The Cancer Centre Eastern Caribbean was launched in July 2015 as part of the Organisation of Eastern Caribbean States’ mandate for its residents.  The centre is based in Antigua, is the first of its kind in the Caribbean and aims to provide the highest quality of care to its patients.  It is equipped with state-of-the-art technology and facilities and the care delivered is based on the Partnered Care Model where the delivery of healthcare involves the private sector, public sector and the general public, making treatment affordable to patients.

Their Services

The centre offers its patients the following services:

Medical Concierge Service – patients will be arriving from a number of Eastern Caribbean countries and having to travel for treatment can be a daunting and draining experience for patients. To ease the burden of travel the centre has set up a medical concierge service. Upon arrival in Antigua patients will be met by a member of the centre’s concierge team. They will be assisted with their luggage and transported to their guest house and transportation can be arranged to take patients to  and from their appointments at the centre.

Treatment Consultations –  all patients will have a professional and comprehensive consultation with an oncologist. At this appointment the patient’s test results and medical records will be reviewed and a treatment plan developed,  any additional tests that are required will be done in-house at the centre.

Chemotherapy –  a wide range of chemotherapy is available and the highest standards of delivery can be expected from the centre.

Radiotherapy –  External beam radiation therapy is also available using state-of-the-art equipment.

Who can access the centre?

The cancer centre serves all residents of the OECS member states as well as patients from outside the OECS. They see insured patients, private patients and government sponsored patients.

More Information

For more information about the centre please contact them using the details below:

The Cancer Centre Easter Caribbean
The Medical Pavilion Antigua
Michael’s Mount
Queen Elizabeth Highway
P.O. Box W599
St John’s, Antigua, W.I.

Tel: 1-268-460-6000
Fax: 1-268-460-6000
Email: info@TMP-Antigua.com
Website: http://www.thecancercentreeasterncaribbean.com

The black community has a higher risk of developing type 2 diabetes and this increased risk was thought to be due to a combination of factors with genetics playing a significant role.

 In a study recently published in JAMA it has been shown that there is no genetic reason linking black people to an increased risk of diabetes. The increase in risk is due to lifestyle factors like obesity.

This study looked at 4,251 black and white men and women, aged 18 to 30 without diabetes.  Forty-nine per cent were black (2,066 participants) and 54% were women (2,304 participants). Participants were followed for an average of 25 years and over time 504 cases of diabetes were identified – 189 white participants and 315 black partcipants developed type 2 diabetes.

The study found that overall black men and women were more likely to develop diabetes but when they took into account factors like biology, neighbourhood, psycho-social, socioeconomic and behavioural, both black and white people had the same risk of developing type 2 diabetes.  If there was an underlying genetic reason then when all those factors were taken into account then there would have still been an increased risk seen in black men and women.

When exploring what specific factors increased black people’s risk of type 2 diabetes they found that factors that were modifiable were the main culprits – body weight, waist size, blood sugar level, blood pressure and others.

Researcher Prof Mercedes Carnethon said:

“Obesity is driving these differences. The findings surprised us, because for the past 20 years there was a narrative that there must be something we haven’t found that was causing this higher rate. Blacks gained more weight over time. It was the accumulation of this and other risk factors that eliminated the so-called mysterious cause of the disparity.”

The findings for this study are empowering, in a way, as it means that clear steps can be taken to reduce the high risk seen in the black community by promoting a healthy lifestyle with lead study author Michael Bancks stating:

“To eliminate the higher rate of diabetes, everybody needs to have access to healthy foods, safe spaces for physical activity and equal economic opportunity to have enough money to afford these things and live in communities that offer this.”

The focus now has to be on ensuring that more black people live a healthy lifestyle so that health inequalities like this can be addressed. This means delving into the social and economic inequalities which may act as barriers to living a healthy lifestyle.

In the past it has been felt that fibroids may increase a woman’s risk of having a miscarriage, but two recent pieces of research should reassure women affected by fibroids who may be thinking of starting a family. Their work has shown that there is no link between fibroids and an increase in the risk of having a miscarriage.

Study on Fibroids and Miscarriage Risk by Women’s Health Research at Vanderbilt

Researchers at Women’s Health Research at Vanderbilt published their first piece of research in November 2017, although the data was made available in June. Their research was part of the Right from the Start study which explored how a women’s diet, health behaviours, medical history, fibroids and other factors may affect her pregnancy. It included 5, 512 women from eight cities in the US from 2000-2012 who were 18 or over and were either trying to get pregnant or were less than 12 weeks into their pregnancy.  During the course of  the study participants had an initial interview, an ultrasound scan, a telephone interview and a follow-up assessment.

