the situation seemed to be. You can’t leave the country it is COVID and the borders are closed,” Persad said.
Persad turned to private health care for treatment. But doctors gave Stephen a few weeks to live
She said: “I was in a mess. I looked at the doctors telling them this can’t be for real.”
Doctors suggested that Stephan be put in a hospice, but Persad wanted her son to spend his last days home with his family.
After spending $500,000 to save her son’s life, Persad said “he didn’t last too long after. He died… me holding him. That is how he passed. He died with me. He died in my arms.”
Cancer survivor Shivana Boodoo is still reeling in shock after forking out over $100,000 at a private hospital to remove her thyroid when she was diagnosed with cancer last November.
“The horror stories I hear in public hospitals… I just didn’t want to take the risk of having to wait longer than necessary in a public hospital to get the surgery done. With cancer, time is of the essence,” Boodoo said.
However, that decision came with a heavy price for Boodoo’s family. The cost to remove part of her thyroid was $45,000 which had to be paid upfront. However, upon completion of the operation, the cost jumped to $75,000 as Boodoo’s thyroid had to be completely removed.
She spent an additional $30,000 in hospitalisation, medication, blood tests and scans.
“Me and my husband . . . our personal savings we had to dip into that. There are setbacks as far as the future goals that we had,” Boodoo said.
Cancer survivor Joyclyn Haniff is the embodiment of true grit and determination. In the last 11 years, she has battled bone and breast cancers. Last Wednesday, doctors discovered a mass on her ovary.
The news was yet another blow to 82-year-old Haniff who kept it from her children. She had to muster enough courage to break the news.
“I want to tell you this, I never believed there is a God in my younger days,” she said with conviction.
Admitting that life has been no bed of roses, Haniff now seems to be losing hope.
“As I say right now I feel I should go. I had enough,” Haniff said.