By Donovan Vincent From The Star

Pediatrician Sharon McLean-Salmon is here in Toronto from Jamaica to learn skills aimed at assisting her in improving survival rates for children in the Caribbean who have cancer.

Dr. McLean-Salmon is in year one of a two-year pediatric oncology fellowship at Toronto’s Hospital for Sick Children. Her training is part of the SickKids-Caribbean Initiative (SCI),a joint venture launched last year between the hospital and six countries in the Caribbean, among them Jamaica, Barbados, and Trinidad and Tobago.

The goal of the five-year initiative is to build capacity on the islands by training local health professionals, Including doctors and nurses, to provide consultation, to pool diagnostic expertise and to increase survival rates for children by expanding access to care and diagnoses. The targets are childhood cancers and blood disorders, such as sickle cell anemia.

McLean-Salmon is a pediatrician at Bustamante Hospital for Children in

Kingston Jamaica. When she completes her fellowship at SickKids in June

2015,she’ll be only the second pediatric oncologist in Jamaica.

The first, Dr. Michelle Reece-Mills, finished her training at SickKids last year and now works at another hospital on the island.

Completed she’s finished, McLean-Salmon will specialize in dealing with children with hematological and cancer disorders. Before coming to Toronto, she served as a general pediatrician in charge of a ward in which she saw all kinds of cases ,not just cancer.

“There will be a pediatric hematologist/oncologist at Bustamante hospital, who will take responsibility for oversight of managing these patients, who will start a clinic, who will take consults, and so on,” McLean-Salmon says in an interview, describing her future role.

It’ll be a tall order for her, but she’ll have a network that includes experts from SickKids and the other Caribbean nations involved in the SickKids initiative. She’ll also be able to consult Reece-Mills.

“The whole vision is for us to share resources for a unified standard of care, through networking. I’m alone at Bustamante, but I won’t really be alone,” MLean-Salmon says.

She has a husband and two children, 10 and 2, back in Jamaica and misses them terribly while she’s training in Toronto. It’s an enormous sacrifice, but it’s also one she’s willing to make so she can help fight childhood cancers back home.

“My husband supports me completely. My mom, his mom, rally, doing some of my responsibilities at home. It’s the support and believing in what I’m doing here that helps keep me going,” she says.

She points out that SickKids is a world-renowned centre for cancer care, and she describes the fellowship as “intense,” exposing her to “probably every possibly type of cancer and blood disorder that there is. Even things undefined. There are diseases with no name that are being discovered.”

Since the initiative got under way in earnest last year, a lot has happened, says Dr. Victor Blanchette, the medical director for the SCI, who specializes at SickKids in children’s cancer and blood disorders.

Through SCI, a telehealth site was opened in the Bahamas at Princess Margaret hospital, the main facility in Nassau. A similar site was launched in Barbados -Blanchette is a native of that island -and there are plans for similar equipment to be installed at Bustamante later this year.

Through large video screens -Blanchette describes the process as “high-end skyping” -experts in a room on one of the floors at SickKids dial in across networks and talk to doctors and medical staff in the Caribbean through video teleconferencing.

“They’re complex cases and they’re asking for our help. By definition (the cases) require multi-disciplinary teams to weigh in. You’ll have pathology samples from there that are sent here for additional (analysis) to get the diagnosis right,” Blanchette says.

By teleconferencing, you can have up to 50 people in different sites listening in and taking part, he says, “We want to, in all aspects, be informing, but also training.”

In a recent case, biopsy material for a suspected bone cancer patient complaining of pain in his left hip was tested at SickKids’ pathology and cytogenetics labs. Imaging studies from the island were reviewed during teleconferencing, and reported on by SickKids’ hematology, oncology and orthopedics departments.

A case summary was prepared and sent to the attending physician in the Caribbean. The patient was later diagnosed with Perthes disease, a childhood illness whereby the bone softens and breaks down but later heals and reforms with age. It was not cancer.

The advice from the doctors involved there and here was that another biopsy should be conducted on the patient in three months.

SCI, a not-for-profit program, is costing about $8 million, an amount SickKids is working to accumulate through fund-raising.

In Canada, where there are 1,400 new cases of childhood cancers a year, about 80 per cent of them are cured. In the Caribbean, the exact figures aren’t known but it’s believed the survival rates are far lower, Blanchette says.

“Some of that gap reflects delays in diagnosis,(an) inability to diagnose complex cancers accurately, because they (in the Caribbean) don’t have the type of things we take for granted here,” he says. “We want to close that gap.”

The funding for the project is not to pay for treatment. That’s very expensive, and there are better ways to do things, Blanchette says.

He adds it will take a few years to measure outcomes of SCI, but so much more can be accomplished for many more children by building this form of medical capacity in the region.

“You want to build a legacy that will go on,not one that will stop the day you walk away,” Blanchette says.

For more on this story go to: http://read.thestar.com/?origref=#!/article/5361360dec0691b72a0005c4-sickkids-targets-children-s-cancer-in-the-caribbean