They found that of the 5,512 women who took part in the study, 10.4% of them had at least one fibroid and 89.6% didn’t have fibroids. When they compared the rate of miscarriages in the group who had fibroids to the group of women who didn’t have fibroids, their rate was the same – 11%.

The researchers explained that other studies have reported a link between fibroids and miscarriages but this was because previous studies hadn’t taken into account other reasons for miscarriages.

To learn more about this work you can view their videos below.

The Women’s Health Research Centre at Vanderbilt published another study in November exploring the same issue – fibroids and miscarriage risk. They reviewed all research papers on this topic from January 1970 to December 2016 and vetted them, this gave them data from 21,829 pregnancies. Of these women 1,394 had fibroids and 20,435 did not. They carried out statistical analysis on this data and found that there was no difference in the rate of miscarriages in women with fibroids compared to women without fibroids.

Their team have put together a really useful infographic that explains their findings (please click on the image below to see a larger copy of it)

 What Does This Mean for Women with Fibroids?

As Prof Katherine Hartman stated in the above video, this is good news  as this is one less thing that women with fibroids have to worry about. Although she does caution that there may be rare types of fibroids or locations of fibroids that may cause a miscarriage but the risk is lower than previously thought.

Researchers from Johns Hopkins University and Meharry Medical College have published the results of their research study exploring the link between Central Centrifugal Cicatricial Alopecia (CCCA) and fibroids. They found that black women with CCCA were nearly five times more likely to develop fibroids compared to those without CCCA.

What is CCCA?

CCCA is a type of hair loss that mostly affects black women. It is characterised by gradual hair loss in the centre of the scalp and it radiates outwards in a circle.  CCCA starts with damage of the hair follicles which leads to scarring and then permanent hair loss.

Historically, CCCA was known as hot comb alopecia as it was initially thought that it was caused by  use of the hot comb as well as relaxers, tight weaves and other practices that may put pressure on our hair and scalp. It is now thought to be caused by a combination of factors as some cases of CCCA are not linked to hair care practices.  Therefore the exact cause of CCCA is unknown but it is thought to be associated with family history (it may run in families) as well as hair care practices.

Exploring the link between CCCA and fibroids

In this current piece of work researchers recognised that women of African descent are more likely to develop disorders such as fibroids, keloids, CCCA and sarcoidosis which all involve abnormal growth of fibrous tissue. Based on these observations they decided to explore whether a link exists between CCCA and fibroids.

To explore whether a link exists they analysed patient data from a four year period (2013-2017).  They extracted data from 487,104 black women who were patients at Johns Hopkins Hospital and  found that 447 of these patients had CCCA (0.09% of patients) and 486,657 didn’t have CCCA.

They then compared the percentage of women with CCCA that had fibroids with that of women who didn’t have CCCA and found that 13.9% of women with CCCA had fibroids ( that is: 62 of the 447 with CCCA) and only 3.3% of women without CCCA had fibroids (that is: 16,212 of the 486,657 without CCCA)

What does this mean?

This means that, in this study, women with CCCA were 4.68 times more likely to have fibroids than women who didn’t have CCCA.

The researchers concluded that there is a strong  association between fibroids and CCCA but:

“The cause of the link between the two conditions remains unclear.”

In their paper they state that:

 “This risk may be due to similar underlying mechanisms in the pathogenesis of both conditions.”

They also cautioned that this data may not reflect the actual association between the two conditions in a real-world setting, so more work will be needed to confirm the association between CCCA and fibroids, and why this association exists.

They do recommend that patients and doctors are made aware of the link so that women with CCCA can be  screened for fibroids and other disorders related to excess fibrous tissue. This will aid early diagnosis and provide the opportunity to control these conditions preventing the development of severe symptoms.

For more information you can download their research summary below

Scientists at the Nanjing University Medical School in China have published the results of their study exploring the effect of ginkgo biloba extract on stroke patients.

Their study was a fairly small one with 342 patients taking part. The average age of participants was 64. Participants were given ginkgo biloba extract daily for six months after their stroke along with aspirin.  The participants took a cognitive assessment test at the start of the trial and at regular intervals.

The researchers found that those patients taking the ginkgo biloba extract performed better on the cognitive assessment test showing better memory and reasoning.  Based on these findings the researchers concluded that:

“GBE in combination with aspirin treatment alleviated cognitive and neurological deficits after acute ischaemic stroke without increasing the incidence of vascular events.”

