What is your role at Bermuda Cancer and Health Centre?
My title at Bermuda Cancer and Health Centre is the director of the radiation unit. Like many people in healthcare in Bermuda, I wear many different hats that includes individual patients whom I meet for their cancer care and also the overall direction of service delivery to ensure that all can benefit from access to high-quality cancer care. I am a clinical oncologist, which means that I have trained to treat patients who have cancer using radiation therapy and systemic therapy (which includes chemotherapy and nowadays also immunotherapy).

 

BCHC is home to the TrueBeam machine, a state-of-the-art piece of radiotherapy technology that promises to revolutionise cancer treatment in Bermuda. Has the TrueBeam performed as well as expected?
Absolutely, when we were designing the radiation programme in conjunction with Dana-Farber/Brigham and Women’s Cancer Center (DFBWCC), the quality of our care and the quality of our equipment was a high priority. As you can imagine, there is significant investment and a huge undertaking in purchasing one of the cutting-edge machines, but it has undoubtedly proven to be a valuable investment. The TrueBeam enables us to provide the high-precision targeted radiation for patients. It has remote upgrades and versatility, which have enabled us to implement new techniques allowing us to keep pace with changes within oncology and radiation happening worldwide.

 

As an affiliate member of the Dana-Farber Cancer Institute and a consultant at Brigham and Women’s Hospital in Boston, can you describe the benefits of Bermuda Cancer and Health’s close relationship with these overseas institutions?
Our relationship with Dana-Farber/Brigham and Women’s Cancer Center allows us to deliver the highest quality care to patients here in Bermuda. I was lucky enough to build both a personal and clinical relationship with the team over in Boston shortly after I moved to Bermuda. This helped initiate the plan to bring radiation on-island and allowed us to grow and become a part of a bigger team to provide fantastic care. Oncology is super-specialised nowadays and as a generalist on-island it is impossible to know the minutiae that the sub-specialist in large academic centres like DFBWCC know about the subsites of cancers. However, if you combine their knowledge with the high-quality expertise we have on-island, you get the best of both worlds.

 

When you first arrived on the island as an oncologist, was there anything that surprised you about cancer in Bermuda?
The first thing that struck me about cancer in Bermuda was actually that the quality of the care that was being provided on-island was extremely high. However, there were also a number of areas of care that were not provided on-island. Seeing patients having the challenge of choosing to go overseas for their care and being away from their loved ones, or some people even choosing not to have cancer care at all, was new and striking to me. In terms of cancer itself, it’s a very complex situation and we’re still just scratching the surface of truly understanding the unique nature of cancer here. 

 

Dr Fosker, you once argued that conventional medicine is at conflict with a more natural approach, when in reality, a holistic approach including both therapies can ensure that every aspect of care is considered. What does this holistic approach look like?
Holistic care for patients and families who are going through cancer journey is imperative if you want to make sure that the experience is as positive and successful as it can be. It often feels like there is conflict between conventional therapy (regarded as surgery, chemotherapy, immunotherapy and radiation therapy) and complementary or alternative therapies that include the “natural” approaches. It really shouldn’t be that way—they should complement each other. There must be a holistic approach to the body and the mind to provide high-level personalised care. As the clinician, you must consider everything when assessing the person in front of you who has cancer so you can help them through their journey.

 

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Dr Chris Fosker, MBChB, BSc, FRCP, FRCR, is medical director and radiation oncologist at Bermuda Cancer and Health Centre, Bermuda, consultant at Brigham and Women’s Hospital, Boston, affiliate medical staff at Dana-Farber Cancer Institute, Boston, and clinical oncologist at King Edward VII Memorial Hospital, Bermuda.

 

Bermuda Cancer and Health Centre is a registered charity engaged in the prevention, detection, treatment and support of cancer and other health concerns in the local community. 46 Point Finger Road, Paget, Tel: 236-1001