Cancer Care: Screenings & Cancer Treatment

Our Chemotherapy Unit offers oncology-haematology services which include diagnosis and management of various cancers and non-cancer conditions (haematology).

The unit saw a total of 1351 patients in 2020. The most common cancers presented are:

  • Breast
  • Colorectal
  • Prostate
  • Myeloma
  • Lymphoma
  • Lung

Cancer patient receiving cancer treatment

The most common non-cancers presented include:

Low blood count (eg. anaemia)

Bleeding disorders

Separated from the main hospital building, our Chemotherapy Unit offers patients an intimate and private setting. Our staff includes a full-time oncologist-haematologist and specialist oncology nurses who provide individualised care to each patient.

Chemotherapy Unit at the Cayman Islands Hospital

Different Types of Cancers

Cancer

Cancer is a condition that can be very invasive, aggressive and fast spreading. Cancer begins to manifest when one cell grows, and therefore outgrows other cells in the body; this prevents cells from dividing and reproducing in an ordinary way. Cancers can vary depending on many different aspects, such as the speed of the spread and the severity of symptoms. In almost all cases, cancers will grow in the form of a tumor or growth: non-cancerous tumors are called ‘benign’, and cancerous tumors are called ‘malignant’.

The main way the spread of a cancer is tracked and recorded is through stages. The cancer stage helps a doctor to figure out if the cancer has remained localised or spread to other organs and/or the bones. For instance, Stages 1 and 2 mean that the cancer has remained largely stable, but Stage 3 means it has spread quite a bit. Stage 4 is the highest ‘stage’ of cancer. Stages are important because they can help your doctor decide the most effective treatment for a specific stage (and therefore severity) of cancer.

Risk Factors of Cancer

Many lifestyle choices or genetic dispositions can increase or decrease your likeliness of developing cancer. You can take steps to prevent your risk of cancer in your life, however it is often difficult to pin-point the predominant cause of cancer in an individual. Nonetheless, there are some known, common causes of cancer:

  • Smoking/Tobacco Use

Smoking and/or tobacco use accounts for approximately 80% of all lung cancer-related deaths. Lung cancer is one of the most aggressive cancers to treat, and tobacco use increases your risk of developing this cancer, or other debilitating conditions such as chronic obstructive pulmonary disease (COPD) and chronic bronchitis. Smoking increases your blood pressure and can cause arterial blockages (PAD). Peripheral arterial disease causes plaque to build up in vital organs, and may result in heart attack or stroke. All these conditions can increase your risk of developing cancers from smoking, especially through exposure to carcinogens in tobacco such as carbon monoxide, formaldehyde, and nickel, all which irritate the lung, nasal and oral cavities.

  • Diet and Physical Activity

If you are overweight, do not exercise regularly and have an unbalanced diet, you more than likely have a higher risk of developing cancer than someone who is relatively active and eats healthily. Bad eating habits and obesity are directly linked to increased risks of developing aggressive cancers such as breast cancer, thyroid cancer and gallbladder cancer. Excess body weight can result in bodily inflammation, faster spreading of cancer cells (metastasizing) and improving the durability of cancerous cell life.

  • Sun or Radiation Exposure

Ultraviolent (UV) radiation is often exposed to via the sun or tanning-beds. UV rays penetrate deep into the skin, which can result in damage to the genes in DNA cells, which can cause cancer. UVA rays indirectly damage cell DNA and are linked to long-term skin damage including growths, wrinkles, and sunspots.

  • Viruses or Infections

Many human viruses are connected to an increased risk of developing cancer. As viruses also affect cell reproduction rates, they too can also increase the rate of cell growth/spread. An example of a virus that may cause cancer is human papillomavirus (HPV). If you have an HPV infection for a long period of time, you may be at a high risk of developing cervical cancer. Other viruses and infections that increase cancer risks include Hepatitis B (HBV) and Hepatitis C (HCV), where chronic cases can lead to liver cancer.

Types of Cancers:

  • Breast cancer

Breast cancer, which starts in the breast, can often be felt as a lump or tumor in the breast for both men and women. There are different kinds of breast cancer, all which can develop in the breast ducts or lobules. Breast cancer can spread through the lymph nodes, where lymph vessels can carry cancerous fluids that can spread under the arm, around the collar bone and inside the chest. Although breast cancer is difficult to cure, it can be treated and in many cases men and women recover from the disease and remain in remission for extended periods of time.

  • Colon cancer

Colon cancers often begin in the rectum or the colon, commonly referred to as colorectal cancer. Colorectal cancers often start with a growth in the colon or rectum called a polyp, which can develop into a cancerous polyp over time. If the polyp begins in the innermost wall of the rectum, it can grow outwards and then travel to near lymph nodes in the body. Other types of tumors can also start in the rectum such as carcinoid tumours, gastrointestinal stromal tumors (GISTs) and sarcomas.

  • Lung cancer

Lung cancer begins in the lungs and is one of the most common cancers. Lung cancers can appear in the lining of the lungs, in the alveoli, or the bronchioles. If the cancer begins to spread, it can enter the diaphragm and affect how air enters and leaves the lungs. Carcinoid tumors can also grow in the lungs, as well as cystic carcinomas and other growths.

  • Prostate cancer

Prostate cancer is a disease that predominantly affects men. As a gland that is only found in males, if the prostate gland appears to have an abnormal pattern of cells, it may be indicative of early signs of cancer. The exact cause of prostate cancer is something that has not yet been discovered by researchers. What we know is that, perhaps, there may be some risk factor in having family members who have/have had prostate cancer, which can then result in an inherited gene mutation, also known as hereditary cancer. Some mutated genes that have been associated with hereditary prostate cancers include BRCA1, CHEK2 and HOXB13 – all which are genes important in the development, functioning, and reparation of the prostate gland.

  • Skin cancer

UVB rays are considered to cause most skin cancers, while UVC rays come predominantly from man-made sources including lamps and bulbs. Exposure to these harmful rays can result in the most common skin cancers: basal cell and squamous cell cancers. One can also develop a more serious, yet rare skin cancer called melanoma.

  • Haematological Cancers

Haematological Cancers, also called blood cancer, are cancers that begin in blood-forming tissue, such as the bone marrow, or in the cells of the immune system. Examples of hematologic cancer are multiple myeloma, lymphoma and leukemia.

Screening, Tests & Diagnoses/Stages

The Health Services Authority (HSA) offers the following types of cancer screening:

  • Breast Cancer:  clinical breast exam, mammograms, ultrasound, MRI, blood test (including markers and genetic testing)
  • Colon Cancer: colonoscopies, stool test, blood test, CT
  • Lung Cancer: CT, blood test
  • Prostate Cancer: blood test (PSA), digital rectal examination
  • Cervical cancer: PAP test
  • Ovarian cancer: transvaginal ultrasound, tumor markers

Cancer Treatment

Our Chemotherapy Unit offers chemotherapy, immunotherapy and endocrine therapy, as well as it works collaboratively with the surgical unit to offer surgery as required. Radiation is not available on island, so patients need to travel overseas (normally to Miami or Jamaica).

We also provides cold cap therapy to reduce the loss of the hair. Its cooling effect reduces blood flow to the scalp, which also reduces the amount of chemotherapy medication that reaches this area therefore helping in prevention of hair loss.

Coping and Support

All patients are offered referral to a psychologist and a nutritionist. Our Chemotherapy Unit provides informational/educational materials as well. Additionally, there are different support groups managed by the Cancer Society and Breast Cancer Foundation.