They recommended “ginkgo biloba extract for patients with acute stroke for its ability to improve cognition and quality of life.”

The scientists did caution that more work is needed as their study was a small one. They recognised that a large and longer piece of work is needed, but their results were promising.

Other studies have had conflicting results – some show improved brain function, whilst other don’t.

What is Ginkgo Biloba?

The scientists explained that ginkgo biloba is an ancient Chinese tree and the extract has been used in China for many years for memory, depression, tinnitus and confusion.  It is one of the oldest living tree species in the world and has numerous health benefits.

Ginkgo Biloba is not just used in China but it is available in the UK, Europe, Canada and the US as a food supplement. It does have side effects such as nausea, vomiting, headache and constipation. There can be serious side effects such as bleeding in the eye or brain, bleeding after surgery and severe allergic reactions, and  it shouldn’t be taken if you’re on certain medication.

Take Home Message

The study was promising but further work is needed to fully assess the effects of ginkgo biloba on stroke patients.

More Information

You can download the full research paper below.

This week scientists in the Netherlands published the results of their research exploring social isolation and type 2 diabetes. They assessed whether particular aspects of a person’s social network like the size of their social network, how often they are in contact with friends and family, the types of relationships they are in and whether they live alone are linked to pre-diabetes, a new diagnosis of diabetes or a previous diagnosis of diabetes.

Their research looked at people between the ages of 40 and 75 living in the south Netherlands. The study is still ongoing and the aim is to recruit 10,000 participants by the end of the study period.

This current piece of work includes 2861 people with an average age of 60, 57% were not diabetic and 43% of the participants either had pre-diabetes, a new diagnosis of diabetes or had previously been diagnosed with diabetes.

They found that the more socially isolated a person was (i.e. the smaller their social network was) the more likely they were to have a recent or previous diagnosis of type 2 diabetes.  They found  that for each fewer network member in a social group there was a 12% higher chance of being newly diagnosed with type 2 diabetes and a 8% higher chance of having a previous diagnosis in women; in men it was 10% and 5% respectively.

In women they found that higher percentages of social network members living within walking distance and higher percentages of household members were linked to newly and previously diagnosed diabetes.  Researchers concluded that for women “a more centralised social network was associated with type 2 diabetes.”

In men, living alone was associated with significantly higher odds (59% higher odds) of being newly diagnosed with diabetes or being previously diagnosed. In women there was no association between living alone and diabetes.

They also found that a lack of social participation was associated with a 60% higher chance of being pre-diabetic and a 112% higher chance of being previously diagnosed with type 2 diabetes in women. For men a lack of social participation was associated with a 42% higher chance of having a previous diagnosis of type 2 diabetes.

They also found that having more emotional support, practical support and support during sickness were all associated with lower odds of having type 2 diabetes.

What does all this mean??

Simply put, people who are lonely are more likely to develop diabetes. Therefore if we can focus on addressing loneliness we may be able to prevent type 2 diabetes in some people.

It isn’t clear why specifically there is a link between social isolation and diabetes but the researchers feel that their work suggests that:

 “High risk groups for type 2 diabetes should broaden their network and should be encouraged to make new friends, as well as become members of a club.”

Type 2 diabetes is more common in the black community and if we can identify whether  social isolation is also linked to diabetes in the black community then this could be an effective approach to  reducing the high risk in the black community.

The world’s first lupus prevention study, the SMILE clinical trial, was launched recently in the US.

SMILE will identify people who are at a high risk of developing lupus and treat them with an immune-modifying drug to determine whether this will prevent or delay lupus developing.

The drug being used for this study is hydroxychloroquine, a malaria drug. As well as exploring whether this drug delays or prevents lupus, the research team will determine if it improves disease activity and patient outcomes.

The trial will include people aged between 15 and 45 who are at high risk of developing lupus. They will be treated with either a placebo or hydroxychloroquine and then monitored for a period of time.

This study is taking place across five sites across the US – Penn State Hershey Medical Centre, the University of Texas Southwestern Medical Centre, Oklahoma Medical Research Foundation, Cedars-Sinai Medical Centre and the Medical University of South Carolina. Researchers aim to recruit 240 patients and the trial is likely to be completed in 2022.

This is an important study for the black community as black women are three to four times more likely to develop lupus than their white counterparts. Additionally black women  develop lupus at a younger age, experience more severe symptoms and overall develop more complications. Having a treatment that prevents lupus will significantly reduce the suffering of many black women worldwide and we thus look forward to the trial’s conclusions in a few years’ time.

