A study to determine if Caymanian women have a genetic predisposition for breast and ovarian cancer begins in the Cayman Islands this week.
Researcher Dr. Judith Hurley of the University of Miami is in Grand Cayman this week to begin work on the study, which will detect if and how many Caymanian women have mutated genes that may make them more likely to develop cancer of the breasts or ovaries.
“I will keep coming back until everyone who wants to be tested has been tested,” said Dr. Hurley, who estimates that there could be between 50 and 100 women who will meet the criteria to undergo the testing.
The study is open to Caymanian women, who have or have had breast cancer or ovarian cancer; who were born in the Cayman Islands; and have at least one parent or grandparent who was born in the territory.
The free DNA test to determine if women have the gene mutation involves a simple saliva swab.
A similar study carried out in the Bahamas by Ms Hurley found that 23 per cent of women with breast cancer there had the mutated genes, known as BRCA1 and BRCA2 – the highest reported rate in the world. In the United States, between 3 and 5 per cent of American women with breast cancer have the mutated genes.
The study in the Bahamas showed that in 2007, 43 per cent of women in the Bahamas who died of breast cancer were younger than 50; 14.3 per cent of them died between the ages of 31 and 40; and 1.1 per cent died in their 20s.
On Tuesday evening, 18 September, at 7pm at Mary Miller Hall in Prospect, there will be a free informational meeting on breast cancer and to explain about the goals of the study. Following that, women who volunteer can undergo the tests on Wednesday, Thursday and Friday at the Cancer Society office near the Cayman Islands Hospital in George Town.
Dr. Hurley said she became interested in the possibility of a predisposition for breast and ovarian cancers among Caribbean women when she realised about 10 years ago that a lot of women from the Bahamas who came to her practice in Miami for treatment seemed to be developing cancer and dying from the disease at a younger age than many of her other patients.
“The average age was 42; in the US, it’s 62. And 50 per cent of the women dying of breast cancer in the Bahamas was 44. It was awful,” said Dr. Hurley, associate professor of medicine and oncologist with the Braman Family Breast Cancer Institute at Sylvester Comprehensive Cancer Centre at the University of Miami Miller School of Medicine.
“We found a population of women who were very young when they got breast cancer. In younger women it’s genetic, in older women, it’s more likely to be environmental. If you get cancer at the age of 28, you haven’t lived long enough for environmental factors to affect you. When there is a cluster of women with breast cancer, you start looking at something else, you look for genetic causes,” she said.
The findings in the Bahamas changed how doctors approached detection and treatment of cancer in those islands, said Dr. Hurley.
“Knowledge is empowering. If women are at risk, if they do the test and if the test is positive, they can do something about reducing their risk. You can go and be screened at an earlier age and be better about going for screenings,” she said.
The study, which is being funded by a US$600,000 grant from the Susan G. Komen for the Cure Foundation, is being done at four locations in the Caribbean – the Cayman Islands, Trinidad and Tobago, Dominica and Barbados. Women from Trinidad and Tobago, Dominica and Barbados, who live in the Cayman Islands and who meet the criteria for the study, are also being invited to undergo the testing here.
Dr. Hurley is being accompanied to Grand Cayman by genetic counsellor Talia Donenberg, who will talk to the test subjects and their families about what the test means and the effect a positive outcome might mean for them.
The full tests can cost up to $3,600, but the tests carried out by Dr. Hurley will be free of charge, paid for by the Komen grant. Dr. Hurley explained that the tests in the Bahamas now cost about $100, because the study has been able to narrow down the number of mutations that are found among the Bahamian population – from thousands to just nine.
The prevalence of breast and ovarian cancer in the Cayman Islands is not known because until recently there was no comprehensive method of collecting and collating information about cancer cases. In 2010, the Cancer Registry was set up to build a database to track the prevalence of all types of cancers in the Cayman Islands and information is now being collected, although it could take five years or more before a full picture of the state of cancer in the territory will be known.
At Tuesday night’s meeting, Dr. Hurley and Chrissie Tomlinson Memorial Hospital oncologist Dr. Theodore Turnquest will be keynote speakers. Dr. Sook Yin, medical director of the Cayman Islands Cancer Society, will also be on a panel to help answer questions about the study. Refreshments will be served and there will be free pap smear and mammogram vouchers available to those who qualify.
Anyone who believes she qualifies for the tests, should contact the Cayman Islands Cancer Society on 949-7618 to make an appointment.