The Tribune

WE WANT to thank those who over the past several weeks have so generously donated to the campaign to raise funds for a much-needed up-to-date digital mammogram machine for the Princess Margaret Hospital. The $500,000 fund-raising goal was achieved and the machine is now on its way.

Although Doctor's Hospital has state-of-the-art equipment, for years the public hospital has been operating on a machine that doctors say is "nearly obsolete" by today's health care standards. The current PMH machine cannot detect a growing cancer cell early enough to make a difference in saving a woman's life. With the addition of this modern equipment at PMH early detection of this dread disease is now available to all women- both rich and poor.

However, our campaign does not end here -- $365,200 more is needed for a two-year research programme -$182,600 for each year. It has been discovered that the Bahamas is a rich research area because more Bahamian women have inherited breast cancer than anywhere else in the world. Bahamian women are also unusual in that they have a predisposition to the BRCA1 and 2 mutation, which attacks them at an unusually early age - much younger than in other parts of the world. It was also discovered that 44.6 per cent of Bahamian women diagnosed with breast cancer had late-stage cancer compared to 12 per cent of American women. This suggests either that women need more education on the importance of early examination, or having gone to PMH, the machine has not identified the suspicious cells early enough to make a difference. And so, not only is more education and research needed, but so is the new machine, which will soon be here. The average age of women in the Bahamas with breast cancer is 42 while in the United States it is 62. This means that screening for Bahamian women has to start at a much younger age.

Because the Bahamas with its unusual BRACA1 and 2 mutation is so unique, it has been targeted as a rich research centre for the world. As a result, Dr Steven Narod, who holds the Canada Research Chair in Breast Cancer at Women's College Research Institute in Toronto, Canada, has offered to devote 15 per cent of his time without remuneration over the next two years to this project. He will also try to obtain research funding over the next two years to support the needed personnel beyond this two-year period.

"I am convinced," he said, "of the value of this opportunity and of the potential for making important discoveries."

Dr Narod said it would be necessary to employ a full-time genetic counsellor and a full-time breast cancer database coordinator, whose activities he and Dr John Lunn would supervise.

"The genetic counsellor," he said, "would provide pre-test and post-test counselling to all new cases of breast cancer on the island. She will be responsible for identifying at-risk relatives and offering them genetic testing. She will coordinate follow-up care for the women who test positive, including screening and medical and surgical consultation. She will also provide counselling to all of the unaffected women who test positive in the context of the large screening study of healthy women and arrange for the counselling and follow up of their relatives.

"The database abstractor," he said, "would maintain a database of all newly diagnosed Bahamian breast cancer patients (and for patients diagnosed since 2005)." The model for this would be the Banting Database at Women's College Hospital of which Dr Narod has been the director since 1995. "This," he said, "will contain information on risk factors, clinical presentation, treatments received and outcomes. She would be responsible for following the women for local and distant recurrence, contralateral breast cancers, other cancers and death. This database will include all women with breast cancer, including those with and without BRCA1 mutation."

Dr Narod said that to identify new breast cancer genes for Bahamian women, they would have to "identify 50 Bahamian women with breast cancer and a strong family history of breast cancer but no BRCA1 or BRCA2 mutation and do complete genome sequencing on these." He said for this, which is not included in the estimate for the current research, he would try to attract outside research funding.

Dr Narod said that finding that 22 per cent of Bahamian women with breast cancer carry the BRCA1 mutation is a "very important finding for women in the Bahamas --both with and without breast cancer-- and gives us a rare opportunity to study the clinical course of breast cancer in BRCA1 carriers worldwide."

To contribute to this important research, which will not only change the lives of Bahamian women, but which will help researchers better understand how to care for women world wide, please help us raise the much needed $365,200 by sending your donations to:

Tribune Radio Limited, account number 5625-289-0705 at the Royal Bank of Canada.

As each contribution comes in, it will be acknowledged in the columns of The Tribune as having been deposited to the Royal Bank.