For more information about the trial you can download the SMILE brochure below or email Virginia-Roberts@omrf.org

In this article we hear from the JustBe Croydon team who tell us about their service and how they can help you become happier and healthier.

JustBe Croydon is a website for all Croydon residents.  It has been designed to help you take positive steps towards becoming a happier and healthier YOU.

Big steps or little steps, we believe everyone can make small changes with a little bit of help and support. We have selected the best tools to help you make a change, from losing weight, getting more active and stopping smoking to drinking less, sleeping better and feeling happier. There are apps, podcasts, expert advice, videos, diet plans and exercise routes to help you get started. This is information on local services and a range of resources that will support you in making changes to your lifestyle.

You can even assess your health right now using our Health MOT. We will help you to identify lifestyle changes and put you in touch with the right tools – or people who can help you make a change.

If you have any problems accessing the website or would just like a chat with one of the Advisors you can find them at one of our health hubs detailed here, where you can pop in without an appointment or you can download the details of the health hubs below.

The Health Services Authority in the Cayman Islands announced on 18^th December 2017 that fibroid embolization will now be available in the Caribbean territory at the Cayman Islands Hospital on Grand Cayman.

This is a great step forward for the islands as it means that patients will no longer need to travel overseas to receive this procedure.

Embolization, or Uterine Artery Embolization (UAE), is a procedure that blocks the blood vessels (uterine arteries) to the fibroids, starving them of oxygen and therefore causing them to shrink.  This procedure is carried out by an interventional radiologist who makes a small cut in the groin area and then inserts a tube (catheter) through the cut, using live x-ray images on a monitor to guide the tube into the uterine arteries. Tiny plastic beads (the size of fine sand particles) are then injected into the artery supplying the fibroid and these tiny particles block the artery.  Over the next few hours, the fibroids ‘die’ and then shrink over the next few months and years.

Complications from embolization are rare and tend to be fairly minor, for example: bruising, pain, fever and vaginal discharge.

The benefits of this procedure are it preserves fertility and it is minimally invasive so there are fewer complications than major surgery and a faster recovery time.

This announcement means that women in the Cayman Islands who are affected by fibroids have more treatment options.

Find out more about the Cayman Islands Health Authority here

Back in June of this year the Lupus  Foundation of America and the American College of Rheumatology launched an awareness campaign  (Be Fierce. Take Control) aimed at African American and Latino women, who are both at an increased risk of developing lupus.

The campaign aims to raise awareness of the signs and symptoms of lupus to facilitate early diagnosis. An early diagnosis is important as it ensures that lupus sufferers can avoid some of the long-term effects of the condition. Lupus can take many years to diagnose as the symptoms are very vague and similar to a number of other conditions, this makes diagnosis very difficult.

The campaign has used social media and digital advertising to reach young black women. They have also created a website with useful resources such as:

• A ‘Could it Be Lupus?’ questionnaire which allows young women to determine whether their symptoms could be those of lupus.
• A lupus symptoms tracker to help women monitor their symptoms and to use at their next doctor’s appointment to explain their symptoms
• A guide to help those with symptoms prepare for their first doctor’s appointment

Although these resources were developed for African American women, they can be used by black women throughout the world who think they may have the symptoms of lupus.

What is Lupus?

Lupus is a chronic (it lasts a long time) disease where the body’s immune system doesn’t function properly and begins to attack healthy cells, tissues and organs.

There are four types of lupus:

•  Systemic lupus erythematosus (SLE) – affects a range of different organs in the body
•  Discoid lupus erythematosus (DLE) – affects the skin causing rashes and a change in the colour of the skin.
• Drug- induced lupus is caused by certain types of medication (for example hydralazine and procainamide which are used to treat heart conditions).
•  Neonatal lupus is a very rare type that affects new born babies

Black Women and Lupus

Black women are three to four times more likely to develop lupus than their white counterparts and results from the Lupus in Minorities study has shown that black women develop this condition at a younger age, experience more severe symptoms and overall develop more complications.

Researchers are trying to understand why it is more common in black women and why it is more severe. It is thought to be due to a combination of genetic and environmental differences.

More Information

For more information about the ‘Be Fierce. Take Control’ campaign, visit their website here and you can view the campaign video, Fierce Women Tackle Health, below

You can also get more information about lupus on website here, from Lupus UK or the Lupus Foundation of America